Office Managers: can be just like risk managers

Here’s are a few excerpts from my emails to the practice/office manager of my bariatric surgeon:

——– Original Message ——–

Date: Thu, 14 Feb 2013 20:00:07 -0500
Good morning (I apologize for not saying that):

Thank you.

He doesn’t have to respond. He didn’t on my last email regarding the situation. I had considered only plastic surgeon previously, but because of the communication between him and bariatric surgeon, I’m required to look for someone else. That makes a vast difference in care & my outlook, as plastic surgeon supposedly is the best. Now I have to settle for less and scramble to find someone.

This is the second time where a relationship I had with a doctor changed due to discussion with bariatric surgeon. In discussing this with others, as with my gallbladder, I am treated differently without medical basis for this fact.

Sent: Wednesday, February 13, 2013 4:52 PM
Subject: call from bariatric surgeon

I got a call at 435 my answering machine time, about 5-7 min. before I got home. bariatric surgeon had called. I called, answering service said you all were closed and didn’t care it would be another week before I could find out what was going on.

I work in cubicles and everyone knows your business if you call at work. I have to wait either another week until I work from home on Wed. to find out what he wanted or I have to schedule time to work from home.

I’m sorry I missed him. I had no idea he would call, otherwise I would have cancelled going to my board meeting. Please let him know. I don’t have caller id so I answer the phone if I’m home (or the ringer doesn’t work & that’s happened before).

> Sent: Wednesday, August 22, 2012 4:37 PM
> Subject: Followup
> Thanks. I will let the practice manager know that the main concern I have is that my GI doc told me he wouldn’t do anything without bariatric surgeon’s “ok”. My relationship to my GI doctor should be based on what I have told him are my symptoms and (especially as the directions given to GI doctor were not complete) a more thorough history. I was able to ask for a HIDA scan test before bariatric surgeon talked with GI doc, and now the GI doc won’t repeat the scan. If they feel that a false positive was given, repeating the test would take care of that, and also that has been pinpointed as the area/region giving me problems. As no testing is considered that involves food or digestive action (when the pain, problems occur) is being considered, I fail to understand the medical reasoning behind not conducting testing to find a surgical problem to be fixed or why the direction of the gallbladder issues was changed.
> I feel that the issue is that bariatric surgeon feels it is mental, anorexia nervosa, and that’s why testing is being refused. It is obvious that from the GI’s followup (a one month appt.) that he does not consider daily RUQ pain to be an issue.
> Should gallbladder removal occur and the pain subsides, this will be another example of the group surgeon who was told of reoccuring pain, correctly told the doctor what the issue was, the doctor said it was “mental” or not physical, refused to address it, the patient went to another doctor, the surgical fix was made, and the pain corrected. This should be a cause for concern for the practice. I know it would be for a patient.
> Thank you,

Sent: Wednesday, July 25, 2012 8:23 AM
Subject: question for you

I’ve put in my medical record the below notes (please also refer to the emails from earlier this week in my medical record). I wanted to make sure that this does not “fall thru the cracks” and does get addressed. Patients have rights and responsibilities & we let our medical personnel know the reasons for not being able to follow through on a plan. Living my life in pain just to be kept alive, being forced to eat & the manner of doing so so that it causes me pain, that’s how I perceive the situation, I have a problem with. I’m not the only one either, so trying to “play off” I’m crazy, well no one who is around me and *KNOWS* me, we’re not buying into that. Whether smiling through it or complaining about it, doesn’t matter, nothing works to get a plan that I participate in (especially its formulation) and am fully informed about.

Is this something that you can do or do I need to take this further? I’ve been several avenues, several methods, and after months, there is still no resolution. I’ve made comments that I’d just rather drop than to continue like this: with no end in sight to an expensive plan that I haven’t seen address the underlying pain issue. All I see is that I get a reputation for not following doctor orders (that I’m not fully informed about other options, tests, given a chance to participate in the creation of a treatment plan, etc.) and for being a difficult patient, when the fact of the matter is that if I felt like I was treated with respect and compassion, included (or even asked) about a treatment plan, things would be different.

We come back to a complain I had months ago: listen to me. Corrollary: take me seriously; work with me; don’t blow me off – or expect the same treatment in return.

Let me know if you get this message and whether or not its workable.


I’m documenting the PICC line removal, etc. is directly due to pain (& other symptoms) that have either gotten worse, keeps coming back/not been resolved. The main reason I exercise is to take my mind off the suffering and to enjoy, with friends, the time left to me.

Need an appt. w/time to discuss the medical reasons why I haven’t been treated for pain, including tests performed to ascertain pain causes, why other doctors’ tests were/weren’t taken into account in making this decision, & timelines when it will be treated (or who I need to go for resolution). Also all diagnoses, course of treatment & timelines involved as to when this will lead me to full recovery, the alternatives, & where I am allowed to participate in my Plan of Care development & the way it is carried out. According to the group, “to have my pain appropriately & quickly assessed & effectively managed & to receive information regarding pain & suitable pain relief measures”. This needs to be addressed without delay.

Sent: Tuesday, February 19, 2013 11:06 PM
Subject: additions to medical record

Good morning,

Thank you for allowing me to review my records. I have some notes that I would like to have added to my record. If the enclosed document could be added to my medical record, I believe it would be helpful. It should provide greater understanding for any one reviewing the record.

Hope you have a great day,


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