Tuesday, January 29, 2013

step one


It was imperative that I get my father to a doctor.  And as if we weren’t facing challenging enough circumstances, this is where things got more difficult. 

Florida, Arizona, the South Carolina low country and Northern California wine country – all places retirees are commonly found.  They leave their chillier climes for promises of sunshine and bliss and often spend years enjoying just that.  But as our parents age and their needs become greater, they often find themselves returning to familiar towns and cities, drawn to adult children or long-time friends.  It’s called reverse migration and while it was not my particular set of circumstances, this moving of the aging from one place to another can get muddy.

My father did not have a primary care physician.  Ever.  He was a ‘wait it out’ kind of guy who used urgent care when it was, well, urgent.  Arriving on my doorstep without so much as a referral from another doctor meant that we had to find him someone who would see him, and for those of Medicare age, that is no easy task. More and more physicians are not accepting new patients if they are on Medicare because of the lower rate (78%) the government pays the doctors.  When doctors compare patients with private health insurance to those on Medicare, the payment is greater and thus, more appealing – which is appalling, but I get it.  What it means, however, is that the common practice – and let’s face it, need – of reverse migration, brings with it circumstances that an already stressed family must face.

The advice from the medical community is to work with an aging parent’s primary care physician prior to the move.  Allowing the doctor to use his or her network to help find a new doctor is advantageous not only in that you are, in effect, getting a referral, but with any luck, the doctor will take into account the needs and particulars of their patient, someone who, presumably, they have had a working relationship for quite some time.

I called several places in my area, none of whom would accept a new patient on Medicare.  I hadn’t wanted to blur the line between patient/doctor and daughter of a patient/doctor, but as a last resort I called my doctor. He was not accepting new Medicare patients accept for those affiliated with the practice already – as in, I am a patient, he is my dad, the doctor would see him.  Phew.  I was nothing but lucky on that one.

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