UCSD, UCLA, or USC MS center?

[Pomegranate]

Hi, so I'm going to be switching my insurance from an HMO to a PPO and now I will finally be able to pick my neurologist and I'll be able to get one that specializes in MS, I'm very excited! Only problem is I've got three really great MS centers within 1.5 hours from me and I don't know which one I should pick. This whole PPO thing is new to me. Any input would be greatly appreciated.

Thank you!

[Redwings]

I went to USC for an opinion outside my HMO and liked it just fine. I was there for consultation and follow-up only. I don't have any experience with being a regular patient there. Bear in mind that all of the centers you mentioned are teaching clinics, and the experience is different than going to a private doctor's office or medical center.

Claremont to LA is about 40 miles and is already enough of a drive, particularly if you're having a flare and don't want to spend a lot of time on the freeway. UCSD is well over 100 miles from Claremont and can't reliably be reached in less than 2 hours. Practically speaking, it's just too far away to be getting regular medical care from.

[Pomegranate]

Oh well, I guess I haven't updated my location. I'm in Riverside county now 85 miles from SD, 80 miles from UCLA, and 60 from USC. I've been with my HMO since I was diagnosed, I've never been able to get in to see my neurologist during an attack or a flare up, I just email my neuro and he prescribes me steroids, so I didn't figure the distance would be a problem. I just figured I should go to an MS center since they specialize in our disease and I could pick. Most of all I don't want to be treated like an inconvenience anymore. I don't want to be kicked out after 15 mins, I don't want to have to interrupt my neuro to tell him my symptoms or ask questions because he talks more than I do. I'm just so frustrated with the way my neuro treats me and is managing my disease.

So I guess, if there is a really good neuro anyone can recommend that isn't necessarily through UCSD, UCLA, or USC but just all around good and you feel like he/she listens to you and manages your MS well in LA county, San Bernardino county, Riverside county, or San Diego county I'm open to suggestions.

[Redwings]

Hi Pomegranate:
Competent, conscientious doctors don't manage patients by email or phone. Yikes! You have one lazy neurologist if he isn't even seeing you before prescribing.

Your doc has given you a skewed and unrealistic idea of how medical care is supposed to be delivered. Standards of good medical practice require that a doctor actually examine a patient before diagnosing and treating, unless there are circumstances specific to the case that allow an exception. When I have a recurrence of optic neuritis, my ophthalmologist makes me come in for an exam, including two sets of visual fields, even if I had done the whole exam only two weeks before.

In whatever defense I can think of for your neuro , the way you've been managed isn't entirely his fault. If you can't get in to see him when you have a flare, and if you're kicked out of an appointment after 15 minutes, it's also because your HMO or the medical group he works for schedules patients that way and he has no control over it. That's probably why he's resorted to treating patients without actually seeing them. But medical ethics doesn't excuse that mode of practice.

From what you've told us, it sounds like you're looking for new doctor more for how compassionate or caring they are rather than for the way you've been managed medically. Being at an MS center doesn't necessarily mean that you're going to like the neuro's personality or demeanor.

But you're also looking for a new doctor with a different approach to managing you medically. No good, competent, conscientious doctor would ever manage a patient by phone or email the way yours has. So your distance from your neuro really IS a factor in which doctor you choose. You'll most likely have to start driving in for exams for flares more often than you think you'll have to. And you should also be prepared for instances where you might not be prescribed steroids, even after driving for 2 hours, if the new, "better" neurologist doesn't feel they're appropriate for the signs and symptoms you present with.

How far are you from Loma Linda University Medical Center? Does Loma Linda take your new insurance? Their neurology department has doctors who treat MS. I have no experience with them, but thought of them because of location, which may be more important than you think.

[Pomegranate]

Hi Pomegranate:
Competent, conscientious doctors don't manage patients by email or phone. Yikes! You have one lazy neurologist if he isn't even seeing you before prescribing.

Your doc has given you a skewed and unrealistic idea of how medical care is supposed to be delivered. Standards of good medical practice require that a doctor actually examine a patient before diagnosing and treating, unless there are circumstances specific to the case that allow an exception. When I have a recurrence of optic neuritis, my ophthalmologist makes me come in for an exam, including two sets of visual fields, even if I had done the whole exam only two weeks before.

In whatever defense I can think of for your neuro , the way you've been managed isn't entirely his fault. If you can't get in to see him when you have a flare, and if you're kicked out of an appointment after 15 minutes, it's also because your HMO or the medical group he works for schedules patients that way and he has no control over it. That's probably why he's resorted to treating patients without actually seeing them. But medical ethics doesn't excuse that mode of practice.

From what you've told us, it sounds like you're looking for new doctor more for how compassionate or caring they are rather than for the way you've been managed medically. Being at an MS center doesn't necessarily mean that you're going to like the neuro's personality or demeanor.

But you're also looking for a new doctor with a different approach to managing you medically. No good, competent, conscientious doctor would ever manage a patient by phone or email the way yours has. So your distance from your neuro really IS a factor in which doctor you choose. You'll most likely have to start driving in for exams for flares more often than you think you'll have to. And you should also be prepared for instances where you might not be prescribed steroids, even after driving for 2 hours, if the new, "better" neurologist doesn't feel they're appropriate for the signs and symptoms you present with.

How far are you from Loma Linda University Medical Center? Does Loma Linda take your new insurance? Their neurology department has doctors who treat MS. I have no experience with them, but thought of them because of location, which may be more important than you think.

I guess I have a very skewed view on how managing MS works due to my insurance company and neurologist. At first I did expect to see him whenever I had a new attack or flare up, but anytime I tried to schedule an appointment with him it had to be 1-2 months in advance.

You are right, I am looking more for a neurologist with a better personality and less cold. I would really love to have someone I can really work with.

Loma Linda is only 20 mins from my house so it is much closer. The neurologist there that specializes in MS is in my new network, so I think I'll really look into him. Thank you so much for the advice. I really appreciate it