Navigating Referrals
The healthcare system can be a pain to navigate. Thankfully Nicole and I are able to lean on our knowledge to get Maddie the care she needs quickly. Even though we’re well versed in the way the medical system works, it can still be difficult. I’m going to touch on referrals.
Back in August, before the seizures, an MRI of the brain was ordered for Maddie. They ordered the MRI due to Maddie’s head size. They wanted to make sure her brain structure was sound. At the same time they wanted Maddie to see a neurologist, that way the neurologist could look at the MRI and counsel us on any abnormalities.
When an MRI is ordered, more than likely it will need approval from your insurance company. After this approval is obtained, the MRI will be scheduled. In Maddie’s case, the MRI was set to take place on October 12th. However, her neurologist appointment wouldn’t be until February. From the time of the referral, it would take six months for Maddie to be seen by her specialist.
This long wait wasn’t acceptable to us. Our pediatrician’s office is a Spectrum facility. Naturally they referred her to a Spectrum neurologist. This isn’t uncommon in the medical world. It’s not the insider baseball that you think it is. The reason why our pediatrician’s office referred her to a Spectrum facility is so that they can obtain the consult notes easier.
Each health system uses their own Electronic Health Records system better known as EHR. When you’re seen by different health systems, sometimes it’s harder to obtain the information needed. Since we were not comfortable waiting six months to see neurology, we took matters into our own hands.
When you’re looking to get into a specialist office, it’s quite easy to “shop” around. You just need to know the right questions to ask. In Maddie’s case, we called Motts Children’s Neurology. I asked just a few simple questions. The first question was how long of a wait it was to get in. With Motts, the wait was only two weeks for a new patient. The next question I asked was if they accepted our insurance, which they did. Then the last thing I asked for was their fax number and phone number.
Once I obtained all of this information, I called our pediatrician’s office and gave them everything they needed. They happily sent the referral and Maddie was scheduled for an appointment the day after her MRI.
This is where things get tricky again. Since she was having a neurologist appointment outside of the health system where her MRI was done, we had to request a disc of her imaging. We then took that disc to her neurology appointment. Thankfully Maddie’s brain structure looked fantastic. However the neurologist wanted to do an EEG, see ophthalmology, and see ENT for a hearing test and to do a consult for Maddie’s enlarged adenoids that were picked up on the MRI.
This is where the water started to muddy yet again. Of course, driving from Muskegon to Ann Arbor for a one time neurology appointment was well worth the trip. We were even willing to do that drive a couple times a year. However with the ENT referral, ophthalmology referral, and EEG we were looking to do those a little closer to home.
The first appointment that was scheduled was ENT. This was a disaster. We were referred to Spectrum ENT which was very close to home. The referral that was sent from Motts, stated that Maddie was being seen for a speech delay. This way Maddie could have a hearing test. When we brought up her enlarged adenoids, the medical assistant started to scramble. We had to explain that Maddie had an MRI and that the hearing test wasn’t the only thing she needed. The MA stepped outside of the room and was frantically gathering the information that the doctor needed. This led to us waiting in the exam room for 40 minutes and when the doctor came in, he was very rushed. A perfect example as to why staying within the same health system can be beneficial.
Another issue that we ran into was Maddie’s EEG. We wanted to do this close to home again. Spending 48 hours in a hospital that is 3 hours away from our house didn’t sound appealing. Thankfully Maddie’s neurologist at Motts was able to pull a few strings at Helen DeVos and Maddie’s EEG was to be done under the supervision of a close colleague. We were told that typically those exceptions are not made. You know the rest of the story though. Maddie developed seizures in November and we decided to make the switch to a neurologist closer to our home base.
As you can tell, the referral process can be complicated. For a neurotypical child, calling around to find a specialist might be to your advantage. If you or your child will need long term care or multiple specialties, it might be better to stick to the same health system. This is all at your discretion. All you really need to do, is ask the right questions.
-Written by Adam Birchmeier
