Being Refused Doctor Treatment for Illegitimate Illegal Reasons

Readers of this article will need to read my immediately preceding one titled: “My Horrific Experiences with Certain Medicare Doctors”. The reason being that this one is directly related to the other. Each will give better understanding to the other.
This one is a response I made to a doctor who, on the same day of only my second appointment with him, dismissed me as a patient by written letter. According to HIPAA and possibly COBRA laws, doctors are never supposed to refuse an established patient unless for highly legitimate reasons. This doctor’s reason was due to my refuting his suggestion that there was nothing wrong with my lungs, when 5 years of consecutive testing shows very clearly that there is something to worry about, including symptoms. Hypochondria is attempting to be implied as the problem but when you read what my Pulmonary Function Tests (PFTs) are saying in the main body of this article below, this is a slough-off diagnosis (he supposedly reviewed all of these tests). It is one that spares a doctor in question, further investigation for “cause”. Please read-on to understand what I mean by this. {Note: I have had doctors diagnose COPD and sometimes Restrictive Lung Disease – the latter being the correct one but finding “cause” can mean the difference between me living longer or dying younger.}
My Reply After Dismissal by the Doctor:

Dear Doctor,
You were anxious to send out the dismissal letter dated April 12th, 2017 (very same day as my 2nd office visit with you), with my next ‘appointment’ not being until December 2017. Your very first sentence (my wife being present) was “I don’t think you have anything to worry about.” The letter you sent to dismiss me, reveals to me that you are offended at patient feedback, especially if it is stated passionately. Yes I did get somewhat forward with you after your remark saying “there’s nothing really wrong” but you have to understand I have been given this same runaround regarding my lung illness for 5 years. Let a legally appointed doctor see my tests and see what answer you get from them. No one, but no one among Medicare MDs knows what it is. However, upon my calling The National Jewish Hospital and speaking to an NP on the phone twice, she said it was a rapid decline according to my ongoing PFT testing.
Her other advice to me was that a pulmonologist needed to find out what “the cause” was, instead of my being told “you have very minimal obstruction” (with 20 points drop in FEV1 and FVC separately and worsening symptoms). I’ve been told this minimal obstruction brush-off at each and every visit with doctors like you; board certified as pulmonologists. I’ve had at least 6 points drop in my FEV1 and FVC at every 6 month office visit and little to no response for it with bronchodilator use in an office test setting.
While I realize you don’t like patients seeking knowledge online, my sources are always the top in the world – The National Institutes of Health, Medline Plus, Mayo Clinic, National Jewish Hospital, Medscape,, Merk Manual and WebMD. These sites have articles stating that restrictive lung disease presents exactly as mine does. The FVC/FEV1 ratio will be normal or even above normal but separately they’re low. I have gone to 3 different Doctors (I have statements showing this), who I actually asked if I could get bronchoscopy but all three backed out, not having the time. My regular Dr. knows about these. He also knows that I went to a cardiologist who would not perform echocardiogram (a follow up one after 3 years – the previous showing several problems), and, even with my appointment being set up for it which was confirmed a second time before the appointment. The reason? Again it was due to time constraints in my strongly-held opinion. He didn’t even listen to my heart with a stethoscope, just as you didn’t listen to my lungs with yours on my 2nd visit (several months apart from the 1st visit with you) – my wife was with me for both.

The true problem? Dr.s want smooth visits with patients and even though the NIH has a radio spot stating “Talk to the Dr. you’re seeing or they will clam up” (exact words). The AARP magazine I receive says “Do not accept ‘it’s just aging’ or other sluff-off snap diagnoses, when you know you have something that needs further attention”. This leads me to my final point. The NIH and other reputable sources state that the “Doctor Burnout” problem is severely bad. If you do a search on the subject, you’ll see there are endless pages on this. One problem is that some doctors entered their profession with true intentions of abiding by their oath and because they literally do have compassion (like my Primary Care Physician). Others entered the profession simply as a career move. …Which of these are you? Have you come to resent patients? Last of all, I have too many ailments/diseases (tests confirm this), that cause me daily suffering, to let the scariest one be sluffed-off – “When you can’t breathe, nothing else matters” (American Lung Association).
My wife and I (married 34 years as of 2017), have family like everyone else, including 2 grown kids – the oldest, age 32, my son who has given me a granddaughter (now age 11) and my age-27 daughter who is a coordinator at an office in OKC for people with substance abuse and domestic abuse problems. She has a Masters but plans to get her Doctorate and PhD. This type information of a human life should wake up any doctor but if burnout is severe enough they will even detest this. Your very first words to us at the 2nd and last visit (again, my wife was there) were “I don’t think you have anything to worry about”. This is why I knew that very moment that you would not be my legitimate 2nd opinion pulmonologist. There is no need to transfer any records; your office never generated any and I have copies of all my past pulmonary records.

Cordially James Lowrance


My Horrific Experiences with Certain Medicare Doctors

This article, covers spiritual aspects regarding doctors who lose their compassion for patients, which I believe to be brought about at least to some degree by the enemy of mankind, Satan’s kingdom of hindering spirits.

Due to my having a lung disease problem, that has been called “asthma” by some Medicare doctors, “COPD” by others, possible “Pulmonary Hypertension” by some and “Restrictive Lung Disease” by yet others, it left me for years, wanting to know the true source of the problem. Everything has a ’cause and effect’ but these doctors who all had my very clear ‘Pulmonary Functions Tests’ to look at, showing 20 points drop in my most important lung functions, within a 4 to 5 year period. Example: FEV1 – a major test, went from being in the mid 80 points in year 2012 to a 20 point drop in the mid 60 points by year 2016. Symptoms-only are what took me to a pulmonologist in 2012 but my test ranges were normal back then. The same is true of the FVC – a 20 point drop in four years. The ratio of these two of course is normal (something doctors also highly consider) because they are both at the same low number, causing a normal ratio. {NOTE: All doctors are not bad; many are excellent, so if you’re a medical professional please remember my stating this as you read the remainder of this article.}
It’s like saying how do I get to 65% using two numbers? Well, you take 65 plus 65 which equals 130. You then divide that number by 2 and it equals 65 – that’s 100% of the number you wanted to arrive at. I had a doctor who only a few days ago, tell me that even with my main lung function numbers being mid 60% on FEV1 and FVC (varies from 65 to 67 depending on the PFT lab used), that because the ratio of the 2 together is normal, all is well. This is absolutely not true because a normal ratio between the two does not take away from the fact that the FEV1 and FVC, each separately, have dropped to a level that normally would represent “COPD stage 2”. With the ratio between the two being normal, this does in fact rule out COPD but at the same time is highly indicative of restrictive lung disease (some forms are deadly within 5 years of diagnosis). One PFT I had done at a doctors office had a computer-generated report/analysis, which stated “Restrictive Disease – Lung age 85”, which of course concerned me but my doctor at this office (different city we lived in when my daughter was in college) was great. I liked him very much and he said “Those analysis-readouts are not set in stone, so don’t lose any sleep over it.” However, like any normal person, I have suffered anxiety and depression ever since but I cope with it quite well with God’s help.
In fact there is a computer generated graph of my flow volume loop that shows an abnormal flattening also indicating a restrictive lungs pattern. I have an upper right lobe nodule with stable scarring around it but my lungs (plural) have either Atelectasis in them (areas of collapsed lung) or Scarring. I do have what I was told were minor heart problems, that could contribute to my breathing problem but has this possible connection been investigated? No, it has not…not even with my going to a pulmonologists, who sloughed me off and would not perform the test that I literally set the appointment for and confirmed with them by phone, before the office visit that I needed that specific test. I was supposed to get the test and there was no misunderstanding regarding my need for it but it still was not performed.
Because of these type battles with doctors, which should never occur, I have become a bit testy with some of them. Never with my PCP (regular Doctor) because he embodies what a true doctor should be and he is, I will guess, about 60 years of age. In my opinion, if a doctor has not burned out by his 40s, he is not a ‘career man only’ but one who actually cares about people and the oath taken by him is also ‘his calling’. The dilemma we also have in our USA nation, is a doctor shortage. This doubles-down on the difficulty in getting proper medical care because overbooked, continually-rushed doctors are more apt to become one of the burnout statistics. The WebMD online site states “Half (50%) of family doctors across all age categories said they had burnout in the 2015 report, up from 43% in 2013”.  If one looks at 2017 statistics, they are almost certainly higher than these numbers.
I have decided simply to live the best I can and let doctors slough me off whenever they like. When something gets bad enough, they’ll simply put me in ICU and I will die at a time of God’s choosing. I have opted out of artificial life support and even resuscitation if it is obvious that being brought back to life means more suffering for me. This may sound morbid to some readers, however, the battles with doctors over the years has done as much damage to my health as anything else. I’m a burn out statistic from the other side of the coin; as a patient. When you have constant pain and other symptoms, including not being able to breath properly, you simply don’t have the strength to battle doctor burn out. I will of course keep doing what my regular PCP asks me to do for the sake of my health. However, I will not battle specialists any longer, in attempt to get them to do the right thing. I ask God that he take them into his hands for the good or bad they do and I’ll just continue to live on. That’s really the best thing I can do after all that has transpired in the past. There’s nothing better than God fighting my battles; He’s far better at it than I am.
I will be posting a letter following this article, as a separate entry, that will be self-explanatory (I hope). It is in regard to my most recent but last battle with a specialist and/or a regular MD (I’ve also had to change PCPs for same reasons in the past). So, look for that posting that will likely appear above this article, since it will be a newer one. It is basically my response to this particular doctor writing a letter to me saying he no longer wanted me as a patient. Did I do something outrageous to make him slough me off completely? No, my wife was with me at both of my visits with him, she said I was straightforward at times but never raised my voice and certainly never threatened him. It was because I, as a patient suggested that certain things should be looked into.
He felt that by my doing this, I was disrespecting him as a doctor. I did also relate to him a negative experience I had with a cardiologist, so that he would suggest a different one. He said he already had planned to refer me to a colleague of his who is a cardiologist but this will now never happen. As I said before it is in God’s hands now, so I will simply let Him handle it from here. I will only do those more simple things, that I know are my duty to do (e.g. take meds my PCP prescribes and live as healthy as possible). Again, look for my next article – my letter of reply to a doctor who sloughed me off in writing. It contains some interesting information that most patients are unaware of but that they should be aware of!

Doctor Visit Steps Five Ways for Better Care

NOTE: The audio above is on the subject of “Hypothyroidism”, a disease that affects 10s of millions of people but that remains undiagnosed in approximately half who suffer with it. With doctor offices being very busy and sometimes overbooked with ill patients, there are things we can do to help us achieve the optimal results from our doctor visits.
1. Write down your symptoms in detail and the questions you wish to ask your doctor and bring the list with you to your office visit. The reason(s) this step is so important is because it assures that you will leave nothing out of the information that is important for your doctor to know about your illness or health concerns. Office visits at non-specialized doctors’ offices are roughly timed so that the doctor is in the examining room with each patient for approximately 8 to 10 minutes. When you have all the information you need to share with him on paper, to take with you, it can be covered more quickly by simply going down the list, rather than having to stop and remember each thing that might be significant. When your doctor sees your list in front of you, he/she will most likely have the courtesy to wait for you to express those things listed.
2. Research your illness, to have some basic knowledge, which will help you communicate better with your doctor. Most doctors are glad to see that a patient has educated himself generally about the illness or health condition he has, because this saves him from having to give the patient a basic overview or to educate him further about his condition at the time of an office visit. Doing a search on the Internet on health conditions, diseases and illnesses is the single most efficient way to learn lots of information from many sources. When doing so however, it is always important to gather the information from reliable, reputable medical sources, such as The Mayo Clinic, The Merck Manual Website, The National Institutes of Health, and the National Library of Medicine. The quality, more mainstream medical sources will assure that a patient who learns information about a medical condition he has will be getting reliable information to help educate him with general information about symptoms, diagnosis and treatment for his condition.
3. Ask for copies of any lab tests you have performed and keep these in a folder of your own, for reference purposes. According to the Health Insurance Portability and Accountability Act (HIPAA), patients may request copies of their lab test results to keep in their own records. This can be helpful for many reasons other than for insurance purposes, one reason being that patients sometimes switch doctors for various reasons. While a patient can request that his files from one doctor’s office be transferred to another office, this sometimes does not take place in the timing needed. When a patient has his own backup file to take with him to a new doctor office, it assures the information needed is immediately accessible. Another reason for having the backup records is because some patients wish to see two different doctors for second opinions, etc., and they wish to keep their original doctor as well. This assures both doctors are keeping a record of your files and that they will not question your dedication or devotion to either of them.
4. If you are prescribed a new medication, ask if “samples” are available. Doctor’s offices are given a supply of samples by pharmaceutical companies of many types of medications on a regular basis. Many times, doctors will give patients samples of a medication they wish to put them on a trial of, to see how they will do on it before having them fill a full prescription for it. They also give samples to self-pay patients who do not have insurance coverage and want to help them with the cost of starting a new medication, by giving them an ample supply of samples. The samples are supplied to doctor’s offices in large quantities and many times they have to dispose of significant amounts of these once they have reached their expiration dates, so don’t be shy in asking for them because they usually have plenty to give to their patients! It’s nice, sometimes, as well, to have the samples for a while, if you are ill at the time of needing the medication as it saves you from a trip to fill the prescription at the pharmacy.
5. Take your spouse, friend or relative to your doctor office visit, for support and a second set of ears. It is a known fact that many people get nervous when seeing the doctor. Nervousness can be a distraction, making it more difficult to take in everything the doctor is telling you. Another person you take with you into the examining room helps to keep you calmer and more focused in concentrating on what your doctor needs to inform you about. The second person you have with you can also serve as a second set of ears, to listen to the doctor and remember the information he/she gave you. Some patients have been known to take a microcassette recorder into the examining room with them, to make sure they have a record of everything the doctor informs them about. This is also not a bad idea if you don’t have a spouse, friend or relative available to go with you, to your office visit. These suggestions can help to optimize doctor office visits and to make them as effective for both the doctor and the patient as possible.