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My wife has a very bad rash in her back and needs help. She has been to her primary care doc who gave a cream that does not work. She has been to the er who could not help and said see a dermatologist and gave her a pill and powder that does not work. Her in home nurses say she needs a dermatologist but can not get her primary to respond. Her primary is refusing to return calls and refer a dermatologist. I can only get an appointment with a referral. How do I get help?

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Her PCP wants and "out" and has found one. It's time to look for a new PCP.
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I would try witch hazel.

I was introduced to this awesome, ancient product by a vet. Had a dog that was prescribed 150.00 an ounce cream for a rash, it wasn't clearing the problem up, thankfully, the vet was on vacation, went to a different vet, saw a marked improvement overnight and complete healing within 10 days. Oh and the problem never recurred.

I keep it in a 2oz spray bottle and use it for tons of things. Especially if collodial silver doesn't make a quick difference.
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Why do you need to go through the pcp?

Call the nurse line (insurance companies provide this service) and tell THEM the problem.
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Sample Sep 2022
Because without a pcp referral appts are 6 to 8 weeks out.
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Call the dermatologist she's already been to see and let them know the prescribed medication isn't working. She's already been to see a dermatologist...........who knows the situation and who can prescribe other medications if the first round isn't working. What's the point in going to see another dermatologist?? Ask the first one to do a skin biopsy if necessary to see what this rash actually is, so the correct treatment can be prescribed.

Get a new PCP for your wife if the current one is refusing to return calls.

Good luck.
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lealonnie1 Sep 2022
Maybe I misunderstood.........has she not been seen by a dermatologist at all yet?
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If you think reporting the doctor to the medical board will do anything, think again. Better yet, familiarize yourself with the case of Christopher Duntsch, who had other physicians calling the medical board on him.

When you say that the treatments aren't working do you mean that the rash is getting worse? How long have you been using the powder and cream? Skin rashes can take a long time to clear.
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Sample Sep 2022
Treatments have been going on for almost 4 weeks. No improvements and getting worse. Her in home nurse is frustrated her doctor will not refer a dermatologist
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Maybe pull HER laundry out of the facility's mass laundry. They wash huge loads and don't 'fuss' the clothing the way we do at home.

In my experience with eldercare and skin issues--it's almost always a new detergent that's highly fragranced. Also, clothing that isn't rinsed enough. Do small loads and double rinse. No softener sheets--and maybe dry the clothes outside on a line.

Same thing with bedding, although I'd imagine they won't let you take home her sheets & blankets. Maybe, though?

It could also be caused by a change in diet. I was never allergic to anything when I was younger, now I have a handful of odd things I can't tolerate.

Good luck with the derm dr. My DH got a reminder that he had a derm appt coming up, so he called and the FIRST available date was January. Crazy.
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Sample Sep 2022
Her laundry is washed separately on a steam cycle and bedding changed twice a day. She caught the rash during a nursing home stay 5 months ago and has gone from a small skin irritation to her entire back and now weeps fluid. Her primary is ignoring her
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I would try using colloidal silver gel on the rash. Works very well on skin irritations and wound care.
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Sample Sep 2022
I have some of that but the area is very large and would take several bottles for each application
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A lot of dermatologists have wait lists. You may want to try medical grade manuka honey on the rash while waiting for an appointment.
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We had a primary care doctor who was unresponsive when my mother was kicked out of hospice and wound up having to find a new primary care physician. I wound up getting the most help from her insurance company (CareNeeds Plus). They were absolutely invaluable during the process. I still had to research primary care doctors around us to select the replacement, but getting the insurance company on board from the get-go was the way to go for us. I checked google reviews and was very happy with the outcome. The insurance company did an internal investigation on the non-responsive doctor, and forwarded information to the state agency that investigates as well. That would be my suggestion, call your wife's insurance company. Mom is super happy with her new doctor. We explained the situation to her new doctor, and he was shocked. It's been 9 months under the new care now and he remains professional and on top of things. I think it never hurts to let a doctor know you reported a previous doctor for being unresponsive, but it may not have made a difference at all. Although it was hell going through the process, mom is getting the quality care she needs now.
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Sample Sep 2022
Yes I am working on a new pcp. Did you know in Oregon physician assistants no longer have to be supervised by a doctor. Law passed last month.
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In addition to advice from FreqFlyer and AlvaDeer, and focusing only on the recalcitrant doctor:

1. Are you in one of those plans which requires permission from a primary to get a referral? If not, start doctor shopping for a different primary care doctor. If you are in a plan and require a primary's referral, call the plan HQ and file a complaint about a disinterested doctor, and demand a different one.

2. If you're not in a plan and can choose, start researching dermatologists, call, and find out as much as you can about the doctor's experience, treatment of an undiagnosed but stubborn skin issue, and other questions you may have.

Another option is to lean on a good doctor you do have, and ask for his/her suggestions on a good dermatologist.

If you find a more responsible doctor, be sure to call the then fired dermatologist and let him/her know he/she has been replaced.

3. Then file a complaint with the state medical board.

Good luck. I've had to fire a few doctors and never regretted it.
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Sample, time to be a detective and find out why that rash is happening.

I see from your profile that your wife is in Assisted Living. I would check the laundry to see what type of detergent and softener products they are using. If they are using "free and clear" type products then it isn't the laundry.

Any new clothing? One could become allergic to certain man-made fabrics. Is there a tag on the clothing and maybe your wife is scratching as it itches?

Any new medicine? Not unusual for prescription or over-the-counter meds to have an allergic reaction.

Any lotion being applied to your wife back to soften the skin? If yes, could be the lotion.

As for why the primary doctor isn't calling, could it be that you and your wife are not giving the meds enough time to work?
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Sample Sep 2022
No longer in assisted living but I think that is where she caught it. She has been home 6 mos now. Not laundry as I have sensitive skin and use free and clear organic soap. She has tried two different prescribed treatments the last is a pill and an anti fungal powder.
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Tell your doctor that further refusal to recommend a dermatology consult will result in your following up with the medical board that licensed him or her.
A good place to start.
And do know that dermatology is best guess/ each patient a mystery, and you may NEVER find an answer or the medication that will work. It is crucial to keep back warm and dry, go over any medications that are new, keep your wife off her back much as possible. Use mild soap in laundry (not much soap at all) and keep absorbant cotton underwear changed frequently next to her back.
Wishing you good luck. Sometimes medications simply cause rebound allergy and creams as well. The best thing is open to air or soft cotton.
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what a bad situation. i hope others have good suggestions. over here, if that would happen, we’d just see a private dermatologist: easy to make a direct appointment.
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