Wednesday, October 19, 2011

Hooray! And Holy Crap…A Precautionary Tale for the Inexperienced & Injured

I haven’t blogged in a while; this is somewhat due to the craziness that my life has become over the past couple of months and otherwise due to the uncertainty I’ve encountered along the way. I’ve started several blogs since my last post, however, a constantly changing circumstance and the feeling of ALWAYS being in a time crunch has kept me from completing any of the blogs I’ve attempted.

Thus, I’ll just give you a quick summation of the Jiu Jitsu relevant happenings since my last post.

I finally got smart and went to another, much more qualified, Orthopedist in the Atlanta area. Here I was told that my initial MRI was done by an old machine and was thus too poor of quality to tell for sure whether or not my meniscus was torn; in order to get a conclusive diagnosis, I’d have to get a ‘good MRI’ on their state-of-the-art machine. I was pretty baffled by this, as I was obviously unaware of the poor quality MRI I was receiving when I shelled out over a grand for it. After getting over the apparent complete waste of time/money, I went ahead and got the second MRI. With this new almost HD seeming MRI, he showed me where the area that appeared torn in the ‘crap MRI’ was shown to just be blotchy irritation in the ‘good MRI’; thus, he decisively diagnosed that my meniscus is not torn. I of course am extremely happy with this outcome; however, the process I took to get to this point has been a bit trying. As a new entrant into the adult world of healthcare and an injury first-timer, I was completely naïve to the entire process. I don’t blame myself for the many mistakes I made (which is good, as I’m typically my own worst critic), but I do wish I’d gone about this whole injury thing a bit differently from the start. Thus, I wanted to share my learnings in hopes of offering some sort of a reference for others who might find themselves in a similar situation. 

Disclaimer: These are only my opinions based on my own craptastic experience as a young adult and injury first-timer attempting to navigate the healthcare system for the first time.

Key Learnings: 

      1) Do your research prior to choosing your FIRST doctor
      Once I realized I might in fact be seriously injured, I was TOO eager to get to the doctor and get a diagnosis right away. In no way am I discouraging going to see a doctor soon after injury, in fact, I highly recommend this, even if you’re unsure of the severity of your injury. HOWEVER, don’t let your eagerness get the better of you like I did. Since I insisted on making a doctor’s appointment right away, I didn’t put a ton of thought as to who I was going to see. My rash decision to go to the first doctor that was mentioned to me was not only due to my own impatience, but also to my ignorance of the best practices when injured. If you do your research before your initial appointment and make sure you’re seeing the very best doctor for your injury type, you’ll likely save yourself a whole lot of time, energy, and money in the long run.

      2) Be prepared for a process, understand your Insurance, and be persistent
My first attempt traversing the health care system as an adult has definitely been a frustrating one. The amount of ‘processing time’ that every step requires has served as a large source of my frustration; however, the additional delay caused by my lack of knowledge of my own insurance policy served as a close second. Thus, it is pertinent that you understand your insurance benefits/restrictions and processes/procedures THOUROUGHLY before pursuing any specialized care. Depending on your insurance, this may be a very difficult process, as mine was. You’ll likely be placed on an infinite automated loop when you call, but this is where the persistence comes in. Endure the automated loop until you eventually speak with a rep; this is your opportunity, ASK AWAY. If they give you vague answers, probe; it is your right to understand the true benefits/limitations of your policy.  Through many calls to both my insurance provider and various doctors, I also found that both sides were very hesitant to tell actual costs. At first, I let this be okay and just hoped my costs would be reasonable, but after realizing this was a bad idea, I became more insistent to both parties. Though not very enjoyable, with my new-found nerve I was finally able to obtain my costs upfront, making the financial portion of the process much more manageable.

Overall, this experience has definitely opened my eyes a little wider.  My perception is that the healthcare system isn’t an enemy, but it’s definitely not a friend either; beware its general indifference, as its always waiting to capitalize on your mistakes. The best defense is knowledge and persistence, but this part is completely up to you.
      
      3) Get a second, third, and fourth opinion and ASK QUESTIONS
Even if you went to a great doctor and especially if you didn’t, get a second opinion! Since my first Orthopedist told me what I wanted to hear, I accepted her diagnosis as correct and final. Therefore, I continued with her recommended recovery process only to find myself looking for more answers a month later. I wish I’d realized that it’s completely acceptable and often necessary to take your X-Rays, MRI, or whatever other tests you paid for to ANOTHER doctor to get ANOTHER opinion. I received opinions from 3 different doctors by the end of my process, and all of them were different. That’s why it’s necessary to do your homework and decide who you trust most. Also, I realized throughout the process that doctors and insurance reps don't typically volunteer information to you; this is when doing your research comes in handy. If you’re armed with a list of questions, their only option will be to enlighten you. If I was aware that not all MRI machines are created equal, I would have asked about their machine type/age prior to paying for the service. Learning the hard way is time consuming and expensive; avoid if possible.

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2 comments:

  1. as someone who works in the billing side of the healthcare industry YOU MUST, ABSOLUTELY must, no matter hw long the hold on the phone or irritated you get check with your insurance FIRST to make sure not only the facility is in network but the dr as well, you have no idea how many times people get screwed because of it, also if they hit you with a huge bill they always have pmt arangements and most have fnancial aid...but we're not allowed to tell you that shhhhh :) Glad nothings torn hope your recovery goes smooth

    ReplyDelete
  2. Thanks for the info and well wishes shakia :-)

    Hopefully we can save a few others from learning the hard way too lol

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