Can anyone help me with this bureaucracy? My father lives about 100 miles from the city where he has his primary care physicians. When he first had to go on dialysis he had to start on Hemo so he had to choose a nephrologist and clinic near where he lives. Now, almost a year later, he is on PD and “settling in” but we feel that he would receive better care if he were with a nephrologist and clinic in the same medical group as his cardiologist and internist 100 miles away. My dad goes to see the faraway doctors several times a month anyway, so that is not an issue. I am hearing from the renal group we’d like to get in with that we may not be able to switch clinics? I don’t understand what is involved in switching clinics and nephrologists. Can anyone fill me in? Very frustrated.
If you send me a private message, I will give you Beth Witten’s contact information. I’d asked her to pop in here and answer you, but she’s been really busy and gets tons of emails, so she may have missed it.
Your father has the right to change to any clinic and any doctor. The way it’s done is to contact the clinic, talk with the home training nurse and facility manager. Send medical records as requested so the nephrologist can review them. The clinic and nephrologist would review the medical records to decide if the clinic can provide the care he needs, which I assume any clinic would be able to do.
Before changing clinics, your father would want to be sure that the clinic accepts his insurance. Every dialysis clinic accepts Original Medicare and Medigap plans. Commercial insurance companies may have exclusive contracts with certain clinics which may limit where patients can go. If he has Medicaid it may not cover in another state if the city is in another state, that could be a problem.
How often does he go the clinic now? Has he had any problems (catheter problems, problems with a line, peritonitis, etc.) that required him to go to the clinic on other days besides clinic days? He may see several doctors in the city already, but he might have to go to the city to see the dialysis staff other days. Traveling 100 miles each way is expensive and with time it takes to see the doctor/nurse and/or other team members, it could take most of the day. This is why most patients like having their dialysis clinic as close as possible.
The bottom line question that only your father can answer is whether he is comfortable and satisfied with the nephrologist and home dialysis staff at his clinic. If so, he may not want to rock the boat by changing to a different clinic…many patients are nervous about doing that.