What do you think of this? Is he a crazy, greedy control freak or an Aspie Genius? I recieved this tonite from an e-pal in another part of the country:
*Bit*
Well I just recieved from the LLMD's office a packet of papers to read through. Bascially outlining the Policy Services & Fees and a Questionnaire. This is the Doctor's office who behaved poorly on the phone w/ me. Anyhow I have written out what they sent me. Thought you might find it interesting. This Doctor in Nevada City holds the position of "clinical Consultant" at Igenex.
So he is between Palo Alto And Nevada City. Outside of the Nevada City offices there is no phone and no ``real'' office space, but rented rooms for only 2 days per month. So, if you live near Palo Alto, you must go to Nevada City at least once, and maybe once every three months also.
It allows 1 free phone consultation w/in first month of visit. The intial visit is $350.00 !!
Follow up visits are $190.00 maybe required if medication is changed.
Phone consultations are available after in person visit for $75/15 minutes. !!
New Patients: must have follow up visit w/in 1 month of 1st visit. first weeks are the most difficult and unsettling, many symptoms change rapidly, neccessatating exam and explaination.
Maintaining Current Patient Status:
By maintaining a 3 months interval time between visits. For Proper care, 1 visit every 3 months must be seen by Dr. After 3 months patient will become Inactive. New Patient fee will be applied along w/ in depth reassesment of your status.
Cancellation: 48hrs or $50 fee billed.
Primary Care Doctor Requirement
Duration of the disease Battle:
There is no Rigid Time frame, in general the more time has elapsed the longer the patient will require treatment.
Mid Lines Picc Lines Medi ports & Hickman Catheters are kinds of indwelling catheters. There advantages & disadvantages
What we expect from Patients:
Muscle toning exercise at least 2 x' per week, 20 minutes per day. Inportant component in combatting Lyme disease. Even if pain prevent a rigorous workout must do something. However Aerobic exercise is potentially dangerous for Lyme patients. Intially one day of rest between workouts is mandatory.
No smoking, must quit.
some nutritional supplements are an integral part of the treatment. and therapies such as acidopholous are essential. Must protect oneself from harmfull effects of long term antibiotics.
Patients must not addres Doctor about payment arrangements. or may be removed from the pratice. Only through receptionist. Must pay in Full before leaving office.
No Alcohol. Detrimental and interacts w/ meds.
Avoid Lyme vaccine unless you are absolutely sure you do not have Lyme.
The Doctor is out of town frequently. Hours are irregular. Monthly calendar will be made available to current patients 1 or 2 months in advance.
The Reception is only staffed part time.
Threats or aggessive behaviour or other forms of Lyme rage.
Will not be tolerated, will recieve written warning, subsequent offenses will result in removal from the practice.
Antibiotic Doses & side effects
Several side effects can lead to possible complications. These include, but not limited to, allergic reactions, stomach, intestinal disorders, antibiotic resistant bugs which can turn mild infections into catastrphic events, nausea, rashes, visual or hearing loss, drug interactions, liver, kidney damage, nerve damage, immune system disfunction and yeast infections. You are assuming the risk if you accept treatment. Several techniques will be used to avoid these complications, but sometimes they are unavoidable.
There is also a page that goes on about:
Political Arena
Lyme disease and associated diseases are complex & puzzling problem that scientists, practioners, and patients are only beginning to understand.
Tremendous controversy surrounds the diagnosis and treatment of chronic Lyme.
Disagreement w/ the of long term antibiotic treatment. The scientific Media lends little support, very few studies illustrating the benefits of long term use.
Many doctors have unwillingness or Lack of knowledge to pursue Lyme as the primary cause of Patients symptoms. As a result many go undiagnosed or misdiagnosed.
It is also true that the conditions, symptoms exist alone without any relation to Lyme disease, Babesia, Erlichiosis or Bartonella. In theses case a Rhuematologist or nuerologist many be suited to mange patients care.
We will inform you when we believe that your symptoms are not Lyme related. A porporton of Patients who come to our practice indeed do not have Lyme.
Oh they also wrote that it is not just getting a diagnosis of wether or not u have Lyme disease but includes an undrstanding of the current state and severity of the disease.
Posted by I Have Lyme Etc (Member # 7439) on :
Posted by I Have Lyme Etc (Member # 7439) on :
I dont know, I have a few problems with all this. This is just my own opinion on it..The fact that you say there are "no real phones" and only "rented office space fo 2 days a month"? That to me is a HUGE red flag. I think for myself, $190 for follow up visits is rediculously high. I have NEVER paid mmore than 85-90 dollars for an office visit. Just because this guy is supossedly an LLMD doesn't give him the right to over charge. To me it makes it look like he's just one more trying to take advantage of the sick and weak. $75.00 for phone calls? Is this guy a doctor or a lawyer? There are some people who when they start Lyme treatment get very sick. I know I did and I needed my doctor to be there for me by phone. I was very lucky back then I had an awesome LLMD but I couldn't imagine having to pay him $75.00 for everytime I had to call him.. Another HUGE red flag to me.. Tells me this guy is in it for the money. As for the $$50.00 cancellation fee and you must cancel within 48 hours of the appointment.. I have a problem with this. People are really sick like most of us are may wake up the morning of the appointment and not be able to get out of bed and therefor may not make the appoinment. It's noones fault but the disease's fault and so therefor More money? Sorry, Im seeing a pattern here and it seems to be all about money... The doctor is out of town fequently? And what happens if you really need him and can't get in touch? The reception is only staffed part time? And what happens the rest of the time? Lyme rage etc wont be tolerated? Hmm not so sure these people understand this disease. I see what they expect from the patient but nothing about what the patient can expect from the doctor, the care or the office staff...If this were me? Id RUN and run fast in the opposite direction. These "guidelines" they sent you the way I see them it screams they are in it for the money and nothing more.. But thats just my opinion..
Posted by lou (Member # 81) on :
This doctor has more than one office and serves people who can't travel so far.
Once you know more about the lyme political situation, this will make better sense to you. Think your best bet is to talk to support group people about your questions.
There is quite a variation in charges, and you need to pick a doctor that fits your wallet, as well as your feelings about treatment.
Posted by duramater (Member # 6480) on :
Crazy Doctor.
Posted by homelandstockfarm (Member # 7757) on :
I really don't have any problems with this.
I know there are other non LLMD's with similar charges. My spouses primary care provider is one. Don't know enough to say if prices for shots are reasonable or not.
If you are someone who wants to be in charge of their own treatment, then this sounds like a good doctor -- by this I mean someone who does their own research and knows what meds they want to try and just needs to have tests done and prescriptions written and hopefully documentation for disability. For children or people whose personality is not "type A take charge and responsibility for themselves" this doctor would not be a good fit.
The main problem I see here is finding a good primary care doctor to supplement this LLMD's expertise.
Personally I really like the idea that the doctor has taken the time to write out his office policies etc. Too many doctors neglect to do this and patients later get surprise charges for the doctor responding to a fax or something like that.
Or the doctor won't make medication changes without an office visit which most people wouldn't think to ask about when they are checking out a new doctor. Unplanned doctor visits are the ones that really hurt your pocketbook.
Posted by riversinger (Member # 4851) on :
Doctor's fees depend very much on the financial climate in which they operate. This doctor is one of the least expensive in the state in which he practices. You have to put everything in perspective.
He also travels extensively so that his patients do not have to.
It is hard to make an accurate assessment based on a very small amount of knowledge about a doctor. The truth is, he is neither a crazy doctor, nor a genuis. He is just a caring human being, who is working way too hard trying to help way too many really sick people get better. Some of whom just aren't GOING to get better, not because of a lack on his part, but because of the illness they are fighting.
Seems to me he is trying to make that clear in advance.
Posted by HEATHERKISS (Member # 6789) on :
I don't like this crazy Doctor. Are there other options?
How does a ruemy treat for TB coinfections???
If you can see someone else do so.
Just my opinion.
Heather Posted by minoucat (Member # 5175) on :
Well, shows to go how differently things look to different people.
I see this LLMD. He's well informed, very caring, very hard working. He keeps his office management costs as low as he can to keep his fees down -- the first LLMD we saw in CA cost $650 for the initial visit! He takes on very sick people, including those from out of state, which some LLMDs won't do. He travels to reach patients that would not otherwise be able to see him. He's very supportive of patients who do their own research and try alternative approaches. He travels across the country to train with other leading LLMDs. He's constantly taking flack from other doctors (in particular, a group of IDs outside of CA) who are hostile to long term abx treatment for LD, or even the LD dx.
I don't think people understand how at risk LLMDs are. There is a lot of CYA in his forms and policies, which is a perfectly reasonable attempt to head off the unending attacks by a group of IDs who have him in their sights. I worry every day that he'll get got, as so many other LLMDs are.
Personally, I appreciated the way he laid out his treatment philosophy, open and above board, so you know what you're getting into with him before you see him. I think it's fair for him to stick to his guns about his experience of what patients need to do to optimize their chances for recovery. As for the fees -- when we had to cancel at short notice because of being too sick to travel, his office rescheduled us cheerfully without charging a fee. He's not a genius, he's not a control freak, he's not a saint -- he's just a guy who's been through the LD political and medical mill, and who is trying to protect his patients and his practice as best he can.
Posted by lou (Member # 81) on :
Thanks, cat, good remarks.
Heather, how can you have that opinion with no facts other than what is posted here? Sorry, little chickadee, think this was not well thought out. Sometimes it is better to say nothing if you don't have enough info. For one thing, ID docs are supposed to be the best educated about diseases like lyme. But the ID assoc. has taken a treatment position that absolutely hurts us. So, the type of doctor is less important than their experience and ability.
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