My Doctor and The Insurance Company Are Now A Team

The other day I got an email from my primary care  provider stating, Harvard Pilgrim , my insurance company,  stating I was to change a medication I gad been taking for fours years to another one in the same class.  I assume the reason was the different drug was now generic.

On the surface, this request may seem reasonable but prior to starting my current medication, I had gone through many medications that caused severe side effects.  The drug I had been asked to change to, had given me some of the worst symptoms.  I had been driving and became so dizzy, I had to pull over and wait some time to continue my trip.  It was one of the scariest moments for me.

My PCP had been involved with my journey to find the right drug.  She had promised she would keep working with me, no matter what, to find a medication that didn’t cause side effects.  I was really dismayed when I received her email and what she was requesting of me.  I wrote her back and stated I was not going to change my medication for the insurance company and why wasn’t she advocating for me?

My feeling was I never should have even gotten the email from her.  I expect her to, at the minimum, read my chart if she had forgotten who I was, and contact the insurance company.  Instead, she wrote back, saying she understood it was frustrating, and what were the side effects I experienced.

I wrote back the side effects and asked her again, why she couldn’t advocate for me?  I added, I didn’t think the insurance company had the right to dictate healthcare over my PCP.  Her response was since the insurance company paid the bill, then that is who had control.  She said she thought I would be OK but would have to wait for the final determination by Harvard Pilgrim.

I was going to write back, that actually, I paid with my $15,000.00 annual family payments over the last 10 years of which hardly any has been used except for doctors visits and medications.   I would say the insurance company has no right to dictate care.  In their eyes, it may be cost savings but for me it could be life threatening.

I didn’t write my PCP back because I decided to leave the practice.  I was under the illusion, my PCP was part of my medical team.  Instead this experience made me realize, she was not going to fight for me.  She has become too busy and overwhelmed.  It isn’t the same going to see her.  I don’t make this decision lightly.  I do, however, need someone who is in my corner and takes an interest in my health.