I am so frustrated. I just don’t even know what else to do at this point.
A week ago Monday, on April 18, I started a new post and wrote those two sentences. Then I saved as a draft and left it. By Thursday I was nearly blubbering into the phone as I tried to explain my situation to yet another person on the other end. I don’t understand why our health care system has to be so hard. And bureaucratic. And expensive.
I’ll focus on the “expensive” in a later post, but for now I’ll concentrate on the “hard” and “bureaucratic.” For nearly a month I’ve been trying to get my paperwork transferred from the Family Care practice where I am currently to an Ob-Gyn/Midwifery practice. I received my initial prenatal care with my primary care physician knowing that I would likely change mid-pregnancy. That was probably my first mistake. As early as 10 weeks or so I was “looking into” this midwifery practice and had pretty much decided that’s where I wanted to be. I liked the idea of having a midwife and having a natural birth in one of the hospital’s birthing suites. I liked that the midwives in this practice deliver at Pennsylvania Hospital, so I will have access to their Ob-Gyns, epidurals and other measures should they become medically or otherwise necessary. I’ve obviously never done this before, so while I would like to try a natural childbirth and stay away from a C-section if at all possible, I am trying to be open to other options and the reality that birth plans don’t always go as planned.
At my 12-week ultrasound appointment, they went ahead and scheduled me for my sequential screening’s second blood test (at around 16 weeks?) and my 20-week anatomy ultrasound. Since I had a good experience at my first ultrasound (and since I had agreed to be part of a University of Pennsylvania placenta study), I decided to remain under the care of my primary care physician through that 20-week ultrasound. I didn’t try to get an appointment at the Ob-Gyn/Midwifery practice until I was nearly 19 weeks. In retrospect, this was another mistake. When I called to see if I could get my paperwork transferred to the Midwifery office and schedule an appointment, the receptionist said they usually don’t accept new patients past 16 weeks. Since I had been under regular care, the receptionist said the decision to accept me would be up to the midwives after my paperwork was transferred and they had reviewed my files. (Apparently, some people try to come into the practice after 16 weeks without having previously seen any doctors–I had been having regular care since 8 weeks.)
The receptionist at the Midwifery practice was kind and told me I could go into my doctor’s office and fill out the release forms, or I could go to their office, fill out the forms, and they would fax it over to my practice. Knowing the over-worked, never-particularly-speedy-or-responsive office of my primary care physician, I decided to go to the new office and fill out the paperwork. That was on Thursday, March 24.
To fast forward through all the small details, I was told it would take 7-14 days for the paperwork to get transferred. I thought that was completely ridiculous. The practices are both part of the University of Pennsylvania Health Care System – why would it take so long? I wanted to just go to the office and photocopy the documents myself. Still, I accepted the red tape as part of the process and decided not to bug them until the end of the 14 days. Of course, the 14 days came and went and no phone call. I called to the Midwifery practice to follow-up, and although my contact on the other line was always friendly, she always said “no,” they had yet to receive the paperwork. Finally, I got confirmation that the paperwork was mailed on April 7. The receptionist told me it could take a week (April 14) for the new practice to get it in the mail. Okay, at least it was in the mail. I decided not to call back until after the 14th.
Meanwhile, I had a routine appointment scheduled with my primary care physician on April 14. I decided to go as planned because I didn’t want to get behind on my care, especially if I wasn’t able to get into the new practice for some reason. At that appointment, my primary care physician said she could see in my file that this other practice had requested my paperwork and that it had been sent. She thought 7-14 days sounded absurd and when I expressed some concern that my April 14 appointment wasn’t going to be in the paperwork that was sent over, she told me I could call her and she would make sure that it got to them quickly.
I waited until Monday, April 18 to call the Midwifery practice and follow-up. I figured surely they would have received my paperwork by this point, and while I knew a midwife would have to review my file before anyone would call to schedule an appointment with me, I just wanted to confirm that they had indeed received it. When I called on Monday, they said “no.” They still hadn’t received it. That’s when I opened my blog and drafted the first two sentences of this post. Tears of frustration overflowed, and I closed my office door to compose myself. Then, I called the emergency number my primary care physician had given me. I felt a little silly for calling her cell phone for such a request, but at this point I had had it. I nearly broke down as I told her they still didn’t have my paperwork. She told me she was going to look into it for me, and called back a little while later saying it had been faxed over.
When I called the Midwifery practice the following day, they still didn’t have it. They didn’t seem to know what I was talking about. I like my primary care physician. She went out of her way for me. I don’t think she was lying. Most everyone at the Midwifery practice was friendly, but there was obviously a communication breakdown somewhere.
I called my primary care physician’s emergency line again and told her they still didn’t have my paperwork and that they had no recollection of speaking to anyone from the Family Care practice. At this point I think my doctor was pretty perturbed herself. She said she would fax it over personally that night.
The next day, last Wednesday at this point, I didn’t get a chance to call the office until almost 5:00pm. My regular contact wasn’t working, and the woman I was supposed to speak with was already gone for the day. I would have to wait and call again on Thursday.
I called early on Thursday morning and the receptionist who has been my main contact was out of the office again. I was trying to be assertive, but it’s likely I was also being slightly bitchy. The receptionist informed me I was never to call that direct line again. Apparently, the number I had been calling was a doctor’s only line. I had called it at least a dozen times as I misunderstood it to be the direct line given to me by my contact. Never before had anyone expressed that I had the wrong number, and at this point it was more than I could take. When she transferred me to “records,” I was already beginning to cry – my voice cracked as I introduced myself and it was clear that I was at my breaking point. Although I felt embarrassed for not keeping my composure on the phone, I realized the woman deals with pregnant women everyday and is probably used to them getting emotional. Finally, she confirmed that “yes,” they had indeed received my paperwork.
Sorry this post was so long-winded. I didn’t intend for it to be so detailed, and clearly it was more for me than anyone reading. However, if there are any other first-time mom readers who are considering changing practices, I’d definitely recommend trying to put things in motion sooner than I did. I’ve also heard that someone in a similar situation went to her doctor, told them she would be traveling the following week and requested a copy of her paperwork to take with her on the trip. They released the paperwork to her within days, and then she copied it and handed it directly to the new practice. I don’t know if this would have worked for me; I have the feeling they only would have accepted the “official” paperwork straight from the doctor’s office, but I guess it would be worth trying.
This process has left me exhausted. When I finally spoke with one of the midwives on the phone last Friday, she asked me what I was looking for in a midwife practice. She was friendly/helpful/personable. I think we’re on the same page, but I won’t have my first appointment for another four weeks. Now that I’m in, I hope my experience there is as positive as I’ve built it up to be.