The needler in the haystack.

Monday, November 17, 2014

A Medicare surprise at the doctor's office


Medicare is tightening up on costs.
I wonder if other Plainfield Medicare patients will have the surprise I got at a doctor's visit on Friday.

Due for my regular quarterly checkup and meds renewals, an office assistant sat with me before the doctor's visit and presented me a card that is being given out to all Medicare patients.

On it were the number and hours for the doctor's office and an 800-number to call if a concern arises when the doctor's office is closed. I was told a live person would answer and discuss my issue. The resolution could be --

  • telling me to arrange for a visit to the doctor the next available day;

  • actually getting the doctor on the phone for a 3-way conversation and resolution; or

  • calling 911 for an ambulance.
When the doctor saw me, he explained that Medicare was moving to control costs by encouraging patients not to use the Emergency Room as their go-to option when the doctor's office is closed.

I like to think that I don't abuse the ER -- the next to last time I visited one was 43 years ago and I was sent home with an appendix about to rupture; the last time I visited one, they cut my leg off -- but I could see the point of controlling costs.

Then he told me that I would be screened for two additional concerns to Medicare: Depression and being a fall risk.

The depression issue we disposed of in 'No' answers to three brief questions -- at the end of which the doctor said, 'I didn't think we were going to find a problem here'.

The fall-risk assessment was a little trickier.

I would have to stand on a platform that moves ever so slightly and measures your reaction. Hands at your side, once with eyes open, once closed.

The doctor told me before the test that I would need a further screening regardless; because of my prosthesis I am considered a fall risk.

When I asked why Medicare didn't already have a profile for me, he said they don't have a database and probably are building it.

This I found somewhat odd, since I have been evaluated for being a fall risk at several points since my amputation --

  • At JFK after the surgery and after heavy-duty pain meds had been withdrawn, so I could get in and out of bed on my own;

  • At Aristacare, where I was sent for rehab before I could be discharged to home;

  • At home, by Muhlenberg's Home Health service before I could be considered completely discharged; and

  • By JFK as part of my outpatient physical therapy program.
So, what's not to know about my being a fall risk?

Medicare is wonderful, but I do wonder sometimes if the left hand knows what the right hand is doing.


  -- Dan Damon [follow]


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