Just got off the phone with my insurance company...

[CoffeeCat]

I've never had a problem with the healthcare system. We have good insurance through
my husband's employer, and I've pretty much paid the co-pays and that was that.

Well, if you think our shoddy healthcare system won't affect you. Think again.
Sooner or later the power of the insurance companies will catch up with you.

It's happening to me now.

A few months ago, I had a mammogram. The technician showed me the films, that were displayed
on a large screen. When she showed me the pictures, I looked at her and she looked at me and
I said, "What's that...um...little, black dot?" She explained that she couldn't say, because
she was only a technician. I asked her to be frank with me. She said it could be a blood vessel
or it could be something to be concerned about--and to wait and consult with my doctor.

The dot was unmistakable. It wasn't a smudge. It wasn't a piece of lint. It was an unmistakable
black dot on an otherwise clear picture.

The next day, my doctor calls to quickly report that my mammogram was just fine. I asked her what
the black dot was. She says there was no black dot. I told her the technician and I both saw it.
My doctor calls the radiologist and calls me back. No black dot.

I totally understand that sometimes black dots mean nothing. I also know that doctors and radiologists
can look at some black dots and know they mean nothing. However, my problem--is that I saw it and so
did the tech--but the doctor and radiologist see nothing. A clear film. If the doctor said, "Yes, we
saw a small dot, but it was normal and nothing to worry about" I would be fine.

The problem is that an unmistakable black dot disappeared from my mammogram.

I called our insurance company to ask what to do in a situation like this. After all, mistakes are made.
Films can be mixed up. People can get it wrong.

The insurance company informed me that I cannot have another mammogram because I am allowed only one a year.

So, there you go. If something is terribly wrong--it appears that my husband, my two children and I--must
wait about 11 more months to find out if that dot is nonexistent, benign or cancer.

All because another mammogram would cost the insurance company more money.

Again, if you think this corrupt, profit-centric system won't catch up with you--just wait.

[annabanana]

1. Everyone is vulnerable. Everyone, that is, except

the obscenely rich. They are safe and secure.

[xultar]

2. Can you go to the Dr. and ask them to show you the films again? Like hold

them in your hands and see for yourself again? Make sure your name and or SSN is on the film etc.

I'd be all over that shit like stink on a freeper.

[DawgHouse]

3. Can you take the films

to another radiologist and let them have a look? Perhaps if a second radiologist believes another mammogram is in order, the insurance will pay for it? Was this a screening or a diagnostic mammogram?

[CoffeeCat]

5. This was my first mammogram....

Just a screening to get a baseline.

I'm 45, so I was a little late doing this.

I was also adopted, so I have no idea what lurks in my genetic background--which makes me
a bit more concerned.

[HopeHoops]

14. Have the film transferred somewhere else.

By law, they must comply with that request.

[Walk away]

4. And on top of that, you better hope you get to keep that insurance.

If there is a job loss and an interuption in your coverage that phone call might someday give some insurance lacky a reason to indicate a pre-existing condition. You have to be very careful what you tell these people.

[CoffeeCat]

7. So true...

i'm thankful everyday for the insurance we have.

I take nothing for granted these days.

[Ilsa]

25. Isn't it crappy how the insurance cos cover foe each other?

The first co gets out of paying for treatment for a new diagnosis while the second co claims pre-existing condition. Nasty racket. It wouldn't surprise me if they had a shared database of names and conditions to be on the alert for.

[AngryOldDem]

6. Sending good thoughts your way.

There has to be some way that your very valid concerns can be addressed.

Can you call your doctor and tell him/her point-blank that you want the films re-examined?

Please keep us posted.

[CoffeeCat]

10. Thanks for your kind thoughts...

You know, you really don't live up to your "angry" DU name!

I'm going to switch doctors and have this issue re-addressed with fresh eyes.

A friend, who is a nurse, recommended a good doctor.

Thanks again for caring. :)

[AngryOldDem]

27. Good for you.

I'm sure you'll get answers -- just hold your ground until you do.

[Lars39]

8. Take your films somewhere else and have another mammogram done, too.

Pick them up yourself. Make sure and ask the name of the previous radiologist that interpreted the first set of films. You'll have to pay for this out of pocket, but you need to know what that dot was. You've got to be able to trust your doctor...sounds like your doc failed the test and you need to find another. :hug:

[patrice]

9. Shouldn't you just buy another mammogram? While you debate this, of course, with your doctor.

[fasttense]

11. Interesting, we had exactly the opposite happen.

We're in the VA system. The doctor did a lung x-ray on my husband and because he had pneumonia, they said he had lung cancer. He also had some benign growths outside the lung wall. I can understand how the doctor thought it was cancer. But, Thank God, five tests and six months later, he was given a clean bill of health.

We ended up paying out about $60 for co-pays and drugs. Would an insurance company provide such great care?

[rucky]

12. Can you take the same mammogram film to a different doctor?

[MercutioATC]

13. Simple fix:

Get your doctor to order the film and view it together in his/her office.

If you don't see the spot, you can argue that they mixed up the films. If you do, he/she can discuss it with you.

[INdemo]

15. It might be worth it to call to the AMA but then they are probably on the

Doctors and or insurance side..But there has to be some avenue you can follow up on this...
So if this is the case and Doctors are instructed to diagnose these questionable "pictures" as negative then this is certainly criminal..so this may even be worth an attorney's involvement..
Now I am wondering if my wife's recent mammogram was read properly..
This is serious business and I definitely would get a statement from the tech take it to an attorney and go from there....

[NYC_SKP]

17. oops, wrong place..

OOPS posted in wrong place.

:donut:

[sinkingfeeling]

16. If you're really concerned there has been an error, then pay for another mammogram yourself.

[NYC_SKP]

18. Your doctor may have never even looked at the films.

Mine would have called me in to look at them with him, even under my shitty plan, but he's exceptional.

I picture your doctor referring only to the report and reading to you what it says, not even looking at the film.

I hope I'm wrong, I hope he or she is not that careless.

But if you saw a dot and he or she didn't, then either the films were lost or he or she is a big fat liar.

I hope everything works out!

:hug:

[OmmmSweetOmmm]

19. There are organizations that offer free mammagrams and my county offers them too.

[DemReadingDU]

20. Is there a health clinic you can go for a 2nd mamogram?

Tell them you don't have insurance coverage for the mamogram (and you don't because your current insurance won't pay for it!)

Some clinics are free, but if not, if you pay cash, you'll probably get a reduced rate.


Some places have 'health fairs' where people go to get cholesterol screenings, blood pressure checks, osteoporosis screenings, mamograms. They cost a small fee, but I think it would be worth it for peace of mind and a 2nd test.

[Emit]

21. I would contact the Radiologist and request a consult to review your films

Whether your insurance covers it or not, in this case, the expense is worth it.

I understand your situation. My son is deathly allergic to nuts and is allowed only one epi pen a year. We, however, need two epi pens in order to cover his school hours and hours he is at home (the school requires that one be kept in the nurse's office all year). To purchase a second, I have to come out of pocket $150 dollars each year. I have gone round and round with the insurance company over this issue.

[Emit]

22. Dupe

[nightrain]

23. So sorry.... can you get a referral to another radiologist to read the mammogram

and take it with you? pay privately? might be worth it to get answers rather than wait a year.

[Ilsa]

24. You may have to get the second mammogram for peace of mind. If

something shows up, go back to your first mammo office and get an appointment with the doctor to review the films again, and take your new films with you. Keep pressing the issue until you are satisfied that no one is deceiving you.

[SlipperySlope]

26. If it makes you feel any better, they aren't looking for "black dots".

Cancer shows up as a denser region, so they are actually looking for whitish blobs:

[nilram]

28. right -- it's a reverse image, so a black dot would be like

there's nothing there. I can relax now, I was anxious for the OP's sake...

[abumbyanyothername]

29. At the very least

you can get the films. They are yours.

That's a starting point.

If you get the films and the black dot is still there, schedule a visit with your Dr., even if it costs you a hundred or two. (Fight the insurance company later)

[Trillo]

45. "you can get the films. They are yours." Says who?

http://www.drvxray.com/ownership.htm

[Contrary1]

30. Go get a written copy of the radiologist's report.

And do this with every mammo from now on. If you need any help with the medical lingo, PM me. I'll be happy to translate for you.

[morillon]

31. Do they have mobile mammography clinics in your area?

There's a huge Mobile Mammogram bus that comes around here and parks at different places -- office buildings, etc. -- on some kind of schedule, and you can get a mammogram pretty cheap from them.

[cbdo2007]

32. Isn't this one of the problems with the health care system? Overreacting to something to

get some useless tests done?

What if you get it done again and there's a "green dot"?!?!?

Come on, stories like this literally don't help anything. Health insurance haters claim this as their new gospel.

Reality is that even with a public option, or a single payer, or whatever other plan you can dream up - nobody would let you go back to get a second opinion because you don't know how to read the mammogram, so why should they waste money by you telling them how to do their job when they know how to do it just fine?

[Contrary1]

34. Tell that to someone who was either undiagnosed or misdiagnosed...like me.

Never mind. No sense in wasting my time.

[cbdo2007]

37. So you think everyone should get double tested for every test they get done?

And you think this makes sense financially for the health care companies and the insurance companies?

You think the doctors have time to give everyone multiple tests for every symptom just cause the patient has a whim?

I know misdiagnosis is a problem but you can't blame the health care companies or the insurance companies all the time. You can blame doctors or nurses specifically, but people misusing their insurance to get multiple tests done, and multiple ER visits for routine checkups, and so on is a huge drain on the system.

[Contrary1]

39. Who said anything about a "whim"?

Anytime that anything out of the ordinary shows up, there should be a second test done. Insurance companies are banking that people will just go away and not worry about it.

[CoffeeCat]

42. You're missing the point...

I'm not reading a mammogram and coming up with a different opinion than my doctor.

Do you understand that a dot---that was incredibly obvious on the screen--was SEEN and
the technicial and I had a conversation about it. Then, my doctor tells me that my
film is clear---no dot.

A dot disappeared. That is the problem. I'm not looking at a dot and seeing cancer, and
then disagreeing with my doctor who says the dot is fine.

The dot is GONE.

It's insane to not question this.

[DU GrovelBot]

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[ecstatic]

35. The once a year testing troubles me too, as an anemic person

But would that change under single payer or a public option? Something tells me we'd still have the same once a year restrictions.

[Jakes Progress]

36. Oh but it will be so much better when everyone

is required to pay insurance companies to regulate their records and doctors.

[shimmergal]

38. There ARE programs that offer

free mammograms, aren't there? If any are offered in your area, see if you can get in on it. If you insurance co. won't pay for a retake under the circumstances, that should be equivalent to your not being insured at all. (I think the programs are primarily for women who're not insured, but maybe not limited to them.)

The dot could even be a flaw on the film surface, but you won't know that without at least a retake.
Good luck!

[DailyGrind51]

40. "They" found a dot on the x-ray of my lungs 30 years ago!

It turned out to be a speck of dust on the equipment, my lungs were fine, can't say the same for my lymph nodes, though.:-(

[mnhtnbb]

41. Call your doctor back. Tell her that for your peace of mind you would like

to see the film either with the radiologist or the doctor present.

Mix-ups do happen. You paid for the damn thing; you are entitled to an explanation.


But I will reinforce the notion that techs (and MD's) sometimes are wrong. An ultrasound tech told
me that my baby "looked like a girl" --around 6 or 7 months and I should have known better--
so when my youngest son was born it was a big surprise!

[CoffeeCat]

43. Thank you so much for the support...

...kind words and also for sharing your own medical experiences.

I'm definitely changing doctors. A friend who is a nurse recommended a great, new
female doctor.

I'll discuss this with her and go from there.

I posted my story because I think it's a good example of what can happen when profits
drive medical decisions. People become balance sheets, and their health and well being
becomes secondary--with cost containment being tantamount.

The insurance companies need to be taken out of the decision-making. Doctors need to make
these decisions, not the people who stand to profit or lose from making these decisions.

[AngryOldDem]

44. And you know what??

Everyone -- and I mean EVERYONE -- who is showing up at these town halls, threatening congresspeople, and spreading the lies and the fear will most likely find themselves in a very similar situation themselves someday. Maybe THEN they will learn.

Good luck to ya.