Wednesday, September 19, 2018

Medical grifter?

I am still perturbed about this so I am going to vent.

I was not pleased at my annual exam when my NP decided I needed to see a cardiologist because of a a Premature Atrial Complex blip on my EKG.  This is something I have had for at least 7 years and no other doctor has considered it worthy of followup. No even a Mayo-affiliated doctor.

But I promised my sister I wouldn't skip any recommended referrals.  She worries.

The initial visit with the cardiologist started out a little odd.  His NP took my blood pressure without ensuring I was relaxed.  And with my feet dangling off the exam table.  Even I know this isn't optimal and this NP works in cardiology.  Add to that "white-coat syndrome" and, of course, my blood pressure was high.

The cardiologist was personable.  Agreed that the blip was probably nothing.  But said we should do a stress test and an echocardiogram anyway.  For a baseline. He wasn't concerned about the one-time blood pressure. But since I was coming back anyway, I should keep a blood pressure journal.

OK.  Made sense.  I made the appointment. The insurance wouldn't pay for the echocardiogram, but  I did the stress test, with a very pleasant technician.

So far so good.  Or at least, not bad.

The day of my follow-up visit, a different NP greeted me.  And proceeded to tell me how many ways my heart could be damaged that would only have been detected by an echocardiogram.  Really tried to frighten me. 

I was riled up, but said nothing.  I wanted to hear what the cardiologist had to say.  He glanced - briefly - over my blood pressure log and said it looked fine.  Said my stress test results were good and showed no signs of blockage.

THEN went into his pitch.  He said I really should have an echocardiogram and it was a shame insurance wouldn't pay for it.  But he said he wouldn't appeal.  Since an echocardiogram is for diagnosing issues when a problem is suspected and he just said my stress test results were good, I was getting angry. 

He continued on to say that he wouldn't prescribe any medication "at this time". I didn't say anything.  I decided it wasn't worth the effort.  But why would I take medication if I don't have a problem.

Then he said he would see me in 6 months. 


If my insurance hadn't balked, they would have gotten the money for a medically unnecessary procedure.  Echocardiograms are between $1000 and $2000.  I'm sure trying to frighten me with tales of what could be going undetected was a ploy to get me to pay out of pocket.  And telling me to come back every six months seemed like a way to schedule income.

I felt like I had a session with a used car salesman, not a cardiologist.

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