I would speak with the doctor. You might be able to clear this up with a telephone call or the doctor may suggest you make an appointment but I think it's important to discuss this with him rather than the nurse.

I have a doctor that is fabulous, but has the worst staff I’ve ever seen. Many instances similar to yours, or prescriptions not processed as ordered, wrong tests scheduled, etc. Finally, frustrated, I made an appointment with the doctor himself, claiming I had a new problem that needed his immediate attention. I took in a list of all his nurse’s mistakes and told him that he needed to be aware of these errors in his practice. He, of course, was totally unaware of the problems this nurse had created. She is no longer on staff with this doctor, and her replacement “seems” to have better control. Still too early to tell, however. BTW, I was not charged for this appointment.

I think this is what you need to do. Often times the practitioner has no idea what the staff is doing behind his/her back.

I agree with 4Hedesign. She is giving you great information.

My doctor and staff are pretty on the ball, but agree I would discuss your frustrations with the dr. He may end up losing patients if the staff is not more attentive and he should know that.

Regarding your high white blood count. I had the same thing last year and I asked about antibiotics,. My dr said " I don't know what type to give you or what I'm treating." I had the high WBC coupled with extreme fatigue and she ended up sending me to a hemotologist. He could not explain the high WBC either( I did have iron deficiency). It remained high for six months and then went back to normal. Both drs say it was a mystery with no explanation as to why it was elevated then returned to normal.

I agree with the above posters. Make an appointment with the Dr. ASAP and tell him exactly what you have posted here with as much detail as you can provide. That is unacceptable service for sure.

One alternative view point is that antibiotics are overused. And there is no "one type kills all bacteria" pill. Personally, I won't take them unless it's a straight forward bacterial infection and my doctor has done the testing to determine which one to prescribe.

That doesn't justify the poor service you've received. You have to be your own advocate, even with the best doctors.

Not as serious, but I have a run in with an office staff at my dentist. They are nice enough to file our claims for us as we pay and walk out the door. For whatever reason, I was having problems getting reimbursed.

I spoke with the staff person and she was annoyed that I was questioning why after a few months waiting, I wanted to know about my benefit check.

I spoke to the dentist. I realize that staff gets frazzled and I do appreciate that they do this part of the paper work because they don't have to, but at the same time, I shouldn't have been made to feel like I was a nuisance.

The dentist agreed and this worker is now nice as pie.

I finally had to give up on my favorite eye doctor ever b/c the rules/practices put in place by the group he joined were so awful. There were 3 or 4 girls behind the main desk and every call was let go to voice mail, even if they were sitting idle. The message said they'd return your call within 24 hours. Then there was the fight over whether or not I'd paid a bill (I had, even though the insurance co. should have paid it). I wrote a letter to the doctor marked "confidential" but my DH says he figures the doc never saw it.

Donna

I'm not in the medical field, but perhaps the nurse was advocating for more tests, and not just more antibiotics, because if the cause of your symptoms has not yet been determined, antibiotics only treat the symptoms, not the underlying cause. If it were me or a family member, I would not want to be on more than 1 round of antibiotics without knowing the cause. I'd want more tests.

Now, if this was her position, she surely didn't go about addressing it with you in a professional way.

Personally, I'd work on ways to naturally boost my immune system, and proceed with more tests until the cause is determined. Then, the doctor will figure out the correct plan of treatment.

I would share your experience with your doctor. I love my GP, and have gone to him for years. Once a few years ago, I was there for an appointment and got on the scale. The nurse said, "You don't look like you weigh that much!" I glared at her, and told the doctor what she had said once he came into the room. He agreed it was inappropriate and said that he would speak with her. At my next appointment she no longer worked there.

How frustrating, Darcy! I agree that this nurse/office assistant has over-stepped her boundaries. Here's what I suggest, having worked in the medical field for many, many years, and being a physician's wife and co-owner of a large medical clinic.

First, I agree that your physician probably has no clue what's happening. Doc's are so busy these days, not only with their personal interactions with their patients, but with all the endless paperwork, dictating charts, answering Rx requests, making call-backs to patients, referring physicians, etc., etc. They treasure their nurses/medical assistants who (1) stay for long periods of time so that they get to know their patients and their boss's likes and dislikes in how to deal with patients. So many job hop, and it's frustrating training new people; (2) a nurse that shows up and doesn't call in sick frequently. You have no idea the stress that causes in an office; (3) an honest, trustworthy nurse/asst. who isn't slipping med samples into his/her pockets; and (4) an intelligent, organized nurse/assistant who can stay on top of keeping things running smoothly.

That said, an inept or rude nurse/asst. hurts patients, patient/physician rapport, patient/office rapport and can give a doc a bad reputation he/she may not deserve.

- As suggested earlier, I would call and make an appointment to see your physician with a bogus complaint. Sad, but because of this gal limiting your access to him, I think a little lie is ok here.

- Office appointments are notoriously short these days. An over-long appointment hurts the poor next patient waiting to see the doc and puts the doc further behind. So, have your complaints written down. Typed and bulleted is preferable. Your doc needs to hear them from you first, but a written hard copy to refer back to is invaluable. And, if he indeed does let this nurse go, a copy of it will need to go into her personnel file for future reference.

- Keep both your verbal and written complaints short, concise and to the point. Dates and times would help, if you can pull them up.

- Don't ramble and absolutely do not use derogatory descriptors (stupid, mean, ugly, dumb, etc.). They could easily put your doc's back up against the wall, perhaps wanting to defend this person and, by association, himself. Let him come to those conclusions himself.

I wish you good luck with this. I think it's very important that you pursue it sooner than later. And, if he doesn't make some significant changes, I'd find another physician.

A few years ago out of total frustration I did the same as 4Heidesign and my doctor couldn't thank me enough. I did as Lynne suggested in her post and kept my complaints brief, no name calling and had most dates/times listed.

You say he recently changed hospital affiliations and practices.

Are you sure this nurse even works for him?

he may not be "in charge" any more and he may not have any control.

there may be a reason why none of his staff followed him.

unfortunately this is happening more and more.

Can you email your doctor directly? I am able to do that with my doc and I absolutely love it. He's told me he prefers it to-he can reply as he's got time, my chart is available and he can order labs/prescrips at the same time.

For routine things his staff will email me. Appointment reminders, lab results, things like that are all done via email.

Your doc definitely needs to know you're having difficulty getting through to him and you're not getting the service (the CPAP) you need. I'm really surprised they haven't expedited that CPAP-having sleep apnea can cause many health problems and should not be taken lightly.

I am very prone to infections, due to my lymphedema, and I have to try to convince docs I need antibiotics even if I get a hang nail. Allergies turn in to sinus infections. Cut on my foot turns into a staph infection. So even if I get a mosquito bite I have to go on antibiotics or I'll develop cellulitis.

Antibiotics are not a one size fits all. And I do think they're handed out way too easily (which is odd considering how hard I have to fight to get them!) But depending on the type of infection they can prescribe a good broad spectrum type.

Thank you all so much for chiming in on this. I called today and the doctor will see me Tuesday morning. I'm not ready to throw this nurse under the bus just yet. Maybe some of you are right. Maybe she was just trying to advocate for appropriate care. it's not the vibe I got but ... maybe? It's hard for me to judge, which is why I asked for your advice. I've lived in a medical way-back machine where my doctor cried with us when my son was diagnosed with cancer. Where he called my home at 8PM and talked me down (for an hour) a couple of years later, after my daughter had her third abnormal Pap. Where his nurses knew my name, my husband's name, my kids' names, and I knew all their kids' names too.

That world doesn't exist any more. My doctor left one large medical system because they tried to dictate how much time he could spend with each patient -- to the point where they made his nurse cancel his vacation to punish him ... without even speaking to him about it first. He tried to go it alone but that proved to be impossible in today's medical environment. So he joined this other system.

It's never going to be what it was, so, like I said, I'm not ready to throw this nurse under the bus ... yet. After hearing all of your comments I was reminded how lucky I have been for all these years. I was also reminded that this nurse doesn't know me like the old nurses did. She doesn't know that I've asked for so few antibiotics through the years that Amoxicillin still usually works on me. She doesn't know whether I'm a whiny hypochondriac, or looking for attention, or whether I'm the kind of person who believes in taking the simplest course of treatment and wishes to be an active participant in my health.

I have two tests that show I have an infection. Why not try an antibiotic before I get a radioactive tracer injected into my body? My doctor (and his old nurses) know that's who and how I am. So Tuesday morning I'll tell my doctor what I want and he'll explain to me why, or why not he thinks that's an okay thing to do. Will I say something about the nurse? Eh ... depends on whether she sighs heavily when she sees me, and what she says when I tell her I STILL haven't heard from the CPap people.

Thank you, all, really!

You need to make an appointment with the doctor. You don't just want to take any anabiotic because it might do nothing more than wipe out your gut bacteria and not cure the real problem.

Darcy, I would say something about the nurse in a business like manner. It is not a matter of throwing her under the bus, it is a question of standards of care. Yes, there are many valid concerns about the overuse of antibiotics but that is for you and your doctor to discuss, not for the nurse to prevent the discussion. Bringing up the CPAP appointment may also net more useful information as it may not be the nurse's fault and you need to know if you need to apply pressure somewhere to get the appointment.

Are you sure the person is a Registered Nurse? Many offices use medical assistants who have very limited medical education compared to RN's (weeks vs years). I am often stunned by what some of my medical colleagues delegate to their unlicensed assistive personnel. Strongly encourage you to discuss your experience, citing specifics, with your physician.

Many years ago, I was suffering from pain that turned out to be my gall bladder. I had called the doctor's office, and the person on the phone listened to my symptoms, deduced it to be an ulcer, and told me it would be four weeks until I could be seen. I was barely 24, and terribly unassertive, so I acquiesced although I was unhappy. I mentioned it to my mother, who saw the same doctor. The next time she was in, she mentioned it to him. The doctor stormed out of the exam room and left her sitting there. Someone got the chewing out of a lifetime. He came back, and explained that she had no business diagnosing anything, let alone over the phone. She received further training, and I had an appointment within two days.

Clearly, a case of the doctor not knowing what his staff was up to, and happy to set things straight.

I want to thank you again for your kind and thoughtful responses. I had an appointment yesterday morning. The nurse was much nicer. She asked if I felt she hadn't answered my questions on the phone. I was honest with her about my frustration and she apologized. It felt sincere.

My doctor seemed set on the new test until we looked at the results of the other tests together. He'd dismissed the urinalysis as contaminated but had overlooked that I had blood in my urine. Even if the sample was bad, blood shouldn't be there. I gave a new sample, which still contained blood. (Hope this isn't TMI.) I also had another round of bloodwork done.

He prescribed an antibiotic and we've agreed that if all of the symptoms don't clear by Friday I will have the other tests he recommends. He also referred me to a different CPap provider who is to call me today.

Again, thanks. Your thoughts and advice made it easier for me to be open and assertive at my appointment. I'm feeling far less frustrated and much more hopeful for a good outcome now.

I totally agree with mdln. Very few offices are willing to pay to hire RNs anymore. You're far more likely to see medical assistants who have very little in the way of education or training, especially in the area of professionalism. That's not to say they don't have a role in medical settings, but the more complicated, science-related conversations should really be left to the experts.

Most doctors' offices would love to hire more nurses, but there simply are not enough. It is one of the most in-demand professions in every market.

Any doctor should not tolerate bad staff, be it personal or professional. I'd speak with him about your concerns and if he really is good, he'll take action to correct the problem if it's at all within his power.

We as patients should never be put off by the front office or support healthcare staff. This is not customer service at Walmart-it's about our personal health and well being!

For anyone who is still playing along ... I put off talking to my doctor about the nurse. I decided to give her another chance. And another. And another. After a series of additional delays and screw ups, she was supposed to schedule another test, but then that was delayed because of "insurance and pre-certification". Today, a week later, the office clerk called to tell me that the test did NOT need to be pre-certified, so I could call the hospital (myself) and schedule it whenever I wanted. Funny thing is, somehow the hospital got word of me needing the test (?) and called last Saturday to put it on the calendar. I had the test this morning -- eight hours before the doctor's office called to tell me I could schedule it. Aaargh.

That is so frustrating, but I'm glad you got your test! It seems like if you felt like fighting that fight you could bring this up to your doctor. Personally I would put it in writing because it's the best way I can express my feelings rationally - I always seem to get tangled up when speaking about difficult topics.

That's about 3 (or maybe more, I've lost track) too many screw-ups for me. I'd definitely put something in writing and make sure it got to the doctor personally. I'm with robo, trying to articulate something verbally can make things seem too emotional sometimes. And if you can succinctly bulletize each event (with a date if possible) this person has messed up, it will help him make an informed decision.

Because different insurance companies have different requirements you don't know if something needs preapproval until you submit for it.

Most patients prefer we check before the procedure, rather than finding out after the procedure that their insurance will not pay for it because prior authorization was required.

However, I would still bring your concerns to the physician and practice manager.

It should not have taken a week to check pre-cert and get back with the patient.

Agree "should" not have, but too often does - especially if indications are not what the insurance company has listed.

I don't want to get off track here. But I oversee Patient Experience at my hospital and the affiliated clinic system. This is a perfect example of a totally preventable, unacceptable patient experience. People don't expect you to kiss their butt. They just want to be called back in a timely manner. Call back and check in. Let them know that the indicators for the procedure are pretty narrow but y'all are working on it. Or be honest and say it's not covered and will be out of pocket. Just communicate and keep people informed.

I still don't have a clue how the hospital found out that I needed the test -- that baffles me. But they knew at the time they called to schedule that the insurance would cover it, and by the time I showed up for the test, they had an estimate ready for my co-pay. All of this before the doctor's office even bothered to call me back to tell me that I could schedule the test myself.

Honestly, I'm getting the feeling that this nurse just does not like me. She doesn't follow through in a timely manner with anything the doctor orders for me, avoids speaking to me when she can, and is downright frosty when she's forced to interact.

I think the idea of writing everything down is a good plan. I'm going to do that, then bring it up to the doctor the next time I see him face to face. I worry that he might "take her side", but then I think it's ridiculous that there ARE sides.

I'd hate to lose a good doctor over this but, at this point, I am almost eight weeks into trying to find out what is wrong and I feel like his nurse is compromising my medical care -- so what do I really have to lose?

Thanks for your help and support.

Depending on the system and affiliations, electronic medical records orders generated in a physicians office can be directly sent to a hospital (and Rx to pharmacies).

Individuals who work in a specific department may have a better idea of what insurance company will pay for what test, under what circumstance.

If you have questions (how did the hospital know about the test and coverage) - ask them. Patients have a responsibility to speak up.

Ah, thanks mdln, for the explanation!