Rant about my cardiologist office

[Alvin Tostig]

I've been seeing my cardiologist, who is part of a big practice, annually for 9 years now. I'm very happy with him, although there was a screw-up on a simple surgical procedure when I first met him, which luckily had no long-term impact. He is very highly regarded in his field and takes his time explaining his findings.

So it's been 5 years since my last stress test, and he recommended in March that I get one. In the same building is the stress test center - so they send everyone there - it's a fancy high end place affiliated with a major hospital - and therefore in a hospital setting.

Now, because my medical insurance is on a April 1 to March 30 calendar, I intentionally moved all my medical appointments to March, since my wife and I had reached the max for out-of-pocket expenses for the year, and after that we are basically fully covered (for reasonable costs). So the test would be free or near free. So no problem, my stress test is late-March.

I show up at the stress test center for my scheduled appointment, and wouldn't you know it - the stress test center has no record of my appointment. So I march back to my cardiologists office and they had cancelled my appointment and were sure that they left me a message. The reason, this super-duper stress test center has now ordered the best of the best equipment on the market that only very few hospitals in the US have and my cardiologist recommended that I wait a few weeks until its delivery.

So, a few weeks go by, my cardiologist calls and says there will be a significant delay in the delivery of this equipment - so just go take the nuclear stress test as we originally planned. OK - but now that it's April and I am starting a new medical year with a new deductible - the test would cost me $3600!! I thought that was outrageous, and told both the stress center and cardiologist office that this was unacceptable. Both places apologized, but made no effort, despite constant dialogue, to seek a compromise.

I told the cardiologist office to find another for me - they eventually and reluctantly after much bickering came up with a $3100 and $2500 nuclear test option (another hospital setting and a private doctor). I told them this is still unacceptable.

Finally my cardiologist calls back and recommends another option - a stress echo test - which he says is 99% as effective as the nuclear test. So next door in the super-duper place is $1600 - told him to go to his buddies in the industry and find me a cheaper place - eventually got one for $970 that he recommended.

Now here is the kicker - the $970 place is booked until May 25th!! So, my originally stress test in mid - March will finally be done more than 2 months later!! What a racket. I asked the cardiologist office to send me to the super-duper place for $970 - and they could not do it (I say b.s.). My cardiologist informed me that his assessment on my health is that I am medically fine to wait until late-May as all my tests do not seem to trigger a problem.

I left it to them to still find me a place earlier than May 25th - I even gave them some places that I researched! If they wanted me to take a nuclear stress test in March - I still think waiting until late May to take an echo does not sit well with me.

[Dtail]

Quote:

Originally Posted by Alvin Tostig I've been seeing my cardiologist, who is part of a big practice, annually for 9 years now. I'm very happy with him, although there was a screw-up on a simple surgical procedure when I first met him, which luckily had no long-term impact. He is very highly regarded in his field and takes his time explaining his findings. So it's been 5 years since my last stress test, and he recommended in March that I get one. In the same building is the stress test center - so they send everyone there - it's a fancy high end place affiliated with a major hospital - and therefore in a hospital setting. Now, because my medical insurance is on a April 1 to March 30 calendar, I intentionally moved all my medical appointments to March, since my wife and I had reached the max for out-of-pocket expenses for the year, and after that we are basically fully covered (for reasonable costs). So the test would be free or near free. So no problem, my stress test is late-March. I show up at the stress test center for my scheduled appointment, and wouldn't you know it - the stress test center has no record of my appointment. So I march back to my cardiologists office and they had cancelled my appointment and were sure that they left me a message. The reason, this super-duper stress test center has now ordered the best of the best equipment on the market that only very few hospitals in the US have and my cardiologist recommended that I wait a few weeks until its delivery. So, a few weeks go by, my cardiologist calls and says there will be a significant delay in the delivery of this equipment - so just go take the nuclear stress test as we originally planned. OK - but now that it's April and I am starting a new medical year with a new deductible - the test would cost me $3600!! I thought that was outrageous, and told both the stress center and cardiologist office that this was unacceptable. Both places apologized, but made no effort, despite constant dialogue, to seek a compromise. I told the cardiologist office to find another for me - they eventually and reluctantly after much bickering came up with a $3100 and $2500 nuclear test option (another hospital setting and a private doctor). I told them this is still unacceptable. Finally my cardiologist calls back and recommends another option - a stress echo test - which he says is 99% as effective as the nuclear test. So next door in the super-duper place is $1600 - told him to go to his buddies in the industry and find me a cheaper place - eventually got one for $970 that he recommended. Now here is the kicker - the $970 place is booked until May 25th!! So, my originally stress test in mid - March will finally be done more than 2 months later!! What a racket. I asked the cardiologist office to send me to the super-duper place for $970 - and they could not do it (I say b.s.). My cardiologist informed me that his assessment on my health is that I am medically fine to wait until late-May as all my tests do not seem to trigger a problem. I left it to them to still find me a place earlier than May 25th - I even gave them some places that I researched! If they wanted me to take a nuclear stress test in March - I still think waiting until late May to take an echo does not sit well with me.

100% agree with you, but don't also get too upset overall that you trigger a bad event for your health.

[kgtest]

Imagine how many folks pay the $3600.

[Texas Proud]

Welcome to the world of medicine.....

BTW, I agree with the Dr and facility that they should not comp your test... you could have insisted that it be done when it was 'free' to you and waited for the next one to get the super duper one....


A question though... will you max out again this year? If so, then it really does not mater if you max with this test or with some other procedure...

[gerntz]

nm

[gerntz]

Quote:

Originally Posted by Alvin Tostig I've been seeing my cardiologist, who is part of a big practice, annually for 9 years now. I'm very happy with him, although there was a screw-up on a simple surgical procedure when I first met him, which luckily had no long-term impact. He is very highly regarded in his field and takes his time explaining his findings. So it's been 5 years since my last stress test, and he recommended in March that I get one. In the same building is the stress test center - so they send everyone there - it's a fancy high end place affiliated with a major hospital - and therefore in a hospital setting. Now, because my medical insurance is on a April 1 to March 30 calendar, I intentionally moved all my medical appointments to March, since my wife and I had reached the max for out-of-pocket expenses for the year, and after that we are basically fully covered (for reasonable costs). So the test would be free or near free. So no problem, my stress test is late-March. I show up at the stress test center for my scheduled appointment, and wouldn't you know it - the stress test center has no record of my appointment. So I march back to my cardiologists office and they had cancelled my appointment and were sure that they left me a message. The reason, this super-duper stress test center has now ordered the best of the best equipment on the market that only very few hospitals in the US have and my cardiologist recommended that I wait a few weeks until its delivery. So, a few weeks go by, my cardiologist calls and says there will be a significant delay in the delivery of this equipment - so just go take the nuclear stress test as we originally planned. OK - but now that it's April and I am starting a new medical year with a new deductible - the test would cost me $3600!! I thought that was outrageous, and told both the stress center and cardiologist office that this was unacceptable. Both places apologized, but made no effort, despite constant dialogue, to seek a compromise. I told the cardiologist office to find another for me - they eventually and reluctantly after much bickering came up with a $3100 and $2500 nuclear test option (another hospital setting and a private doctor). I told them this is still unacceptable. Finally my cardiologist calls back and recommends another option - a stress echo test - which he says is 99% as effective as the nuclear test. So next door in the super-duper place is $1600 - told him to go to his buddies in the industry and find me a cheaper place - eventually got one for $970 that he recommended. Now here is the kicker - the $970 place is booked until May 25th!! So, my originally stress test in mid - March will finally be done more than 2 months later!! What a racket. I asked the cardiologist office to send me to the super-duper place for $970 - and they could not do it (I say b.s.). My cardiologist informed me that his assessment on my health is that I am medically fine to wait until late-May as all my tests do not seem to trigger a problem. I left it to them to still find me a place earlier than May 25th - I even gave them some places that I researched! If they wanted me to take a nuclear stress test in March - I still think waiting until late May to take an echo does not sit well with me.

My guess is socialized medicine would get you cheaper care at higher quality in less time. Have you tried Costa Rica?

[MRG]

Quote:

Originally Posted by kgtest Imagine how many folks pay the $3600.

+1

I recall a specialist visit when I showed up they said I didn't have an appointment, but I did. Then I received a no show bill for the appointment they said I had!

They backed off when I complained. Humans make human error.

[Teacher Terry]

Texas Proud: BTW, I agree with the Dr and facility that they should not comp your test... you could have insisted that it be done when it was 'free' to you and waited for the next one to get the super duper one....

His doctor cancelled his test without asking him so yes I think they should comp it. Then it was to late to get an appointment.

[calmloki]

Yeah, pretty fun getting all stressed out on heart issues. Kind of thing that makes you feel like "they" are trying to delete your high cost self from the patient pool. My insurance has covered some pretty high dollar adventures for me, but billing? I swear they are trying to kill me.

Maybe you could convince your doctor to just let you strap on a Holter monitor and have you try and get a stress test scheduled.

Peaace brother - this too will pass

[W2R]

Quote:

Originally Posted by calmloki Peaace brother - this too will pass

+1

Don't stress out over this! Life is too short and it just isn't worth it, especially if you have a history of heart or BP issues. Maybe you could regard this as one of those unexpected big expenses that we budget for in advance.

That said, I do understand your aggravation! Nobody likes paying more than planned.

[Dash man]

Oh the things to look forward to tomorrow with my cardiologist appointment...

[Texas Proud]

Quote:

Originally Posted by Teacher Terry Texas Proud: BTW, I agree with the Dr and facility that they should not comp your test... you could have insisted that it be done when it was 'free' to you and waited for the next one to get the super duper one.... His doctor cancelled his test without asking him so yes I think they should comp it. Then it was to late to get an appointment.

No, he did not say that he could not get an appointment.... he wanted to wait for the super duper test....

I have had something like this happen to me (except for a new machine) and they were able to work me in either that day or a couple of days later...

Also, if it were me I would not have waited until the end of the last month if I did not have to... you never know when something else might come up to prevent you from making an appointment....

[travelover]

I think that the OP has a right to be upset. One of my pet peeves is that most docs and other health professionals seem to have no idea what anything costs. I know, I know, they are very busy and highly trained and can't be expected to consider such plebeian concerns as cost.

[Texas Proud]

Quote:

Originally Posted by travelover I think that the OP has a right to be upset. One of my pet peeves is that most docs and other health professionals seem to have no idea what anything costs. I know, I know, they are very busy and highly trained and can't be expected to consider such plebeian concerns as cost.

I think they have no idea because the same procedure at the same location can be any number of prices...

There is the rack rate.... which we know can be 10X to as high as 100X of what insurance will pay.... each insurance company has a different agreed upon price.... and I suspect that even at the same insurance company there are various prices based on which policy you have...

It is a messed up pricing structure...

[travelover]

Quote:

Originally Posted by Texas Proud I think they have no idea because the same procedure at the same location can be any number of prices... There is the rack rate.... which we know can be 10X to as high as 100X of what insurance will pay.... each insurance company has a different agreed upon price.... and I suspect that even at the same insurance company there are various prices based on which policy you have... It is a messed up pricing structure...

I agree, but that is no excuse - pleading ignorance only propagates the problem. Computers can spit out these figures in seconds. Beyond the cost of services, there seems to be a lack of even a simple understanding of what a particular drug costs and how it might be prescribed as opposed to a generic that typically costs 1/10th as much. Why prescribe a drug to someone that can't afford to buy it?

I know it is complicated, but I think docs, especially, need to step up to the cost issue.

[calmloki]

Consider that maybe you don't want to have doctors consider cost of treatment - just what the best course of treatment is. Not sure I want my doctor to look at me and decide my holey T-shirt doesn't look like I need the same course of treatment Biff in the vest would be prescribed. In an ideal world don't you want the best and same medical treatment for all?

[Bamaman]

Quote:

Originally Posted by travelover I think that the OP has a right to be upset. One of my pet peeves is that most docs and other health professionals seem to have no idea what anything costs. I know, I know, they are very busy and highly trained and can't be expected to consider such plebeian concerns as cost.

My cardiologist lives in a 10,000 square foot house lake house with 1/2 mile of water frontage. His boathouse has a 50' Sea Ray, and his garage has at least 5 Ferrari's.
The heart scanner is booked 100% day after day, and he charges like a hospital. The heart scanner and MRI are so expensive that I suspect they are leased at very high rates monthly.
This doctor didn't get rich giving away services.

[Alvin Tostig]

Thanks everyone for all your input.

I did forget to mention that as someone noted above, the cardiologist presents me with his professional advice on the best option for me, regardless of cost. When I mentioned the nuclear is $3600 he was very surprised as he stated that is not involved in the insurance/out-of-pocket nuances of these procedures. Actually, when I googled "cost of stress tests", the complaints when on and on - usually the patient had no idea until "after" the procedure - and in many cases their out of pocket cost was even higher.

However in a nutshell, I found it interesting that my cardiologist original plan was for me to take the test in March - but he's ok with me taking it in late May and doing an echo instead of a nuclear If the echo is 99% reflective of the nuclear, as he states, I guess I'm okay with it.

[joeea]

Quote:

Originally Posted by Alvin Tostig So it's been 5 years since my last stress test Now, because my medical insurance is on a April 1 to March 30 calendar, I intentionally moved all my medical appointments to March, since my wife and I had reached the max for out-of-pocket expenses for the year, and after that we are basically fully covered (for reasonable costs). So the test would be free or near free.

So if you expect to max out your out-of-pocket expenses again this year, you should have just gone ahead with the pricey tests now. Later expenses would be "free or near free".

Quote:

I asked the cardiologist office to send me to the super-duper place for $970 - and they could not do it (I say b.s.).

Did you really expect them to discount their services this much because you happen to restart your deductibles on April 1?

Quote:

My cardiologist informed me that his assessment on my health is that I am medically fine to wait until late-May as all my tests do not seem to trigger a problem.

If this is true, then it's likely your 5-year test could wait until year 6.

[mpeirce]

Quote:

Originally Posted by calmloki Consider that maybe you don't want to have doctors consider cost of treatment - just what the best course of treatment is.

Of course I do. You may not, and we differ.

Grant doctors and other medical practitioners carte blanche and you are going to get huge amounts of waste. They are people like the rest of us with all the complex motivations (good and bad) that entails.