Another surprise to the budget.

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I'm really not sure what I should have done here, but in the short term we just took another hit to the monthly budget. I was coming home when the phone rang. It was dad's doctor. His appointment for next week, which I already transportation and everything figured out was switched by them - with no input whatsoever by any of us - to tomorrow. When I protested, they told me that if we do not come tomorrow, they may not be able to see dad until around Christmas! Now, dad has to fast tonight, and if I cannot hire an elder companion to drive him the 90 mile round trip on very short notice, it is $180 for a cab. If I get the companion, we will "only" be out $125. Normally, I budget about $20 for this trip when I drive. But because of this, there is no way for me to take him. It feels like one step forward and then POW...

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Hi GardenArtist (great name, BTW!) - I'm afraid it is necessary. He is already almost a month overdue because they cancelled his last appointment. I understand that doctor's schedules might change, but I wonder why can't they give us fair warning? It really puts enormous stress on us.

The closest VA is even further than this heart specialist. I don't think they can handle this - I will ask again next visit - but I think they were the ones that originally sent him to this doctor? It's confusing with all the different doctors he's seen.

The taxi service is already giving dad a 10% discount because of elderly. I can ask about a lower price, but I don't know if they'll do it. It is one more thing to try, however.

I did speak with the para -transit people and they will not come out this far. They only do rides around town anyway, but it's still a little disappointing. I thought it would be a cheap way for dad to go shopping, and just get out.

She would not tell me the type of tests they're doing because I'm "not the patient." Dad says it blood tests. "It's always more blood tests."
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Erwin, is this visit absolutely necessary? Over the years I've found that doctors often want to see someone every 3 - 6 months or so, but they do the same thing over and over, or they don't do anything except get an update.

You mentioned fasting - is your father getting blood work done? Some other type of testing?

What I suspect is that the doctor's schedule changed, perhaps he's going on vacation, and the patients are being shuffled around.

That's happened to us but I've learned to stand my ground if the appointment isn't convenient.

I'm wondering also if you can make a deal with the transportation service that you'll use it alone if they give you a price break.

Also, is there no VA near you? If so, I would talk to your father's primary care doctor at the VA about switching some of the services to the VA. I think I wrote in another of your posts (or perhaps someone else's) that we get mileage reimbursement from the VA.

However, if you need a cab or something else b/c of your own schedule, I can see that this abrupt change of appointment dates poses a real inconvenience.
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Dad used to have supplemental insurance. He could not afford it, Medicare, and his VA costs under his budget. I am not sure if he could afford it now even if I took away all of his discretionary spending. I wish we could afford better.

Also, Jeannegibbs is correct. If you are on Medicare, the doctors will not see you regardless.
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Pam, I'm not sure if you've had experience with this, but no matter what other supplemental insurance you have, as far as medical providers are concerned, if you have Medicare, you are considered a Medicare patient. Doctors who aren't taking Medicare never ask about your additional coverage.
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I would get something better than just Medicare. Open enrollment is NOW. Then get a better MD
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That's tough. When you're not so rushed for time, I might explore to see if there are any visiting doctors in your area. I know of one such facility in NC that has traveling doctors and PA's that go to various facilities to treat seniors and those with disabilities. I'm not sure if they see individuals or not, but, I'd explore it. The doctor's headquarters is hours away, but it's the doctor who travels, not the patient.
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He has a bunch of conditions including congestive heart disease, COPD, and diabetes. You are very lucky. Most doctors in town here will not see any new medicare patients.
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Does he have a medical condition that requires frequent doctor visits? I'd try to find someone nearby who can minimize the visits. I guess we are spoiled in central NC. I don't know of anywhere that doesn't accept Medicare. Many facilities are Duke or UNC based and they all accept Medicare.
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I am going to try and change this doctor, too. But a lot of doctors - especially nearby - will not take medicare. If we want to drive 90 miles one way, there are more options. But it is hard on Dad, and obviously problematic in its own right.

I really feel this is simply a staff that just wants to take it easy during the holiday week. I may be wrong, but I also feel it is age discrimination, they know dad is elderly, and really needs his appointments, so they switch him at their convenience. My doctor never does this to me.

I am so frustrated. Here I get dad to cut out his restaurant habit for a week, and all the savings are going to be lost because of one inconsiderate doctors office.

It undercuts me with dad as well. First thing he said to me, "You see? It isn't so simple as you think. I did everything you asked, went nowhere, ate food I don't like, and what got saved? If the money doesn't go one way, it goes the other. I'm old, that means I'm out of luck."

So, now I need to convince him again that some sacrifices are ultimately going to be worthwhile. It's very hard to ask a 90 year old in poor health to think about the future. The only reason he compromises at all is because of the pressure on me, but he's not happy about this. I'm VERY frustrated. This stuff just cannot happen if I am going to maintain an orderly budget for him, but it keeps happening.
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I would be livid. Most people would not be able to adjust their schedule and budget to accommodate that kind of change at the last minute. I hope they had a very good reason to reschedule. I've found that most medical offices don't have much concern for the patient's situation.

I might explore switching to another doctor. Is that an option? I doubt they would agree, but, I would likely tell the person in billing the costs he sustained due to their switch and ask that his co-pay be waived in light of it.
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