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Say It Ain't So

My newer doctor that I got connected with by my Pharmacist, has unfortunately been a dud. It always feels hopeful and positive in the first 2-3 visits but the tune tends to change with the not so good ones, which was the case with this one. My health care is so intertwined with the car insurance company and is heavily leaned upon what a doctor (especially my family doctor) says and does. The car insurance company of British Columbia does this on purpose, sinking them with endless paperwork, assessments, letters, phone calls, which I know is the last thing that the doctors need with their busy schedules, but we as British Columbians didn't make these rules, our government has. When you mix this with doctor shortages and a crazy virus that shuts the whole world down, you are crossed with even more challenges to your much needed care. Tip toeing, trying to not ruffle feathers and being extra careful on what you say and how much you bring to the appointment to talk about, it becomes an added uphill battle. This type of system burns relationship building and hinders the patient\doctor relationship, and yet each doctor that I have spoken to are well aware of the horrible tactics that this company does and though they understand, I still get mixed up with the grumpiness and irritation of needing the help and support of a note because any doctor that sticks their neck out for you, is now at the mercy of being sunk by the insurance company with paperwork, letters, phone calls, assessments, etc.

I had a phone call appointment with my doctor and needed to talk about the car insurance company and what I needed him to write a note for me about. That was all. To my surprise, I was met with "I don't have time for this," and the phone was abruptly hung up on me. Another time, I sat in his office and relayed some medication ideas that my Pharmacist had researched and recommended for me. I got met with him telling me that he would never prescribe me any of the recommendations and if I understood what he was saying, "Do I make myself clear?" I felt more like a chastised child than a grown woman, sitting in a supposed trusted, safe environment.

One phone call appointment, my family doctor brought up the car insurance company. He told me that they had phoned him and in his words, "This adjuster is very pushy and out for blood." He told me that she was trying to shut down my treatments and to be prepared for being sent to an IME ( independent medical examiner). I had asked him what he said or if there was anything that stood out to him or what else I should know. He told me that he wanted me to bring in a break down of treatment plans from my physiotherapist as well as any and everything that showed support for my care, because he needed back up for sending in a note to continue forward with my treatments. I mentioned the plan to my physiotherapist and he explained that he never speaks to the adjusters on the phone, as they can easily coerce you, and to tell my doctor that he should only be corresponding with them by email or letter. I relayed the message to my doctor and provided him with a binder that my husband put together with an index, highlighted important information, and tabbed pages for him to easily access important medical information and back up for my care. I asked again, "Did you say anything else to them? Did you give them anything?" His reply was that he just needed more information and that he couldn't quite remember all of the details.

The next thing I know, we are being told by the insurance company that my doctor is going back and forth on things and that because of his wishy washiness, I needed to be sent to an IME to get a valid opinion on my care. In the meantime, they went behind my back and called my physiotherapists office informing them that I would be cut off by a certain date and my treatments would no longer be covered by them. It was so confusing as to what basis they were making this decision on and we were left in the dark. As far as we had known, we gave the binder of proof to my doctor, which he was more than satisfied with, and he wrote notes supporting me.

The amount of games that the insurance company has played with us, is too many to count. We've been threatened by them so many times and once these threats are challenged or questioned, it only causes more strife on our part. More hoops to jump through, more emails drawn up to bring in upper management, and a whole heck of a lot more stress and pressure. There has been countless hours of anxiety and figuring out the next game plan and all of the angles around this, but interestingly enough, we have found that they have a large bark but their bites don't allow for much. They are truly empty threats or carefully curated wordings that give a lot of fear and seeming power, but when broken down or put up against their own regulations, they don't have that say so, which you would never know unless you read their regulations and upped it to the manager. But they will make you pay for challenging their authority, which becomes this vicious, endless circle of the stupid dance they do and they don't care because they have endless adjusters and endless monetary funds, as well as lawyers that give them the upper hand. One adjuster told my husband this on the phone, " We don't care, we'll just bring it to our lawyers." The wording in their regulations is all left open ended, conveniently enough to benefit their side. As an example, a regulation will sound really good but then the wording at the end will be " under the discretion of the claims specialists." So, whatever type of personality type or grumpy pants jerk or someone who is just having a bad day, can create this massive ripple effect on your treatment plan.

My massage therapist has had to deal with them for her clients and she said, "It's as if they are all trained like the border control officers with added fear and intimidation tactics." They remove humanity, care and compassion out of the equation and it is ultimately a government run business that is all about making money and making cuts to save a dollar for their own gain.


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