Reporting a doctor. First steps.

[WinterSown]

I stopped at my  insurance company today and asked their advice on what is the right procedure when you think you have not been properly served or cared for by doctors they have paid. I had some testing done and well, you shouldn't need to have the same test three years in a row! The third test by the local hospital group was much more professional. I want to find out the right way to proceed--is this something the insurance company takes care of or do I go to the state? I'm not sure yet if I am observing genuine offenses which should be reported, being rude is not a reportable offense but not doing your job is, so I must be very certain and I must proceed with a path that repairs rather than damages. I do well know that many doctors do not know dysautonomia when they see it but they know symptoms which can be proven with tests. Ignoring the documented results in front of you is problematic. The doctor, I think, needs to learn some things--respect your patient being first, but really--if there is nothing in their partnership spec book on what to do when you encounter something you've never seen before they might want to add some pointers about what to do because doing nothing does nothing but take the patients money and leave them still in need of care.

The woman I spoke with at the insurance company was so kind and caring,  and I am glad for that, she made it easy to talk about something I believe needs to be looked at by professionals. She took my information and she did some checking and came back with a number for a special division in their company that helps members with advice and guidance. She also told me to also pursue with the state's office of professional medical conduct. 2019 is gonna be a roller coaster. 

[Pistol]

Good for you @WinterSown - the insurance companies mostly look at if any of the test he ordered were duplicate or unnecessary. That way hey can get him for Fraud. I have never went as far as reporting a doc to the state but I would totally do it. The only reason these docs get away with their snobbish and ignorant dismissiveness towards us is because we let them. They work for US and we do not have to put up with them. If we have a contractor working on our house doing a bad job - we fire him and ( in this state ) report him to the licensing board. Tht way they will not do a bad job to the next person. It should be the same with docs. --- If the doctor is part of a group or hospital you can also start an official complaint to the quality assurance department. I have done that before and the doc in question had to go in font of a peer Review ( other docs investigating the incidence ) . /then they decide what action or punishment is appropriate. In my case there was disciplinary action and this ER doctor no longer is allowed to treat me. Good riddance! 

[p8d]

Good for you!  I completely agree with letting people know when this happens.  I reported a dr once to the organization she works for and had a number of calls from various people seeking facts.  I even had one from the head of her specialty department, her boss, and another from the dr in charge of the facility where it happened.  I know she was referred for special training but I don’t know the details.  She’s still there but I will never see her or go to that facility again.  I did not escalate it to the state because it wasn’t warranted but I would never hesitate to.  

[WinterSown]

4 hours ago, Pistol said:

Good for you @WinterSown - the insurance companies mostly look at if any of the test he ordered were duplicate or unnecessary. That way hey can get him for Fraud. I have never went as far as reporting a doc to the state but I would totally do it. The only reason these docs get away with their snobbish and ignorant dismissiveness towards us is because we let them. They work for US and we do not have to put up with them. If we have a contractor working on our house doing a bad job - we fire him and ( in this state ) report him to the licensing board. Tht way they will not do a bad job to the next person. It should be the same with docs. --- If the doctor is part of a group or hospital you can also start an official complaint to the quality assurance department. I have done that before and the doc in question had to go in font of a peer Review ( other docs investigating the incidence ) . /then they decide what action or punishment is appropriate. In my case there was disciplinary action and this ER doctor no longer is allowed to treat me. Good riddance! 

it's very complicated but I think it should go to peer review

 

[StayAtHomeMom]

Good luck. I hope everything works out.