Things that make me grumpy

If I'm still prescribing medications for a patient, I want to see them once a year (give or take a month). I'll see them more than that if needed, obviously, but for a stable patient I think once a year is reasonable if I'm still the one writing their scripts. Dr. Darth, a neurologist downstairs from me, makes everyone come in every 8 weeks, and Dr. Ivyleague across the street requires monthly visits. But I think that's just digging for a co-pay.

Mrs. Bagge is an elderly lady who I see for benign tremor. I see her once a year, and refill her Inderal, and she goes on her way. But she always bitches and complains about her $25 HMO co-pay to see me once a year. I'm not that desperate for the $25, but if I'm taking the legal liability of writing her pills, I want to see and examine her once a year.

She was due for a return visit in early November, 2009, so I had Mary call her. Mrs. Bagge said she'd just had surgery on her bunions, and couldn't get in then. So, to be nice, I wrote her for another month.

So in early December, her next refill came up. This time Mrs. Bagge had family in town through the holidays, and so asked if I'd give her until January. I don't want to be Scrooge, so I said fine.

Last week another refill came up. Mary called her, and Mrs. Bagge wanted to make an appointment, but she needed an insurance authorization from her internist to see me. So Mary called Dr. Internist (twice) to ask for one, and said she'd call Mrs. Bagge to schedule the appointment as soon as we got it.

In the meantime she was out of Inderal. I told Annie to give her 15 days worth of pills, and no more until she was seen. Annie argued with me that Mrs. Bagge is on a fixed income, and we shouldn't put her in the position of having to make 2 medication co-pays for one month of pills. Since we were in the process of getting the auth for her to see me, and I'm a soft touch, and (most importantly) because I never argue with Annie, I said fine. Give her a whole month.

So yesterday afternoon her insurance auth showed up for her visit, and Mary called her.

Mrs. Bagge refused to make the appointment. She said she was tired of dealing with my greedy office, and accused us of harassing her with phone calls and holding her Inderal hostage. She then sent over a request to fax her records to Dr. Darth, because she has an appointment with him next week.

Good riddance.