What you've said in previous answers about getting care from a migraine specialist made a lot of sense to me, so I finally took the tiger by the tail and made an appointment with the closest specialist, whose office is four hours away. Since my migraines are frequent and unpredictable, my husband took a day off work (without pay) to take me. We read all kinds of stuff on this site about what to do in advance and what to take with us. We had our list of questions and topics to discuss, a clear and understandable list of current medicines and preventive medicines that I've tried in the past. We also had a copy of my chart from my last neurologist and copies of MRI films. The appointment was pretty expensive for us by the time you add up insurance copayments, my husband's lost day of work, paying someone to watch our kids for the day, and gas for the car. That's OK. You don't get something for nothing.
What doesn't seem OK with us is the way the appointment went.
- The doctor was 3 hours late for the appointment, and it was supposed to be his first appointment of the day at 9 am. Nobody would tell us anything during those 3 hours other than "he'll be here soon." When we asked what had held him up, he told us it was none of our business.
- He didn't want to see the chart or films I brought. Just asked if I wanted them back or if he should just throw them away.
- He said it didn't matter what medicines I'd taken in the past because HE hadn't prescribed them.
- When I handed him my list of questions and topics he handed it back to me and said that HE would ask the questions.
- When my husband tried to say something, the doctor told him he could be quiet or go sit in the waiting room.
- There was absolutely no exam. No blood pressure check, no "follow my finger," nothing.
- He was in the room for no more than 15 minutes. All he did was write new prescriptions for the same medicines my GP had prescribed, and they don't work. When I mentioned that, he told me to try them longer and quit feeling sorry for myself.
I think I would have cried, but I was too stunned. My husband was furious and working so hard at controlling himself so he wouldn't upset me. We got a notice from the insurance company today that the doctor billed $650 for a "new patient evaluation." We're considering contacting the insurance company and telling them not to pay it.
We're trying to be calm and rational about this appointment. I really need this doctor to work out for me because the next closes specialist is more than nine hours away. If this is what going to a doctor who's "certified in headache medicine" gets me, I'm not sure how valuable that certification is. Teri and Dr. Krusz, you're wonderful, and we trust your advice. Can you tell us, please, was this as bad an appointment as we think it was? Also, do you know of any way we could get around the problems with this doctor so I can get treatment from him. Thank you so much for your time and dedication, Gillian.
We're not even going to attempt to be tactful about this. The man was a jerk. His behavior was inexcusable, and if it were up to us, his certification would be yanked. Truly, we admire the control you exhibited in writing your question. In fact, we admire the fact that you actually sat through the appointment. Neither of us would have.
UCNS certification is great for evaluating a doctor's knowledge of "headache medicine," but passing a written test is no indication of how he or she interacts with patients. At this point, UCNS certification has only been available for a few years. There are some very good Migraine and headache specialists who had already been in practice for some time when certification began, and they chose not to pursue it. So, at this time, we don't recommend ruling out someone who isn't certified.
Yes, the appointment was as bad as you think it was. The very fact that he didn't prescribed medication for a new patient without reviewing your records and conducting an examination is horrifying. Honestly, we're not sure there's any saving this patient/doctor relationship. We would suggest that you request a copy of your records from his office so you have a copy of what he noted from that appointment. Under HIPAA, you need to make the request in writing, then he has 30 days to provide you with the copy. See Your Rights to Your Medical Records.
Let us share with you that your experience made both us pretty angry and sad. We both understand how much Migraineurs depend on a good relationship with their doctors, and we admire your hard work and patience. We don't know how you found this specialist, but you can check the Find a Health Care Specialist on the ACHE web site, which has specialists who are and are not UCNS certified, and the listing of certified specialists on the Migraine Research Foundation site.
Please send us a note sometime and let us know how things are going?
Thanks for your question,
John Claude Krusz and Teri Robert
About Ask the Clinician:
Dr. Krusz is a recognized expert in the fields of headache and Migraine treatment and pain treatment. Each week, he and Lead Expert Teri Robert, team up to answer your questions about headaches and Migraines. You can read more about Dr. Krusz or more about Teri Robert.
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Published On: April 16, 2014