Thank you Colleen. Very helpful. I’ve submitted my doctor’s referral and I will be meeting with her on Monday to plan a “battle strategy” to get me admitted.

Yes - it would be additionally helpful to know of the so-called “1-year rule” in IM. (If it is true, it certainly puts a lot of pressure on the patient to get it right the first time. In my case, as I can’t wait a year, my life depends on it.) In fact, it would be good to know if that same rule applies to all departments. I was told contradictory information on it too - including by IM staff themselves.

Overall, the administrative staff at Mayo is far far better than the 2 other hospitals I’ve looked at (Columbia and Johns Hopkins). However, I came across two very nasty administrative staff in Mayo IM who told me of this so-called 1-year rule.

For background ... when I first contacted Mayo (and knew nothing), I was immediately sent an online Patient Appointment Request form - which asked questions already answered in my very carefully prepared (by 4 of my doctors) Clinical Summary / Referral. I then completed the appointment form but since it had no option to attach the Clinical Summary, I simply put “need email to send Clinical Summary”. I put no clinical information on the online form. A couple of days later, I received what seemed like an auto-reply stating the my request for an IM appointment was denied. The email didn’t mention a 1-year to re-apply rule. I also never received an email for where to send my Clinical Summary.

I then called IM and was told of this so-called 1-year rule. It didn’t make sense to me so I called back. After telling the new admin staff member the story, she then contradicted what I was previously told and said she would just send me another online appointment request form. Given it seemed like such an important form though, I told her to wait to send it until I got my doctor on board to help complete it.

Once I did that, I called IM back and asked for the same person to send me the form. That’s when I encountered 2 nasty IM admin staff (in a row). Both told me of this so-called 1-year rule. They also blocked me from speaking to the woman who was to send me the form, as well as denying my request to speak to a supervisor or a doctor. The second woman even (shockingly) said to me, “IM cannot help you”, then when on to further say (very pointedly), “do not call IM again”. Can you imagine? Your life is at risk and you have to hear such rude and even dangerous words?! This too by a non-medical person who is usurping the judgment of a doctor?!

Needless to say, I called another department to not only complain but also to rectify the situation - especially since the rejection decision made no sense as it was based on no review of (plentiful) clinical data. I was relieved then to speak with a women in that other department who said I could appeal the rejection decision and that she would file a report explaining my “story” and supporting me.

I’m still not sure but I have been further told that to gain admission, I would both have to 1) complete the same patient appointment request form, and 2) have my local doctor refer me. Since it seems duplicative, does anyone know if this is accurate? Given the confusion (and now fear), I am now letting my local (Florida) doctor complete both.

My local doctor referring me is a Neurologist and I will be meeting with her Monday - for her to call Mayo. Though my IM doctor is referring me too, she refuses to get on the phone with any hospital - though curiously, she’ll accept a call from the hospital. My guess is that she already knows the addministrative bureacratic nightmare that most hospitals are - and she’s not getting paid for wasted time - that is, being transferred around, being placed on hold, speaking to non-doctors, etc. So much for my local doctor’s ethics as well.

However, since I am told I need an IM doctor to act as a “quarterback” and bring in the necessary specialists to address the sysemic issues (liver, heart, pancreas, neurological, etc), I still need IM - and am therefore wondering if my Neurologist should call to speak with an IM doctor. Or should she call another Neurologist? Does anyone have any thoughts on this?

Since the medical criteria for admission - “acute medical necessity” is also a subjective standard, it sure seems that my local doctor has to be a passionate advocate in fighting for me - I’m more comfortable in having my Neurologist do it rather than my unimpressive IM doctor, as my Neuroligist seems more capable and interested.

Excuse my rambling but if anyone could answer the questions peppered throughout my note, I would appreciate it. As always, thank you.

PS: Though I am from NYC, I presently live in south Florida. Though I have never really been hospitalized, I grew up in a ‘medical family’ - with a father who was a doctor and a mother who was a psychologist as well as nurse. Not that it takes much more than common sense, but I was going on rounds as a child, reading my father’s texts, hearing about both patients and hospital dynamics etc - perhaps making me a bit more ‘hip’ to things medical. Of the 9 states I’ve lived in, I’ve never come across worse health care (generally) than in south Florida. It’s very much not like the America I knew. As such, it makes me all the more appreciative of the refreshing input I am receiving here on this Mayo Clinic forum. Thank you.

I was a self referral. I was first seen and evaluated by the General Internal Medicine department at the Mayo Clinic in MN. After a very comprehensive exam and their studying the CD's I brought with test results and local physician's notes, I was referred to, and given appointments in numerous departments of the Clinic. Plan on an extended stay. They are great about setting up your appointments but it keeps you busy. With my issues involving numerous areas I managed to go from one week to two. But I got answers and that's why I came. Keep pursuing.