Thursday, April 30, 2009

Finding an OBGYN

Just a warning: this may be too much information. It's not boy-related.

So I'm pregnant and I have a confession to make: I don't have an OBGYN. I haven't gotten my annual exam since my post-A check-ups. I had one scheduled at the Birth Center and they told me when I showed up that they wouldn't take my insurance and it would cost me upwards of $270 for an annual with labs.

So I didn't get it done.

I've been dragging my heels because I knew I was now a post-C-section mommy, which meant I had to try and find a doctor who did VBACs (vaginal birth after Caesarean). This is not something they put on business cards, and there's apparently a fair amount of bait-and-switch: yes, first-trimester-mom, you can have a VBAC; well, it's week 28, let's start talking about scheduling a repeat C-section. So it's important to find out if the doctor has actually delivered any VBACs.

I don't want another C-section if I can avoid it. I don't have trauma; I don't wake up shuddering in the night thinking, what could have been. If there's a medical reason for a C-section, well, let's schedule the sucker far enough in advance that anyone who wants to be here for the birth can get plane tickets.

But the C-section wiped me out, recovery wiped me out, and this time we'll have both a newborn and a very insistent three-year-old to deal with. I don't need to have four weeks before I can manage a trip to both Target and Trader Joe's again. It is freaking major surgery, after all.

Okay. So I know that once I get that first confirmation exam, our insurance is like a pitbull that won't let go and the doctor who confirms is the doctor who delivers. I know, I can fight to change it, but I like to sidestep the insurance company fights, don't you?

None of my contacts have a decent VBAC doctor to recommend. I get a somewhat helpful list of "not this doctor," but that doesn't help me figure out who to go to.

I gather a list of doctors with positive reviews from yelp and kudzu. I read a couple local midwives' blogs and one name keeps coming up again and again. He's like a midwife in a doctor's body, they say.

I check my insurance list. The website search is inscrutable. I don't have a paper provider directory. I call and ask if he's on my plan. Yes, he is.

Great. I call Dr. Wonderful. I hear you're on my plan. I'm newly pregnant. I'd like a consultation to see if we click before I commit to your practice.

Of course we do consultations, but he's not on your insurance, they say. Not on your group, which is the important thing. You have to change from the Dancing Monkey Medical Group to the Twirling Elephant Medical Group. Then he'll see you.

I argue and plead. I talk to the insurance person. I wait patiently for cross-checking. "Sorry, honey," they say, but in a nice way. "You could switch to the other medical group and it would work."

Okay, no problem, I've got lots of other doctors on my list.

First one: Won't do VBACs. Thinks I'm silly for even asking whether or not they do them since the doctor will determine for me whether or not I can have one.
Second one: Won't do consultations. Quote: "If you're the kind of person who's interviewing doctors, you wouldn't fit into this practice."
Third one: Won't even talk to me because I'm not in the right medical group. I need to call my own PCP and get a referral from him (a blatant lie).
Fourth one: I don't have to time to be messing around interviewing people. I need to get in and have that first-visit ultrasound. "You do ultrasounds on the first visit?" "Sure, how else would we determine gestational age?"

I hang up. I cry. The only office that's treated me with a smidgen of kindness is Dr. Wonderful's and I'm not on their plan.

I sleep on it.

I call Dr. Wonderful's office the next morning. "Hi, I know I'm not on your insurance, but could you schedule a consultation and then if I like him I can meet with your insurance guru and go over exactly what I need to do to get covered?"

"Of course, honey. Our first appointment is..."

So I have one appointment scheduled, with Dr. Wonderful.

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