2nd trimester: Real Life Drama of the OB

by longtallyarn

I have been fortunate not to have had any morning sickness or any real symptoms other than weight gain and acne.

We had our third OB appointment with Mid Carolina last week.  The obstetrician listened to the heart beats.  The one on the right was beating about 150 bpm, the one on the left was beating at 140, until the sonar device started poking at it.  The doc said it was probably initially resting because after that, its heart beat picked up to about 150.  At one point she was able to pick up both babies’ heartbeats and mine at the same time.  Pretty neat.

The doc also listened to some of our questions.  Dr. Wind is the one I have liked the best so far at the practice.  She actually sat down on her chair and seemed interested in talking with me.  In the course of asking her opinion about something, I mentioned that I had applied for Pregnancy Medicaid.

This may have been a mistake.

Within a day or two I got a call from Mid Carolina.  Someone I assumed was a nurse needed to talk with me–could I call back?  I got this message too late in the afternoon and worried for the rest of the day that they had found something wrong with my labs…

When I reached the “nurse” the next day, she told me she was from billing.  Did I know they didn’t take Medicaid?  Yes, I knew that, and had planned to look for another doctor if I was approved.  Or maybe I would stay with Mid Carolina and pay my out-of-pocket expenses out of pocket if I couldn’t find another doc I liked.  She suggested that if I might be changing docs I should go ahead and make an appointment with one who took Medicaid because it might be difficult to make an appointment with short notice.

Two days later, I got another call from Mid Carolina.  Another individual asking me if I’d made an appointment with someone who took Medicaid.  No, I hadn’t done it yet.  I told her that it had been difficult to find someone who would take it.  I thought I might call Triangle OB, but was undecided since I had read some poor reviews of them online.

Would I like her to go ahead and send my files over to them?  she asked.  I asked her if I could keep my appointment with Mid Carolina until I found out about the Medicaid and made a decision about the docs.  She said she would ask the doctor but she didn’t know.

Then she explained that Dr. Creighton, who I think owns the practice but whom I haven’t met yet, and Dr. Madison, the first doctor I had seen, had decided that I was too high risk for them to treat.

She offered to refer me to one of the obstetrics clinics at one of the larger hospitals in the area.  Wake Med, Duke, or UNC.  She said I could have until Monday to decide.  This was Thursday.

On Friday morning I called her back.  She was delighted to hear from me, and delighted that I had chosen Wake Med.

On Friday afternoon, the Wake Med clinic called and said they had recieved a bunch of papers and labs about me, but weren’t sure who I was or why I had been referred.  Did I want to be treated by them?  Should they make me an appointment or should they discard my files?

What I think happened is that the professionalism at Mid Carolina took a nose dive when I told them that I was applying for Medicaid.

I have since heard that many docs discriminate against Medicaid patients because many patients abuse Medicaid.  Another issue is that Medicaid doesn’t reimburse doctors fairly, and requires so many submissions of paper work that most of them prefer to just write off Medicaid patients as a loss.

This makes me wonder why people think things will improve if the federal government takes over all of health care, but that’s another blog topic.

I still feel that Mid Carolina should have given my individual situation some consideration.  I have not abused Medicaid.  In fact I have never used it before.  I have not had a large number of children, and am not reliant upon the government for my every need.  I have been paying taxes since I received my first W-2 in 2000.

Just because I have applied for Medicaid doesn’t mean that I will not pay my bills.  In fact, I had paid Mid Carolina all that they had asked so far.  I have made a point to always hold a job that provides medical insurance, and still do so.  I am at a low point financially right now, like a lot of people, and was hoping that Medicaid might step in and pay what was left after Blue Cross stopped paying.  I guess I was looking for some assurance that if the twins require a hospital stay, as I have read they sometimes do, I will not be left with a “co-insurance” bill for 20% of half a million dollars.. .

In reality, I was a not any higher risk at my third OB visit to Mid Carolina than I was at my first, when they discovered I was pregnant with twins, and I have been compliantly following the advice of my doctors.  The fact that Mid Carolina’s representative would have been happy to transfer me to Triangle OB, a regular OB provider who may accept Medicaid, makes me think that they were more intent on getting rid of me than on getting me to a higher level specialist.

The good thing, from my perspective, is that it worked.  I hope that I will not, now, be supervised in labor and delivery by a doctor who is preoccupied with the fact that I applied for Medicaid.  I know that doctors work for a living just like the rest of us, but I like to think they also care about my health and that of the babies.

P.S.  On the day that Mid Carolina told me I would need to find another obstetrician, Medicaid sent me a notice that my application has been denied because my income is more than the allowed amount to receive Medicaid.