Really concerned about referral

[awgv001]

I knew it may be too good to be true to get a referral back into Neuro so soon...

So I found out today, after short research on who I will be seen by, I'm being sent to a (less than) 2 star Neurology office in TN - with an MD with almost 40 reviews and his personal rating is a 2.8/5...Now I obviously may have a chance at a decent experience as every encounter I have had has been different. I don't expect to get a 5 star anything, but when a majority posts how you spend little time speaking with this individual, and how they scribble out information and attempt a variety of prescriptions...like, I know I gotta let them do their work, whatever that entails, and they should also have access to all my VA medical info for review right? I'm going to bring copies of my evidence, some of which I planned to bring to my hearing whenever that happens.

I honestly don't want any of that except for scans or perhaps something to counteract the double vision if possible...I have had diagnosis since 2016 for TBI from the director of the VA office in Decatur (STILL NOT SC'D, awaiting BVA hearing) and several residuals/secondaries (migraines, tinnitus, double vision, balance disorder), and I'm hoping to just sit with the guy, get paperwork filled out (TBI DBQ), and get an impression on my TBI and its secondaries...I have already dealt with "bad" Neurologists that pick and choose what they want to tackle, or record. What options do I have? I'm thinking about calling TriWest again to see what other options are available...

This scares me. I want IMO's, and a rather extensive DBQ done, not to become a test subject, or a punching bag.

 

Edited March 3, 2020 by awgv001

[broncovet]

This is the drawback to "free" medical care, the VA mostly picks who you get care from and, as far as C and P exams, they make it clear you dont chose your examiner.  This is the precise reason I opted into Part B for medicare, because we have more choices there.  While I would have to pay deductables and copayments, many, many Vets elect not to go to VA, but instead seek their care outside of VA and, for some very good reasons.  

The biggest one?   Well, both VAMC and private care have "good" and "not so good" docs.  But, in the VA, they have a "magic wand" to make a good doc bad.  How do they do that?

Its easy, really.  They force that doc to be overworked, pushing hundreds of patients in on them in a small period of time.  So, the "good doc" has to do a very hurried job, and that haste lowers the quality of medical care.  

[awgv001]

18 minutes ago, broncovet said:

This is the drawback to "free" medical care, the VA mostly picks who you get care from and, as far as C and P exams, they make it clear you dont chose your examiner.  This is the precise reason I opted into Part B for medicare, because we have more choices there.  While I would have to pay deductables and copayments, many, many Vets elect not to go to VA, but instead seek their care outside of VA and, for some very good reasons.  

The biggest one?   Well, both VAMC and private care have "good" and "not so good" docs.  But, in the VA, they have a "magic wand" to make a good doc bad.  How do they do that?

Its easy, really.  They force that doc to be overworked, pushing hundreds of patients in on them in a small period of time.  So, the "good doc" has to do a very hurried job, and that haste lowers the quality of medical care.  

Thanks for your fast response as always @broncovet - Oh, I forgot to mention this is not a C&P exam! Which is in part why I'm going to push for a full TBI DBQ if possible. It's an evaluation, and perhaps any workups and medical tests as they are opening the door to analyze my issues again.

They had another option, albeit that one was even worse, they called mainly because they couldn't get in touch with the "other office"...guess they didn't want any more business, lol. So I asked them about who else I could go to, so instead of further east in NC (the drive is atrocious) they mentioned the one in TN (all highway nice, straight, and easy for the most part.

This person's clinic seems to be under-worked, as even google shows a review of 1.7 (only 6 reviews) as of today. The feedback is pretty atrocious, so I'm looking to prepare for the worst. 66 reviews with 35 of them being 1 star on the doctor himself...

What kinds of things should I do to further prepare?

I have a folder organized with my notes, evidence, and some prior diagnosis etc. Being a specialist facility, they should afford the time to the patient to address the medical and administrative needs...

Not sure how long the appointments are with this person either, but if I'm going to be driving for 3-4 hours a day to go see this person, it better not be adversarial.

Edited March 3, 2020 by awgv001

[broncovet]

It sounds like you have reviewed the options, and you are not willing to drive to seek better options.  Oh, I completely get that.  The science of "proxemics" affects our everyday decisions. 

We make choices based on what is available locally, including marriage, food, shelter, and pretty much everything.  Even if you like authentic Mexican Food (I do), its hardly practical for me to travel to Mexico every time I want it.  

If you find the medical care to be sub par and of a concern then try to get it changed.  I would not change it "solely" upon substandard reviews, those can happen for a number of reasons, sometimes unrelated to the quality of care.  One or two reviewers with "anger management" issues, can skew the review ratings negatively, just like "favorable" reviews can often be bought.  

[awgv001]

Wish I could give your comment a "Like" - so I hope that counts for one.

I understand the business warfare, and I will note that "drug seeking" plays a huge role with the negative reviews aspect as well. If it were that consistently bad, you'd think there's an entity out there to do "QA" work and either remediate or shut down a derelict office in such circumstances, aside from general annual or other re-training.

I'm going to give it a shot regardless, and hopefully be granted an honest and fair impression of my circumstances.

[awgv001]

@broncovet

Whelp, if it looks and smells like a stepped-in dog turd...

Had the consult, Doc immediately starts rambling off his common knowledge factoids about Syncope and such, in story-time mode. First, he asked why I was even seeing him in the first place, after having seen other Neuros in the past. Did not review any records, paid little attention to what I had to say, and instead ordered new scans wanting to check out my heart (I had a stress test not all that long ago, exam came up negative for any discrepancies, and have 0 known heart issues. I briefly explained my injury history, and how other similar injuries were incurred as a result of personal assault...(begins staring a hole through my head).

I made sure to hand the DBQ across his desk, trying to steer the conversation to something productive, to which he commented "This is not typical that a Veteran makes a request for these, as it's usually something assigned from VA." Glances briefly at the first page, refuses, ...then hands it back to me.

Now, I firmly believe I won't get anything accomplished with this individual.

Complete waste of a trip in my opinion.

I guess my only option is to call the my care team, describe what happened and if I should be taken out of this referral and the extra tests he wanted ordered.

If I can get back to the VA Neuro Dr. in Atlanta I saw before I think that would be the key. He know my history, and most likely would assist as I still believe he did a terrific job treating, explaining, and recording. Only issue was I didn't request the dbq right then and there, but I hadn't found out about this DBQ until after I had already ran out of time with him. I walked out of his office originally without a DBQ back in 2016...(The VA website does not distribute a TBI DBQ). Instead, I am using a copy of the DBQ found here --- https://www.ncbi.nlm.nih.gov/books/NBK542603/

I'm hoping that by getting this done it will save me from a remand. It's already been 8 years...

Edited March 5, 2020 by awgv001

[awgv001]

Do medical workups have to be done every time a Vet wants to have a DBQ filled out?