[PTennismom0202]

I expect my primary care doctor to refer me to specialists known to him, and I expect that all the pertinent history, lab work, etc. will appear at the specialist's office when I arrive for the first time. It never seems to happen here. Does anyone else have to coordinate their own care? The PCP drops the ball on making the appointment so I make my own, and the specialist has zilch on me when I show up. I have taken to creating a personal health record in hard copy when I appear at a specialist's office (they copy it) so they don't waste my time because they're unprepared. Worse yet, they want to recreate my history and reorder lab tests. I'm horrified at what I've seen here.

[Cobh521]

I agree with you. I have not seen continuity of care amongst PCP and specialist. I have a blue cross/blue shield PPO and the Villages health acts like it is an HMO. They tell me they are referring me to specialist i.e. Gastro for colonoscopy. It took gastro office a month to call and set up an appointment. I could have done this myself but I wanted to test the system. I had procedure performed in June. I looked at PCP reports on line, not one report from specialist. Also, being a healthy person, thank God, why do I have to get blood work every 6 months. I contacted The Villages health and said I was leaving as I am upset about the Medicare situation with my husband. Not a word from them

[Mudder]

It's simple, take responsibility for your own self! You can request hard copy of all records, test, etc... As you leave appt. usually you can pick them up in 24 to 48 hours. Actually usually you can get them online even faster. It's not like a small town where all docs know all others, so it's better to research and pick the specialist you want and thinks best will meet your needs. Personally my Village Health Center is always on top of and keeps track of everything, but I still like to have hard copies of my records to take where ever I go.

[PTennismom0202]

Sorry, Mudder, but I have to disagree with you. There has been a tremendous move toward Patient-Centered Medical Homes (PCMH) and Patient Centered Specialty Care all across the country. We grew up with Doctor-Centered practices. Your Villages Health practice is an NCQA Level 3 PCMH. (I am not eligible to go there). One of the standards of PCMH is that PCP practices coordinate all the care of their patients. Patient-Centered Medical Home PCMH Specialists resist this coordination, probably because they don't want to cede control to PCPs, but we as consumers should be holding them to it. Almost every practice in the country now has an electronic medical record system and they can talk to each other, if the practices want them to. There are a few other PCP practices that are certified PCMHs here near the Villages, but not many. If we 120,000 seniors wanted to rise up as consumers we would have a lot of power.

I moved here from Washington, DC. Not a small town. Most of the PCP practices were owned by big outfits like Johns Hopkins, Inova, or Medlantic. The PCP practices were all NCQA certified PCMHs. There was tremendous competition amongst them, and also great coordination of care.

We are seniors. Many of us don't have the background to understand the health care system. Others are frail and can't coordinate their care anymore. I have walked into a specialist's waiting room and seen dozens of very elderly patients who are in wheelchairs and need a lot of assistance to get to the doctor. When I see this scene I can't help but wonder if there is Medicare claims churning going on, because old folks like this need a lot of coordination of care to avoid wasting health care dollars. I will be one of the frail elderly soon enough, and I sure would like to be able to trust my physicians to coordinate my care so I don't fall through the cracks or end up with unnecessary out-of-pocket costs.

I will continue to coordinate my own care if I can't depend on my PCP and specialists to do it. Wish I didn't have to.

[Villager Joyce]

I am very pleased with my PCP and care I have received at Villages Health. My doctor discusses with me every test or appoinment I have had with a specialist. I imagine I would be tbere for a long while we're it not for this insurance fiasco.

[rivaridger1]

In my experience and in that of one of my friends who actually moved back to Vermont to obtain better medical care then available here, there is little to no coordination between physicians in Central Florida. They simply will not talk to each other even in the local hospitals. The specialists focus solely on what they are treating and if that condition impacts on a different medical problem not related to their specialty the reaction is " not my problem ". The patient is left with trying to determine the best course of action. Just for the record, when my friend arrived back in Vermont when he was admitted to the local hospital there were four specialists who had reviewed all of his medical records and came in a group to his room to do the consultation relating to his future health care and prognosis. I am from the greater Cincinnati area and like in Vermont generally whatever physician you saw had prior access to your medical records and they actually talked to each other if your medical needs overlapped their specialties. The reverse is true here.

[rivaridger1]

In my experience and in that of a good friend who actually moved back to Vermont to obtain superior medical care there is absolutely no coordination of care between specialists in Central Florida. They simply will not talk to each other or review each others notes even in a hospital setting. If you have a medical condition necessitating involving two or more areas of medical specialty care, good luck ! You are the one left sorting out your meds and trying to get the answers needed to maintain and restore your health. It seems sometimes information is relayed back to the PCP and at other times not. The referral system in Central Florida is also in need of significant reform. The time delays for and out right ignoring of even " urgent " referrals is oftentimes appalling. I personally was admitted to a hospital through the ER and scheduled for surgery when my phone rang in the room acknowledging a referral made ten days before. I did not need to keep the appointment. For the record, when my friend returned to Vermont and was immediately admitted to the local hospital all his medical records had been reviewed by four specialists who came to his room together as a group to do a consult and prescribe a plan of treatment. I am originally from the greater Cincinnati area and overlapping medical issues were generally treated the same way there. It just does not work that way Florida and it is probably the fault of the legislature who enacted a statute dealing with " medical malpractice reform " and got nothing in return in manner of " medical practice reform ". Yep, a little ice and snow might be preferable after all to dying.

[Villager Joyce]

Originally Posted by rivaridger1

In my experience and in that of a good friend who actually moved back to Vermont to obtain superior medical care there is absolutely no coordination of care between specialists in Central Florida. They simply will not talk to each other or review each others notes even in a hospital setting. If you have a medical condition necessitating involving two or more areas of medical specialty care, good luck ! You are the one left sorting out your meds and trying to get the answers needed to maintain and restore your health. It seems sometimes information is relayed back to the PCP and at other times not. The referral system in Central Florida is also in need of significant reform. The time delays for and out right ignoring of even " urgent " referrals is oftentimes appalling. I personally was admitted to a hospital through the ER and scheduled for surgery when my phone rang in the room acknowledging a referral made ten days before. I did not need to keep the appointment. For the record, when my friend returned to Vermont and was immediately admitted to the local hospital all his medical records had been reviewed by four specialists who came to his room together as a group to do a consult and prescribe a plan of treatment. I am originally from the greater Cincinnati area and overlapping medical issues were generally treated the same way there. It just does not work that way Florida and it is probably the fault of the legislature who enacted a statute dealing with " medical malpractice reform " and got nothing in return in manner of " medical practice reform ". Yep, a little ice and snow might be preferable after all to dying.

I have decided to remove my opinion.

[rivaridger1]

I was not taking issue with Central Florida. It obviously has an awful lot going for it. I am sorry you view my post pointing out what I perceive to be some serious issues with the medical system here as disparaging the whole geographic region and all of its citizens for it honestly was not intended to do that. I really also do not think the taking issue with the entrenched public institutions of any locale if you think can be improved should evoke the " if you do not like it here leave " response. I almost did quite permanently in a box about fifteen months ago because of one of the issues I mentioned. You are blessed to have your good health and may it always remain that way. Some of the rest of us are not so lucky.

[Villager Joyce]

Originally Posted by rivaridger1

I was not taking issue with Central Florida. It obviously has an awful lot going for it. I am sorry you view my post pointing out what I perceive to be some serious issues with the medical system here as disparaging the whole geographic region and all of its citizens for it honestly was not intended to do that. I really also do not think the taking issue with the entrenched public institutions of any locale if you think can be improved should evoke the " if you do not like it here leave " response. I almost did quite permanently in a box about fifteen months ago because of one of the issues I mentioned. You are blessed to have your good health and may it always remain that way. Some of the rest of us are not so lucky.

I have decided to remove my opinion.

[rivaridger1]

I believe the original post was titled " Coordination of Care- What is your experience ". I related two experiences involving coordination of care, one involving myself and another my friend. Yes, they did point out problems which might exist with the medical system in central Florida. If you choose to view the relating of these experiences as " shots " so be it. My friend almost died because of the failure of specialists to " coordinate care and talk to one another " when assessing his medical problems this year. I almost died in May last year because of the failure of the referral system. I relayed nothing but the truth. Would you like the cell phone numbers of both my friend's and my wives to determine if what I am saying is true ? Please remember the OP's last sentence was " I am horrified at what I've seen here ". The second poster said " I agree with you ". Are we all just taking " shots " for the sake of taking " shots " ?