Training

I have read where patients travel to another location to get training for home programs and must travel the many hrs/miles to see the neph monthly. But is it also possible to travel to a unit that has an established home program, get training there, but then be under ones local neph?

I would think that could be decided on an individual basis. Maybe you could be seen periodically by both? If you really like your current neph maybe ya’ll can work something out for him to give a second opinion if any change in your treatment is recommended?

My husband’s nephrologist told him that when he goes to Atlanta (over two hours away) for training he will have to change to a nephrologist affiliated w/ the clinic there, and would be seen by that neph at least once per month.

The director of the clinic told me she would recommend that my hubby switch to the nephrologist she uses as she also has PKD and her neph is experienced w/ PKD. Her neph is also affiliated w/ Emory which is BTW one of the sites for the HALT study, so I think we will be very lucky to get him.

One thing which put me so at ease w/ the situation we will be going into is that this clinic branch has home dialysis patients only, AND the director gave me her home phone number and her beeper number, and told me she is available 24-7 for all of her home dialysis patients. I’ve already called her at home for advice regarding my husband’s fistula and she could not have been any nicer! I hope when we meet her that she is as good as she now appears to be.

Our home hemo center is 5 hrs. from our home. We have a nephrologist we see at home once a month but we also travel back to the clinic to see the nephrologist in charge of the home hemo program. He doesn’t charge us a nephrology visit but has to see us as it is the law. The physician overseeing the home program has to see the patient. We also have to meet with the social worker and dietitian and the home training nurse at that time. Maybe other states are different but in NY that’s the requirement I was told.

Sounds good, but it’s a shame you have to travel 5 hours to get what you need for home hemo. I think you are correct; I think federal law requires a minimum of one consultation per month. I know Medicare covers the cost of the Neph consult at the clinic, but do they also cover the cost of the other Neph?

Medicare covers the charges of 1 nephrologist. Our home nephrologist charges. The clinic nephrologist doesn’t charge but he does have records of seeing us. Saw him yesterday in fact. It sure would appreciate having it closer to home. Clinic day for us is 12 hrs. 5 hrs. one way. But it still beats going in-center 3 times a week and having a life scheduled around the clinic.
Not to mention the payoff in energy, health and diet.