Trials and tribulations with the "UC Care" medical plan & w/ UCSF, UC Davis health systems

The University of California healthcare options are, well, less than ideal right now, in my opinion.  Here is a little story about my recent experiences.

September 2014.

Forced to switch to the UC Care health plan because UC cancelled the health plan that allowed me to be a part of the Sutter Medical Group. Sutter has always been awesome. Wonderful care. Wonderful people. Rapid scheduling of appointments. And I was very sad to be forced to switch. I kept my primary care physician at Sutter but realized I would have to switch for many other things.

I was not pleased to be pushed into the UC Care plan because my experience with the UC Davis Medical Group has been beyond disappointed in the past.  For example see this: U. C. Davis Medical Group – their time is MUCH more important than yours.  Admittedly, I had not been to people in the UC Davis group in a while, so — maybe things had changed.

Plus I was pleased to note that the UC Care said I should choose their plan if “You want direct access to all providers without a referral.”  Why yes, that sounded good.  Hah hah hah.  Silly me.

September 2014.

Of course.  Just as I switched medical groups I had a serious health issue in need of attention.  Called UC Davis Nuerology  to make an appointment with the specialist recommended by a colleague.  They told me I needed a referral. I told them I had UC Care health plan which says I do not need a referral. They said that it did not matter what plan I had, I needed a referral. So I asked my doctor for a referral.

October 2, 2014.

Meanwhile I wrote to one of the people in the UC Davis Neurology Department where I wanted an appointment to ask how I should make an appointment and told him that I had been referred to him by a UC Davis MD (trying to pull some sort of nepotism here). He connected me to his assistant and I sent her the info she asked for.

October 13, 2014. 

I had not heard back from his assistant so I wrote to her again.

I am writing to see if you got this information I sent Oct 3 and if there is any more information you need from me. Thanks

I again did not hear back.

October 19, 2014.

I received a letter in the mail from UC Davis “reminding” me I had an appointment in Neurology scheduled for December 17, 2014.

Now, I guess it was nice to have an appointment.  But I note – they never called me to ask when would be good for an appointment. They never contacted me at all. And this was clearly less than ideal – an appointment in two months.

So I called them to ask – how did this get scheduled? They said they must have scheduled it with me. I told them, no, nobody even contacted me. I then asked – is there anything sooner? Nope. I then asked – what if I cannot make that date and time (I was scheduled to be away). They then said that would cause a significant delay in the appointment. What the $*@#$8? This is not the first time I have had trouble scheduling appointments with UC Davis physicians but this was absurd. I then asked – is there anything I need to do in advance? They said nope. So I waited. Two plus months. For an appointment for which I needed a referral even though I had signed up for UC Care.  Oh – and – I guess just to prove they had no clue what they were doing – they spelled ny name wrong (Johnathan).

December 17, 2014.  

I had my appointment with the neurology specialist.  He was very nice.  Seemed pretty knowledgeable.  He had some disconcerting misconceptions about me and I tried to correct them but he did not seems to be paying attention.  He did not do any of the more complex tests I had seen in the literature that were standard in the literature I had seen for my condition.  He did not even order any such tests.  He concluded the visit with a possible diagnosis and then said he needed to order a series of blood tests to test some alternative possibilities.  They decided I did not need a follow up appointment and that we would wait to see what the blood tests showed before deciding what to do next.  I told them I was not fasting and asked if that mattered and they said no (one of the reasons I ask in advance about blood tests is that freuqently they need me to be fasting and it is easier to do that early in the AM … but nevermind that … they said it was not needed).

December 22, 2014

I signed up for Mychart.ucdavis (based on the recommendation from the printout I got when I left the doctor’s office)– an online system to communicate with the UC Davis Medical Group.

December 23, 2014

I got an email saying there were test results in Mychart.

January 2, 2015.  

I still had not heard anything from the doctor’s office.  I wrote to him via the MyChart system asking if he had any update based on the test results.  I called too.  No response.

January 6, 2015.

I finally got a message from my doctor.  It had my name wrong, again, in a different way (John).  The message was short, had one useful thing in it and then said he “You need to check in with your PCP– I have instructed our staff to contact your outside PCP and transmit labs to him and to contact you.”  So much for seeing a specialist directly and communicating with them.  Oh, and he ended the message with “Good we checked labs and caught this now before your travels.”  What the $&##?  I had no travel plans.  This had nothing to do with travel.  He spelled ny name wrong.  They had me listed as having type II diabetes, when I have type I.  And they wanted me to communicate with my primary care physician instead of him.  Such excellent care.  Oh, and he made a comment about my vitamin B levels being too high when I had told him I was taking a specific prescribed vitamin therapy and that I had taken some that AM (this would likely screw up the blood test – I think to know if vitamin levels are off one has to NOT have recently taken vitamin pills).  Jesus Christ what a sham.  In fact, when I told him I was taking this vitamin prescription, he said something to the effect of “random vitamins don’t usually help” and I said “it is not random it is actually prescribed and there are clinical trials showing it has some benefits” but he had never heard of it nor did he seem to care.

January 7, 2015. 

I decided, I needed to see another specialist.  So I went back to a recommendation from another colleague for someone to see at UCSF.  So I checked out the protocol for making an appointment at UCSF and I filled out an online form to request such an appointment.  In the request system it asked for the preferred method of contact for me, and I said email.

January 8, 2015 

A day or so later,  I received an email from their system which said I had an encrypted message regarding my appointment request.  I had to create a new log in to a new system in order to read the message about my appointment request.  The message started with the following:

This email is to acknowledge receipt of your online appointment request for a new patient appointment. We have been unsuccessful in reaching you by phone. Before an appointment can be approved for scheduling we will need the following required documents to start the review process:

·         Referral along with reason or diagnosis
·         Pertinent clinical notes or records
·         Pertinent test results
·         Front and back copy of insurance card and authorization if required by insurance
·         Patient demographic information

What?  Why did they ask for my preferred means of contact if they were then going to call?  Oh well, at least this got through.  I called to ask some questions and only got a machine so I left a message.
Janaury 12, 2015
Appointment with my primary care physician.  He told me they had not received any information from the UC Davis specialist.  But he agreed that it might be good to see a specialist who gave a shit (my words, not his).  So he said they would make a referral to UCSF for me.  I gave them the printout with the information requested from UCSF.  
Janaury 17, 2015. 
Got an email saying my doctor had sent over the referral information to UCSF.  Called UCSF on MLK day and alas they were not open.  But I left another message asking what I had to do to make an appointment.
January 19, 2015.  
My wife took down a message and gave it to me saying UCSF had called about making an appointment.
January 22, 2015.
I called UCSF Neurology.  It took a long long long time to get through to a person.  When I finally did, I said I was calling to set up an appointment.  The person was immediately somewhat rude.  I gave my name and DOB and the person said I had no referral and my record there was empty.  I said I had been called by UCSF and they had left a message saying I should call about an appointment.  Now, mind you, I am not sure why UCSF had called me – it could have been about setting up an appointment or it could have been just to return my call.  But regardless, I told the receptionist that my doctor’s office had told me they had contacted UCSF and that I should call.  The person repeated that they had no record of anything in my file – no calls to me – nothing.   This sounded so weird that I said “Is this definitely the file for Eisen – E-I-S-E-N.” and the person snapped back “I do not make spelling mistakes” or something like that.  Nice.  Eventually, the person transfered me to someone else who actually offered to help and to call my doctor’s office.  They then said they could call me back after this.  I asked what number they had and the number they said was not one I recognized.  Weird.  But I gave them the correct number and then hung up.

After I hung up I started to get pissed off.  What was the deal here? I signed up for this UC Care health insurance beause I was supposed to be able to make appointments with specialists without referrals.  And I am a UC Professor – with an appointment in a medical school.  I probably get treated better than the random person.  What a scam.  And then I remembered how badly UC Davis Medical Group treated my wife many years before.  And how good the treatment we received from Sutter has been.  So I posted something to Twitter.

//platform.twitter.com/widgets.js
And finally I got contacted by someone who actually seemed to care.

Not sure where things are going to go – but at least one person associated with a UC Medical Group is trying to help …

UPDATE January 29, 2015

Still no call back from UCSF Neurology despite their promises that they would call my doctor and then call me back as soon as possible.  Unbelievable.

UPDATE January 29, 2015 #2

Wrote an email directly to the Doctor I wanted an appointment with.

UPDATE January 29, 2015 #3

Tried to contact the appointment desk.  Was on hold for 30 minutes before I had to hang up.

UPDATE January 30, 2015

Got through to the appointment desk.  OMG how ridiculous.  They said they needed to transfer me to another department (memory and dementia) because that was where I had the referral (I had asked for an appointment in neurology, I have some peripheral neuropathy).  They said the doctor at UCSF had reviewed my chart and that is where they determined I needed an appointment.  And that I would need to contact my doctor about this.

What the F#*$*#?  Completely insane.

UPDATE February 2, 2015

Lesson of the day.  UCSF doctors and personnel, other than the receptionist I interacted with on the phone, really really really do care about getting things right.  After I posted again about this issue to Twitter and sent an email to my brother who forwarded it to people at UCSF, many people stepped up to try to help.  All of them have been incredibly gracious and concerned and helpful.

And at the same time I decided to get a copy of the referral from my primary care physician just in case there was a mistake from their end.

And, well, there it was.  The referral was to see a neurologist for diabetic related neuropathy issues.  Looked good.  Then I looked at page 2.  And there was a comment about my having a history of dementia and that they could not do an MRI due to my pacemaker.  Well.  WTF?  What chaos.

Certainly this explains why UCSF thought I should see the dementia clinic.  It does not explain why UCSF neurology would never return my calls and was rude on the phone, but, well, it does make me feel like a schmuck for the mistake my doctor’s office made.

UPDATE February 2, 2015 1:45 PM

Finally – a call from UCSF.  Yay. And they are going to contact my docs office and confirm that I do not have dementia.  And then, maybe then, I will get an appointment.

UPDATE February 2, 2015 5:45 PM

Well, I got a call from the UCSF Neurology appointment desk.  The person said they were calling because I had apparently contacted another doctor who contacted them (were they pissed off about this? sounded like it).  And they told me the first appointment was April 19.  Wow.  That is, like, not soon.  Lovely.  I took it.  But am going to see if there is a way to move it up.

UPDATE April 19, 2015

So – I finally had my appointment with a Neurologist at UCSF.  I had to get up so so early for my 9 AM appointment at UCSF Parnassus campus.  I was planning to take the train at 5:45 AM and then somehow wind my way to the UCSF campus.  And my alarm was somehow silenced.  I woked up at 5:30.  And I literally threw stuff in my bag and changed and jumped in my car.  But there was just no way to make it.  And so I decided to suck it up and drive into SF.  Traffic was bad already that early.  And I was pretty wiped when I got to UCSF.  And I was prepared for the worst.

But OMG.  What a difference.  I was treated so incredibly well by everyone there.  The information desk people on the 1st floor were helpful.  The lab people where I went for blood tests afterwards were pleasant and helpful.  The staff in the Neurology Department were friendly and respectful and helpful.  And my doctor.  Wow.  She was just so great.  Yes I do have some neuropathy.  And yes indeed it does completely suck.  And yes it still freaks me out and stresses me out.  But now I finally feel like I am getting excellent medical care.  And that is uplifting, even though my health is imperfect.  Such a contrast compared to the awful experience at the UC Davis Neurology

UPDATE April 21, 2015

Got a call from a UCSF Neurologist to discuss my blood test results.  My doctor was not available so an alternative doctor called me.  And she was phenomenal too.  Spent quite a while on the phone discussing things.  Came up with a plan.  All based on actual science.

UPDATE April 22, 2015

Got my medical report in the mail from UCSF.  Incredibly detailed report about my appointment, recommendations for me, and more.  Another wonderful feature.  I have STILL not gotten any such thing from UC Davis.

//platform.twitter.com/widgets.js

Email from #UCDavis on UC #OpenAccess Policy

Just got this email

Just got this email

On behalf of Provost Hexter and Academic Chair Nachtergaele, please find the attached letter regarding the UC Open Access policy. For your convenience and reference, the text of the letter is pasted below.

ACADEMIC SENATE AND ACADEMIC FEDERATION FACULTY

COUNCIL OF DEANS AND VICE CHANCELLORS

DEPARTMENT CHAIRS AND DIRECTORS

Dear Colleagues:

We are pleased to inform you that on July 24, 2013, the Academic Council voted to adopt an Open Access Policy for scholarly articles published by Senate faculty across the University of California system. An article deposit system to support the policy was released, on a pilot basis, at UCLA, UC Irvine and UC San Francisco on November 1, 2013, and will be officially rolled out at the other campuses on November 1, 2014, pending the outcome of the pilot.

The Open Access Policy allows faculty members to maintain legal control over their research articles while making their work much more widely available to the public. The policy does not require faculty to publish in open access journals, or to pay fees or charges to publish; instead it commits faculty to making a version of each article available publicly in an open access repository.

Faculty can take advantage of this right by using UC’s eScholarship digital repository via http://www.escholarship.org/ (or any other open access repository) to make a version of any article publicly and freely available worldwide. While it is expected that faculty at UCLA, UC Irvine and UCSF will make their articles freely available (via eScholarship or another OA Repository) effective immediately, faculty at the other 7 UC campuses are also free to begin depositing their articles now if they wish. Faculty authors may opt out of the policy for any given article, may delay the date of appearance of the article (“embargo” it), and may choose the terms of use that will be applied to each article (for example, whether it is for commercial or non-commercial reuse).

This policy has been under review by the Senate divisions and committees for two years and its implementation is a move of major significance. Policies like this one have been adopted by more than 175 universities but none as large, influential or productive as the University of California. The move signals to publishers that UC faculty want to see open access implemented on their own terms.

The California Digital Library and the campus libraries have developed a streamlined eScholarship deposit system and tools for obtaining waivers and embargoes to assist faculty in complying with the policy. The CDL has also contacted over 600 publishers to alert them to the policy and encourage their cooperation with its terms. Faculty on all campuses may receive questions about compliance from publishers and can consult the resources listed below (including an FAQ) for assistance.

Learn more about your rights and responsibilities under this policy at the UC Open Access Policy website.

http://uc-oa.info

Watch a 90-second video about the policy – and pass it on!

http://osc.universityofcalifornia.edu

Discover how easy it is to deposit your articles in eScholarship.

http://osc.universityofcalifornia.edu/open-access-policy/deposit/

Find out who to contact at your campus library for assistance.

http://osc.universityofcalifornia.edu/open-access-policy/oa-contacts/

Sincerely,

Ralph J. Hexter

Provost and Executive Vice Chancellor

Bruno Nachtergaele

Chair, Davis Division of the Academic Senate

Open Access Policy 11.26.13.pdf

California Breast Cancer Research Fund Tax Checkoff; wondering about Open Access policies

Just got this email below about what seems to be a worth cause:

March 8, 2012 

Dear UC Colleagues, Throughout California and UC, researchers are developing new approaches to prevent, treat and cure cancer. I am writing you to share important information with those of you who will soon file your California state tax return. At the end of California Tax form 540, there is a section in which you can donate to two highly regarded cancer research programs that are administered by the UC Office of the President.

If you go to line 405, you can contribute to the California Breast Cancer Research Fund and if you go to line 413, you can contribute to the California Cancer Research Fund.

No contribution is too small, and 95 percent of contributions to these two programs via this tax check-off go directly to cancer research or community-based education.

Donations from line 405 go to our California Breast Cancer Research Program, which is renowned not only for its cutting-edge research, but also for working with community advocates and health care providers in targeting the issues and needs of patients and families, especially the underserved.

In recent years, donations from line 405 have supported critical research including: identifying environmental factors that potentially cause breast cancer; developing targeted therapies to block breast cancer from spreading to other organs; and improving support networks to empower patients as they maneuver the health care system. See this website for more information: http://cabreastcancer.org/taxcheckoff/

Donations to line 413 go to the California Cancer Research Fund, which is helping to provide prevention and awareness programs in communities disproportionately affected by cancer. One major ongoing project is increasing the understanding of the impact of tobacco use and cancer on vulnerable populations. This research could lead to reduced smoking, increased cancer awareness and strengthened prevention programs.

I wanted to be sure you were aware of this means of investing in research that can serve all Californians and our communities.

Sincerely,

Lawrence Pitts, M.D. Provost and Executive Vice President University of California, Office of the President

However, I wonder about the open access requirements of the fund. I sniffer around at their web site http://cbcrp.org/about/ and could not find anything about guaranteeing access to the results of the work supported by this fund. That is too bad – this seems to be a great case where openness could be both a good thing and a useful marketing tool (to get people to chip in money from their taxes).