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Author Topic: Unnecessary doctor visit for lab results?  (Read 3541 times)

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Offline Ocean1617

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Unnecessary doctor visit for lab results?
« on: May 21, 2012, 05:31:41 AM »
Hi all:

I have just started my meds this month. My doctor states that she only gives out 3-month refill on the meds per prescription. I guess this is normal for a person who just started meds. So, that means I have to visit the doctor's office every three months for them to collect my blood and to get a new prescription. I asked the doctor whether I have to come back for the lab results, and she said yes. Is this standard practice? So, when people say they have to see their doctors twice or four times a year, do they mean four or eight times a year (one appointment to collect blood and another to receive the lab results)? I understand if the lab results warrant further discussion or consultation with the doctor. But, what if the lab results are ok, is the second visit to the doctor unnecessary?

Offline darryaz

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Re: Unnecessary doctor visit for lab results?
« Reply #1 on: May 21, 2012, 08:49:02 AM »
Sounds pretty similar to the way things work where I live.  Drawing blood takes less than 5 minutes and where I go you don't even need an appointment.  Just show up between 8:30 and 5 on that day.  Then I see the doc about 2 weeks later.

Offline mecch

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Re: Unnecessary doctor visit for lab results?
« Reply #2 on: May 21, 2012, 12:56:48 PM »
Yes, its standard in Switzerland.
Drawing blood - you don't see the doctor.
You go back a week or so later when he/she has the results, and that's the doctor consultation.
When you have been on HAART awhile, with everything is going smoothly, doctors can be cool with phone consultations. 
As for the 3 month refills, it seems normal enough.  I dunno, maybe its a bit stingy but you can ask your doc for the rationalization. Might be a concern about costs and making sure medicine is not wasted.
I bet if your HAART goes swimmingly, you'll be down to every 6 months or so soon enough.
ďFrom each, according to his ability; to each, according to his needĒ 1875 K Marx

Offline miked

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Re: Unnecessary doctor visit for lab results?
« Reply #3 on: May 21, 2012, 01:31:04 PM »
My doc likes to see me every 3 months, it usually drags out to more than 4.  He will send me lab results by email.  My previously doc would call you with the results.  There is no reason that they should require you to go in just for the results, but if they want to discuss changes in your meds because of that, the situation changes.

Offline Miss Philicia

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Re: Unnecessary doctor visit for lab results?
« Reply #4 on: May 21, 2012, 01:35:47 PM »
My doc likes to see me every 3 months, it usually drags out to more than 4.  He will send me lab results by email.  My previously doc would call you with the results.  There is no reason that they should require you to go in just for the results, but if they want to discuss changes in your meds because of that, the situation changes.

I agree, generally -- but the OP is newly diagnosed so perhaps that's why his/her doctor is doing it this way initially.
"Iíve slept with enough men to know that Iím not gay"

Offline newt

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Re: Unnecessary doctor visit for lab results?
« Reply #5 on: May 21, 2012, 02:28:05 PM »
If everything is fine I really don't see what's wrong with a phone call

- matt
"The object is to be a well patient, not a good patient"

Offline Ocean1617

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Re: Unnecessary doctor visit for lab results?
« Reply #6 on: May 21, 2012, 03:14:47 PM »
Thank you guys for all your replies.

Now, I know what to do. I just asked the doctor's office to send me to the lab directly, and I just make an appointment 2 weeks after to see the doctor for results and prescription. I'm trying to avoid setting foot into the doctor's office unless necessary. They tend to charge me for anything they can think of even for just collecting blood, and it's expensive. This way they can only charge me just for that one office visit.

Offline eric48

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Re: Unnecessary doctor visit for lab results?
« Reply #7 on: May 21, 2012, 06:32:27 PM »
Our standard here is every 4 months

At beginning of therapy was every 2 weeks... (because of the combo I chose), then gradually reduced to once every 4 months.

I am able to manage it through my schedule, but, the one I found annoying is that our local regulation, despite allowing a 4 months prescription, does not allow the pharmacist to provide for more than 1 month (and needless to say, we do not have the luxury of home delivery...). Isn't that ridiculous ?

That one was really stressing because you have to go to the pharmacy in person to give your 4 month valid prescription once a month, then go to the pharmacy again one week later

Noway I could manage it with my work and level of (dis)stress !

So I went pharmacy-shopping, explaining my case, until I found one smaller independent pharmacist more than happy to have a high prescription customer and to accommodate my schedules. instead of 8 pharmacy visits per 4 months period I am down to 2 and working on towards 1

If  you are not too happy with the doc, depending where you live, you can try to find a  doc more accommodating.

Me, I would not do that since I have a doc worth dating ;-)

Cheers! Eric

NVP/ABC/3TC/... UD; CD4 > 1000; CD4/CD8 ~ 2.0   safety stock : 2 months

Offline Ocean1617

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Re: Unnecessary doctor visit for lab results?
« Reply #8 on: May 21, 2012, 07:05:37 PM »
@eric48....

Thanks for the reply. I didn't know that different pharmacies can dispense medication at different frequencies. I thought the frequency is determined by the insurance companies--mine is spelled out in the handbook:  (1) regular pharmacies can dispense every 30 days and (2) mail order pharmacies can dispense every 60 days. Luckily, I only have to present the prescription once which is valid for 3 refills.

I guess I'm neutral/happy with my doctor because I have no other points of reference. The good news is that I don't dislike her. She seems to be respectful, knowledgeable, and it is not that difficult to get an appointment with her. Oh by the way, big thanks for lettting me know that I can shop for pharmacies and doctors just like I shop for deals on plane tickets and vacation packages. This is really helpful. I promise I won't get too crazy shopping. Top of the shopping list:  an HIV specialist who is worth dating.

Offline darryaz

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Re: Unnecessary doctor visit for lab results?
« Reply #9 on: May 21, 2012, 07:19:21 PM »

Me, I would not do that since I have a doc worth dating ;-)


Yeah, me too!!!  :)

Offline emeraldize

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Re: Unnecessary doctor visit for lab results?
« Reply #10 on: May 21, 2012, 09:55:10 PM »
After you build up a relationship and if your numbers are satisfactory, ask if you can get your labs on a quarterly basis and get results by phone or e-mail and then have a face-to-face visit once every six months. My personal goal is to get it down to the equivalent of a car inspection -- one visit a year, get a sticker on my forehead, and oil changes (labs) on a 3-4 month interval. I'm almost there.

Offline J.R.E.

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Re: Unnecessary doctor visit for lab results?
« Reply #11 on: May 22, 2012, 01:26:20 AM »
Hi,...

When I go to my HIV doctor to get the lab results, I've already had those results about 3 weeks prior. So I already know those results, I get them on-line'. My follow up visit with the doctor ( to discuss labs is generally about 3-4 weeks after the last labs were taken.


So the doctor will discuss lab results, even if all is A-OK. The visit is usually not longer than 30 minutes.

But ,... He will also check my weight, blood pressure, look down my throat, look into my ears, look in my eyes,  listen to my lungs, listen to my heart.

I will then lay down, and he will push and probe around the abdomen, checking for things, I will the sit back up and he will feel on each side of the throat, and then feel under the armpits.

This is what I go through every 3 months, when I see the doctor, for the last 9 years.

He will then ask me questions like, do you have diarrhea, constipation, he will ask me how my vision is, And ask me about the degree of pain associated with the neuropathy ( if it's worse, better or no change).

 He will ask me if there are any other issues that he should know about, or anything that I would like to discuss with him.

Finally, he ask if there is anything he can do for me, and then says he will send the order out for 4 months of meds. 

This is how the VA does it, and prior to going into the VA healthcare system my previous doctor did exactly the same thing, with just about exactly the same questions.


I look forward to these follow up's , because they are not just to discuss lab reports, he is physically checking me over to see how everything is.


Ray
« Last Edit: May 22, 2012, 04:31:37 AM by J.R.E. »
Current Meds ; Viramune, Epzicom, 40mg of simvastatin, 12.5mg of Hydrochlorothiazide.
Metoprolol tartrate 25mg



http://forums.poz.com/index.php?topic=40802.0

http://forums.poz.com/index.php?topic=45159.0

http://forums.poz.com/index.php?topic=39722.msg495621;topicseen#msg495621

http://forums.poz.com/index.php?topic=46806.0

http://forums.poz.com/index.php?topic=39414.msg491701#msg491701


 In October of 2003, My t-cell count was 16, Viral load was over 500,000, Percentage at that time was 5%. I started my first  HAART regimen  on October 24th,03.

 As of 8/2514,  t-cells are at 402, Viral load <40

 Current % is at 11%

  
 62 years young.

Online leatherman

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Re: Unnecessary doctor visit for lab results?
« Reply #12 on: May 22, 2012, 03:26:04 AM »
Finally, he ask if there is anything he can do for my, and then says he will send the order out for 4 months of meds.
for 20 yrs, I've always seen the doctor and gotten my lab results 2 wks after my blood draw. Along with the poking, prodding, looking down my throat, taking my BP, etc, he's checked the charts to keep me up-to-date on all my shots. I used to have to see the doc every 4-6 wks back during the "AIDS yrs". Luckily in the last 5 yrs when my counts have been stable, I've been able to stretch that time out longer and longer. I was very pleased at my last visit to hear that I didn't need to come back for the next lab work until 9 months later.  :D

I've also found out if I'm foolish enough to admit to the sex I've been having since the last visit 8), then the doctor is libel to stick things inside parts of me so he can run tests for other STDs. :o
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Offline Miss Philicia

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Re: Unnecessary doctor visit for lab results?
« Reply #13 on: May 22, 2012, 10:43:47 AM »
For some reason the clinic I go to has a funding mandate (I assume via the City Dept. of Health) that requires a minimum of a doctor's visit/lab work every four months. My doctor actually apologized for not allowing me to do it just ever six months since I am so stable and have no adherence problems. I assume this is related to the recent statistics that only one in five diagnosed HIV patients actually stay in medical care on a regular basis. Personally based on those statistics I can understand doing it that way.

As far as bloodwork I pop in with no appointment 5-7 days before my doctor's appointment and have it taken. But then I only live one mile (1.35 km) from the clinic so it's not a big deal for me.
« Last Edit: May 22, 2012, 10:48:29 AM by Miss Philicia »
"Iíve slept with enough men to know that Iím not gay"

Offline aztecan

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  • 29 years positive, 57 years a pain in the butt
Re: Unnecessary doctor visit for lab results?
« Reply #14 on: May 23, 2012, 11:26:36 PM »
For some reason the clinic I go to has a funding mandate (I assume via the City Dept. of Health) that requires a minimum of a doctor's visit/lab work every four months. My doctor actually apologized for not allowing me to do it just ever six months since I am so stable and have no adherence problems. I assume this is related to the recent statistics that only one in five diagnosed HIV patients actually stay in medical care on a regular basis. Personally based on those statistics I can understand doing it that way.

As far as bloodwork I pop in with no appointment 5-7 days before my doctor's appointment and have it taken. But then I only live one mile (1.35 km) from the clinic so it's not a big deal for me.

Yep, a lot of people, especially the more recently diagnosed, don't see the need for regular doctor visits and lab work.

At our recent HIV update sponsored by the state, one doctor said statistics show that people who miss appointments during their first year after diagnosis actually have a shorter life expectancy.

The reason was it seems people who ignore their health early on tend to not seek care when they need it, or not until there has been disease progression.

For the first six years after diagnosis, I didn't see a doctor. It wouldn't have done me any good anyway.

But after I did start seeing a doctor in 1992, and for the 10 years thereafter, I saw my doctor every three months. I would do labs a week or two prior to my appointment, then go in for results.

The doc then reduced the number of visits, so now I go twice a year. But I have been stable for a long time.

HUGS,

Mark
"May your life preach more loudly than your lips."
~ William Ellery Channing (Unitarian Minister)

Offline J.R.E.

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Re: Unnecessary doctor visit for lab results?
« Reply #15 on: May 24, 2012, 07:54:15 AM »

For the first six years after diagnosis, I didn't see a doctor.

Mark

And I didn't see a doctor for anything HIV related until 14 years after I was diagnosed.  :o

The next time I saw a doctor was in 2003, when I was knocking on deaths door. Not smart at all !



Ray
Current Meds ; Viramune, Epzicom, 40mg of simvastatin, 12.5mg of Hydrochlorothiazide.
Metoprolol tartrate 25mg



http://forums.poz.com/index.php?topic=40802.0

http://forums.poz.com/index.php?topic=45159.0

http://forums.poz.com/index.php?topic=39722.msg495621;topicseen#msg495621

http://forums.poz.com/index.php?topic=46806.0

http://forums.poz.com/index.php?topic=39414.msg491701#msg491701


 In October of 2003, My t-cell count was 16, Viral load was over 500,000, Percentage at that time was 5%. I started my first  HAART regimen  on October 24th,03.

 As of 8/2514,  t-cells are at 402, Viral load <40

 Current % is at 11%

  
 62 years young.

Offline eric48

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  • @HIVPharmaCure & tinyurl.com/HIVPharmaCure
Re: Unnecessary doctor visit for lab results?
« Reply #16 on: May 24, 2012, 05:36:23 PM »
Some meds will require a bit more in-depth monitoring (e.g. viramune for the liver)

I have just met my all new cardiologist: the ace of a first -in-class research and prevention facility.

He said the virus warrants this kind of monitoring, and , as he was scrolling my 'numbers' I had the impression , that :
A- this superb monitoring is not so much required in my case, but they seem to be happy to monitor some low risk patients as 'control'. test have not been completed yet, so, let's wait and see..
B- I get this free of charge
C- I would never get such expert monitoring if I were not infected.

It is a bit of a pain when one has a busy schedule, but could turn out beeing a blessing if monitoring can detect a problem early , that would otherwise been left unattended.

Eric


   
NVP/ABC/3TC/... UD; CD4 > 1000; CD4/CD8 ~ 2.0   safety stock : 2 months

Offline Ocean1617

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Re: Unnecessary doctor visit for lab results?
« Reply #17 on: May 25, 2012, 01:15:10 PM »
Thank you everybody for the replies. This is very helpful.

It makes me think about my current doctor. I saw her twice so far. The first appointment her staff took my weight, heart rate and blood pressure. She then talked to me and drew my blood. I left.

I came back two weeks later, and they took my weight, heart rate and blood pressure again. She then looked at my lab results, VL, CD4, resistance data, etc. She then told me I should take medication and to come back after six weeks on medication. She hasn't listened to my lung, probe my abdomen, arm pit , looked down my throat or asked me anything about my sexual behavior. But again, it's just my first two visits. I did ask a few questions, and she answered them ok. I'll keep what you guys told me in mind. I may have to switch doctor anyway because I plan to move in a few months.

I'm not sure if she is not being thorough, or I looked ok and she didn't need to ask me those questions. I'll keep this in mind.

Agian, thanks guys.

Online leatherman

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Re: Unnecessary doctor visit for lab results?
« Reply #18 on: May 25, 2012, 06:28:09 PM »
I'm not sure if she is not being thorough, or I looked ok and she didn't need to ask me those questions.
"looking ok" isn't worthy of being called a diagnostic skill. My partner "looked ok" but ended up dead 69 days later from cancer. I "looked ok" for 8 or 9 yrs till I didn't look so good and was diagnosed with AIDS.

With you as a new patient, she should have thoroughly checked you out to determine your condition as she doesn't know you from adam's house cat. Every time I've switched to a new ID doctor (never have used a GP), I've been given a thorough physical and by the second visit I was receiving any need innoculations (flu, hep, pneumo, etc along with tetanus), a TB test, and other STD tests (because I identified as sexually active). I also got "the lecture" (about safer sex).

I would say that it doesn't matter whether you look "well" or not, sadly your doctor is just not thorough.
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Offline denb45

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Re: Unnecessary doctor visit for lab results?
« Reply #19 on: May 25, 2012, 07:13:22 PM »
I started AZT in AUG of 87 2 months after my DX, and I took whatever I was prescribed thereafter, I was on AZT for almost 4 yrs. until they had something better then they added DDI and 3TC around about 91 or 92 if my memory serves me right  :(

all the AZT did was make all my body hair fall-out  :-[
and it had some wicked-side-effect to boot......I saw my ID Doc every 3 to 6 months at that time, maybe that's why I'm still alive today, don't think I'd be here today typing this I didn't. so to the OP........don't ever think that going to the doc is
unnecessary  ::)
"it's so nice to be insane, cause no-one ask you to explain" Helen Reddy cc 1974

Offline J.R.E.

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Re: Unnecessary doctor visit for lab results?
« Reply #20 on: May 25, 2012, 07:28:37 PM »
Hello Ocean,

I understand you have a lot going through you mind right now, especially just starting on meds....



...and by the second visit I was receiving any need innoculations (flu, hep, pneumo, etc along with tetanus), a TB test, and other STD tests (because I identified as sexually active).

But when you get an opportunity, talk to your doctor about the above immunizations. It's good to get them done and out of the way, if you haven't had them. It's taking control and being in charge of your health !

I get an annual flu shot, I've had the pneumonia shot ( and Booster) tetanus...

http://www.aidsinfo.nih.gov/contentfiles/Recommended_Immunizations_FS_en.pdf


Take care ---Ray

Current Meds ; Viramune, Epzicom, 40mg of simvastatin, 12.5mg of Hydrochlorothiazide.
Metoprolol tartrate 25mg



http://forums.poz.com/index.php?topic=40802.0

http://forums.poz.com/index.php?topic=45159.0

http://forums.poz.com/index.php?topic=39722.msg495621;topicseen#msg495621

http://forums.poz.com/index.php?topic=46806.0

http://forums.poz.com/index.php?topic=39414.msg491701#msg491701


 In October of 2003, My t-cell count was 16, Viral load was over 500,000, Percentage at that time was 5%. I started my first  HAART regimen  on October 24th,03.

 As of 8/2514,  t-cells are at 402, Viral load <40

 Current % is at 11%

  
 62 years young.

Online leatherman

  • Member
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  • Google and HIV meds are Your Friends
Re: Unnecessary doctor visit for lab results?
« Reply #21 on: May 25, 2012, 07:55:09 PM »
great link there Ray!
Interesting too - chickenpox is recommended, Shingles is NOT.

now I'm heading over to that shingles thread to post your link so the ones talking about getting a vaccine will think twice.  ;)
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Offline Bbnb

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Re: Unnecessary doctor visit for lab results?
« Reply #22 on: May 28, 2012, 12:26:11 PM »
My experience is similar to other posters here. I went to the doctor every 3to4 months  when I first went on meds. Once the doctor saw that I was responding well /numbers regulating as well as other side effects are managed,  they changed me to every 6 months.

What you are experiencing with doctor visits, doesn't sound out of the norm to me. 
Just looking to socialized with like minded people.

 


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