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Accepted for Cardiology, denied internal medicine, need collab team!
TL;DR: Denied by internal medicine, but then accepted by cardiology. I need doctors that communicate across specialties, how do I get appointments with other providers despite denial? Is there no hope?
List of specialists farther down in post (NO, I don’t want to see them all, but a few).
Hi, hoping someone can give guidance or encouragement as this far it’s been a very frustrating journey. Sorry this is long… I’m a 42yo F that recently experienced a rare type of Heart Attack with no previous heart issues. I am however treated for several other conditions, and now that I’m a cardiac patient, things are even more complicated, especially with meds. After my 3rd hospitalization in 4 months, my cardiologist (at northwestern, so a very reputable program) suggested Mayo as he feels some of my other conditions are at play with what’s going on and he knows hearts, but not the other stuff.
It seems to be especially challenging as there aren’t a lot of female cardiac patients my age so a lot of the doctors aren’t used to having some of these conditions cross.
My initial application through internal med was denied, and quite frankly, I was devastated. I let my cardiologist know and he was shocked and told me to call cardiology directly.
I called cardiology directly and when telling them my diagnosis and such, they got me in, and FAST. Like less than 2 weeks fast. I explained that one of the complications I was having was treating my other conditions in conjunction with the heart issues and she said when I’m there, the cardiologist may be able to write me referrals to other departments. Great!
Then, the next day I got an email saying never mind, the doctor said I’d have to go through internal medicine for any additional appointments. I called internal medicine and they said since I was denied, I’d need to wait 12 months before applying again, but there were some departments I could contact directly. She did send me the link again and say I could try to reapply, but I will most likely be denied because the doctors will see they just denied me. (Which is exactly what happened).
So now, I’ve spent countless hours on the phone, on hold with various departments going back and forth. I do not expect to be able to get everything in, especially with the fast turnaround (at this point, I fly in to MN in 72 hours, and it’s a weekend), however, the whole thing with Mayo is they are supposed to set you up with a team that works together, especially when dealing with multiple conditions. They tout making it “easy” with central scheduling making sure you see all the necessary providers and creating an itinerary to maximize your time….
But so far, after hours and hours on the phones, I’m still only scheduled with cardiology. One department said they would get me in while there if cardiology refers me, but cardiology said they won’t be able to do that, I’ll need to go through internal med for everything else.
Any condition that goes through internal med, they tell me no, I’ve been denied. If I ask about it being related or impacting the heart stuff which I’m already accepted for, they still say I need to wait a year and try again.
One department is STILL reviewing my application, another claims they can probably get me in but asked for certain documents…my doctor sent them 3 times, I sent them twice, I confirmed the fax number twice, but they keep saying they don’t have it.
Others say they can’t even go through the questions because I’m denied…even though I’m accepted in cardiology, and others spend 30-40 minutes on the phone with me to either give me a mile long list of requirements they seem to need months in advance, or tell me I need to go to said department and ask to be a “checker” while I’m there, though I may end up waiting literally all day and not being seen.
I’m already under so much stress and this process has had me in tears, literally.
I don’t understand, if the whole point is for you to have a cohesive team that works across multiple specialties, how/why is it that you can be accepted in one area and then denied access to see ANY additional providers?!
Again, I’m not asking to see every type of specialist I need, but two or three doesn’t seem ridiculous given it’s the whole model for the place! And I’m fine coming back, but with having to book so close, my air and lodging alone is already over $1500, I’m unable to work and not yet approved for disability, I can’t keep doing trips like this for one provider.
Does anyone have any suggestions/relatable experience?
Will it get better/easier once I arrive? Or, is it really just an exhausting game where you waste all your time to get denied over and over? Can I expect that I will get to work with a team of providers that work together on my case, or is it just a bunch of BS?
If anyone has any insight about ANY of the following areas, I’d appreciate it.
Allergy testing
Genesight testing
Genetic counseling
Rheumatology
Medication therapy management
Pain management/fibromyalgia
Sleep medicine
Spine care
Plastic surgery (related to spine, not cosmetic)
Urology
GI
Neurology (the ones still reviewing application)
Gynecology (the ones who never receive the documents)
Psychiatry (the ones who say they will see me if cardiology refers me)
Audiology (The ones who say to come as a “checker”)
I KNOW that’s a long list, and no, I didn’t put that ALL on my application because I read about people being denied for being “too complicated”. And like I said, I’m not delusional thinking I’ll get a team with all of those covered, but please, how do I get anything in addition to cardiology?
Having Northwestern telling me they aren’t sure what to do with all the co-morbidities was so discouraging. Then they suggested mayo and after reading I thought I had my answer.
The first denial had me really down and then when I was so easily accepted by cardiology I thought there was light at the end of the tunnel. Now I feel like there’s just a bottomless pit.
I get in late Monday night, Tuesday have ECG & ECHO, Wednesday have bloodwork and cardiology consult, will be done by noon. I’m not set to fly out until Saturday morning because 1) surprisingly the airfare was much less and 2) I had foolish hopes of having additional appointments.
If you got this far, thank you for your time.
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I have an appointment in women’s cardiology next week. (Well, 4- echo, ECG, bloodwork, consult.)
Internal medicine denied me, obviously cardiology accepted me.
I do have several other health issues. And I’m 42.
Did anyone else come in through cardiology and then once you had your consult receive referrals for other conditions?
If so, were they only things directly related to your heart issues, or things where the treatment was problematic due to the heart issues? And were you able to get in during same stay? (I’ll be in MN Monday night - Sat morning).
If one mayo dr refers you to a different specialty internally, do they have to take you or do they still deny you?
Do you feel like you’ve gotten appropriate care covering all your health issues with how they work (and don’t) react with one another as well managing the treatments with a collaborative team?
Everything has been really terrible since the heart attack in March and I just want to set realistic expectations for my upcoming visit.
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3 ReactionsHello @doesitcomeinglitter, and welcome to Mayo Clinic Connect!
I "got that far" and I am here to see if I can help!
WOW!
So. You certainly do have a lot going on for one person...no wonder you're so frustrated by all you gone through. And rightfully scared!
I am posting a link with some information I found about MINOCA that you may or may not have read:
https://www.ahajournals.org/doi/10.1161/CIR.0000000000000670
None of this information can help with your scheduling issues at the Mayo, but learning as much as you possibly can before you are seen will only help you going forward.
You need to be your own best advocate.
Having said that, gosh...I wish I could help you understand how every single thing works at the Mayo Clinic, but I can't because I just don't know.
I can say from my own experience...being seen at the Mayo Clinic is a blessing, and you have that going for you right now. Your appointment is so fast, 72 hrs from now. You can call that a blessing indeed!
If I could offer any reassurance about your current situation it would be to trust the process.
Trust in the way this is working.
The very first and most important consideration is your young heart. And that is where you are starting. It's the best news possible that you have an appointment with Cardiology !
The things that can kill you should be a priority and put first, and I don't mean to discount any of the other co-conditions you mention. They are "co" conditions. Your heart is so much more important than some of the things on your list.
It's got to be overwhelming, and I get that. Been there. Done that. I want to reach out an let you know your feelings are valid, your concerns are real, and in 72 hours you are going to be in THE best place on the planet for heart issues.
Have you made a list of questions?
Have you packed?
Suggestions: Pack easy on, easy off clothes. You're going to be getting in an out of your tops a lot! Wear comfortable clothes, slip on shoes. You have to take your top off for x-rays, echoes, EKGs and a myriad of other things. You want to be comfy first. Stylish last! Just my two cents. Which isn't much in this economy!
I wish I could help more...
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7 ReactionsHi @doesitcomeinglitter (love the username). You can be assured that you will receive care from a multidisciplinary team. It is the Mayo Clinic way.
@fuzzlepuff had a similar experience of being accepted into Cardiology and not General internal medicine. This is what I wrote to here in this related discussion:
- What to expect and chances of getting in? https://connect.mayoclinic.org/discussion/what-to-expect-and-chances-of-getting-in/?pg=2
Given that you're primary concern is heart-related, you've landed where you need to be based on the review of your medical records by Mayo Clinic experts.
Once you have your initial appointment, testing and assessment, additional appointments in other departments (including internal medicine and/or additional specialists as required and based on expert evaluation) will be arranged. Your cardiologist will be your main provider and will quarterback any additional needs.
Here are a few discussions that may help as you prepare for your appointment:
- Your Tips on How to Get Off to the Best Start with a New Specialist
https://connect.mayoclinic.org/discussion/your-tips-on-how-to-get-off-to-the-best-start-with-a-new-specialist/
- First Visit to Mayo Clinic: How do appointments work? What to expect?
https://connect.mayoclinic.org/discussion/new-internal-med-patient/
- Mayo Clinic Patient Portal: How do I find it? Do you use it?
https://connect.mayoclinic.org/discussion/mayo-portal/
Have you downloaded the Mayo Clinic patient portal?
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8 ReactionsMy initial consult at Mayo Rochester with Cardiology was two years ago. I had multiple health issues. My experience at Mayo was fantastic. The Cardiologist ordered complete testing and referred me to multiple other specialists. The Cardiology scheduling team coordinated the appointments and testing. Some of the consults and testing were able to be done during my stay, some I was a checker ( you go early and sit in the waiting room to see if a provider can fit you in their schedule), and some I was able to get testing done and then have a follow up video consult when I was home.
I have been back several times for follow up and surgery. My Mayo Cardiologist is an angel and he continues to refer me to other specialities at Mayo. I am grateful for the wonderful care I have received.
Best wishes for a positive experience during your stay.
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6 ReactionsMayo uses the electronic record system developed by a company called EPIC in Wisconsin. Many hospital systems use EPIC. This system allows you to link multiple EPIC systems together so all your medical records (notes, tests, etc) are viewable by all your providers. This is very convenient. You may want to check to see if you have records that can be linked together.
I became a patient of Mayo Clinic Rochester in Dec 2021.
I have developed multiple health issues which are related so I need my specialists to closely collaborate in deciding on diagnosis and treatment because there are hard decisions to make. This also requires consistency in testing by doing in same place all the time. I asked about a primary care doctor (Internal Medicine) and was told that those are reserved for people who live in close geographical area - otherwise such people would not be able have one.
So, I manage my own multiple conditions. I have now been seen and treated in 5 different Mayo departments, mostly referring myself. I entered Mayo for multifocal lung cancer which requires ongoing monitoring and treatments. I asked for referral to Mayo cardiology to determine if I needed stent or could stay on medication for a blockage, important because next surgery is coming. Mayo put in stent and said they do not follow stent patients. Following year I had complications with SBRT and got referral to Cardiology because the heart could be involved. And it was.
My tests also indicated other issues. I self-referred to Mayo Endocrinology to decide on osteoporosis medication since some are protective against cancer. I got in faster than I could do locally! I needed uterine biopsy because of something on PET and I thought I should stay with the same lab for consistency, also it might be related to my lung cancer, and Mayo Gyn did it.
I was due for colonoscopy and have breathing issues, needed pulmonologist input regarding anesthesia and for safety I went to Mayo GI St. Mary's.
I made the case that my issues are related. I also see different Specialists in same dept. because Specialists have subspecialties.
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4 Reactions@doesitcomeinglitter I agree that there has to be a quarterback and it sounds like cardiology will provide that for you. Mayo is set up to coordinate your care. In my opinion they are conservative in their approach and once they are sure, aggressive in making sure you know how to live your best life. Like @janet23 my care has been coordinated the past couple years by Mayo Cardiology. I ended up there because Mayo is set up for exactly what you are coming with, complicated. The one thing I would recommend is to above all try to find some peace in the process. Let the doctors do their part and walk you through what they learn. I don’t want to come across like I know much. I only know what I wish I could have, am trying to do better at. You do have health issues. It is going to inconvenience you. It will take some effort on your part. However, they are absolutely fantastic to make this marathon you’re on be productive and as smooth as possible. Ditto to “trust the process”. YOU can do this!
Side note: Rochester is a fun place to explore and you will be there at a great time of year. I try to find one new thing about the city each time I’m there. My son and I used to go to an away football game of our fav college team every year while he was at home. We quickly learned they were miserable trips when our team lost. We added fun so the trips were about so much more than a ballgame. Your time, energy, money can be about so much more than your doctor appointments. I hope you find some decompressing time and maybe something to look forward if/when you return.
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2 ReactionsLocating departments/specialties, no directory, looking to be checker
I arrived late last night to meet with cardiology. Since my appointment was scheduled on pretty short notice, I haven’t been able to get in to any other departments. I have been advised to go as a checker.I cannot locate a directory of any type (I’m currently IN the Gonda building). Even the websites and pages for various departments/specialties only list the building and not floor/location etc.
While in theory I’d love to just wander around the buildings, I’ve got chronic pain and very low stamina.The process of calling every department just to ask that question takes SO long. I tried searching the threads but didn’t see anything.I know I can’t see all of these but I’ll take what I can get, so I’m also open to suggestions and hearing others experiences with these areas.
Allergy/Immunology Testing-I need an allergy blood test as well as the skin scratch test
Center for Aesthetic Medicine & Surgery- need evaluation for lip removal of “Buffalo Hump”
Spine Center- my back and neck are a nightmare. I have Scoliosis, kyphosis, and degeneration even though I’m only 42.
Pain management- Chronic pain and Fibromyalgia
Rheumatology- many doctors suspect something autoimmune
Pharmacogenomics-Genetic counseling/Genesight testing- I have an order for this from my PCP
Ophthalmology- I just need a basic eye exam and new rx. I realize this can be done at any number of places, but if it’s an option that works out while I’m here, great.
Audiology- Need my hearing retested and to get new hearing aids
Urology- I had to miss my scheduled Cystoscopy due to being hospitalized and haven’t been able to reschedule back home yet
GI/Gallbladder issues- Same as above, I had appointments scheduled (home in Chicago, but had a heart attack and was unable to go, not yet able to reschedule.
Can anyone let me know if/which of these might be worth visiting as a checker and let me know where the heck they are/how to find them without calling? I’m literally starting to lose my voice.Thank you in advance for any/all feedback.
@doesitcomeinglitter
On street level of Gonda is admissions, I would stop there and see if they can give you an answer where each dept is located. Not by drive up entrance, but on other side of building across from Kahler hotel.
Any type of testing, allergy , genetic, hearing, etc... will not be done without an order from a provider.
Have you met with cardiology yet? Any referrals to other depts will help, even if appt is out months, then the front desk will know what type of an appointment you are waiting for. There are so many specialties within each dept, they try to match the right provider to your needs.
Good luck
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4 Reactions@doesitcomeinglitter, I moved you latest question to your original question so that the members like @karukgirl @janet23 @vic83 @jlharsh and @roch who are familiar with your situation can continue to guide you during your first visit to Mayo Clinic in Rochester.
You sound like you are working very hard to organize everything. I agree with @roch that you're best to start with your cardiology appointment. They will schedule appointments with the necessary departments and specialists. This will be much easier on you. You will get to experience the Mayo effect, something that @loribmt likes to call "being Mayo-naised".
If for some reason, an appointment with a specific department as suggested by cardiology isn't available during this visit, you can sign in at the checker desk to get an appointment that may become available due to a cancellation by someone.
There is a “checker desk” located in the Gonda lobby and admissions area where patients can talk with a representative, discuss what appointments they would like to get into early or rearrange and the checker desk does the calling to rearrange the patient's schedule. This is strictly for consultation not testing. Not all departments accept checkers but many do.
Read more here:
- How does the Checker process work at Mayo Clinic?
https://connect.mayoclinic.org/discussion/checker-process/
In the morning, you may wish to call or visit Concierge Services. They can answer your questions, including details about the Checker system.
In person: Concierge Services desk https://www.mayoclinic.org/patient-visitor-guide/minnesota/concierge-services
Mayo Building (lobby level, in the International Center)
Monday-Friday: 8 a.m. to 5 p.m.
No appointment necessary
By phone 7 a.m. to 6 p.m., Monday-Friday: 507-538-8438
Email: concierge@mayo.edu
When is your appointment with Cardiology?
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