My husband scheduled his own MRI. 

He became ill in Orlando, developing excruciating pain on the left side of his back, across the shoulder into the left side of his chest, and down his left arm, with his hand going almost completely numb.  

He has had multiple sclerosis for 14 years now, and you’ll have to forgive him taking matters into his own hands a bit, but we’ve been around the medical block a time or two, and he could anticipate the need for three appointments: his neurologist (in case the problem was a new MS lesion), a back doctor (in case the problem was a ruptured disc), and an MRI in either case. 

So he scheduled his own MRI.  Crazy, I know, to think you can have your own thoughts about the medical procedures you might need, but he called the MRI facility all by himself, and when asked the name of his physician, he said the name of the back doctor, a doctor referred to us, one we had never before seen.  For clarity’s sake, I’ll call him Dr. New. 

I’ve learned an important life lesson this week.  Insurance companies really, really don’t like you to schedule your own MRI. 

When we showed up for our doctor’s appointment on Monday, my husband barely able to talk through the pain, our long-time neurologist went into immediate action, ordering an EKG (because the pain was on the left side) and two MRIs.  And he did not want the MRIs from the clinic where my husband had made his appointment.  He wanted them taken at the hospital where he offices, as that facility uploads the images for immediate diagnosis.   

So I called and canceled the appointment with Dr. New and with the first MRI facility.   

Our neurologist then tried to schedule the MRIs at the hospital.   

And our insurance company refused the order. 

“There has already been an MRI ordered for this patient,” a representative told our nurse. 

I called our insurance company and politely and contritely explained our mistake to a representative named Marcia.  “My husband placed the first MRI order,” I said.   

“Your husband placed the order?”  Marcia said.  “How could he do that?  He can’t place his own order.” 

“I’m truly sorry; I know he shouldn’t have,” I replied.  “I’ve already called to cancel it.”  

“You may have canceled it at the MRI office,” Marci shot back, “but you can’t cancel it with US. Only a doctor’s office can cancel that order.  That’s the only way the computer will take it.” 

“Okay, but the lady in Dr. New's office says they never PLACED the MRI order, so they’re not going to waste their time canceling it,” I said. 

“Well, they’re gonna have to cancel it,” Marcia said.  “Otherwise, your husband isn’t going to be having an MRI this week.” 

I apologized profusely for our mistake in taking medical matters into our own hands and scheduling our own procedure.  “My husband is in really terrible pain,” I said.  “Couldn’t you please find it in your heart to just delete that first order?” 

“It’s the computer,” Marcia said.  “It won’t let us make any changes unless it comes from a doctor’s office, with a special code.  No one here has the power to override the system.  Not me, not the managers, not even the president of the company.  No one.” 

(Remember the all-powerful computer in the Terminator movies that becomes self aware and destroys the world? That computer currently runs the show at a prominent national insurance company I’ll call Ick-Na.  You heard it here first.) 

In the end, I had to (tearfully) convince a kind soul in Dr. New’s office to cancel an MRI that they had never ordered for a patient they had never seen.    

Again we tried to schedule the two MRIs our doctor ordered. 

Again we were turned down.  A new insurance representative named Joseph told our doctor’s office they wouldn’t authorize two MRIs. 

“Why do you feel you need both procedures?” Joseph asked. 

“Because he’s experiencing intense pain in both regions,” our nurse said. 

“Well, I guess you’re going to have to choose which region is most important, because you can only have one MRI, not two.” 

Finally, Joseph whispered a secret:  “If you go to the ER, and they order the MRIs, the insurance company will approve them because they’ll be deemed an emergency.”   

The emergency loophole – spends thousands more, and you’ll get the tests you want. 

Over the course of several conversations with Marcia and Joseph, I had the opportunity to ask about their medical backgrounds (none), and their location (Ohio, far away from medical events occurring here in Texas).  I really wanted to ask them about the details of their incentive plans, or hear their company’s mission statement (“You don’t need a medical degree to eliminate waste!”  or  “Making patients so frustrated, they almost forget they’re sick!”). 

But I would never anger our insurance company, because once they’re done obstructing the diagnostic process, they’re in position to obstruct the treatment process.  Which of course they proceeded to do. 

Our doctor prescribed IV steroids, but the nursing service he requested, one conveniently located near our home, was refused – too expensive.  I guess it was deemed the Nordstrom’s of nursing services.  Our insurance company wants us to use a different nursing service, perhaps more of the Dollar Store variety, located an hour from our home, and also one that doesn’t have an opening until Wednesday of next week. 

I tried asking (begging) yet another representative if we could pay the price difference between the company our doctor chose and the company they preferred.  No luck.  Computer won’t allow it, and no one can override the computer.  Nasa can’t override the computer.  President Obama can’t override the computer. 

These are the frustrations and gripes of a wife watching her husband soldier through more pain than I’ve seen him endure in our 21-year marriage.  I realize we are luckier than most.  Our insurance company, compared to many, is okay.  They obstruct, but they usually pay.  We are allowed to continue with our doctor, a warm and caring man who also happens to be one of the world’s best-known MS research physicians.    

We are fortunate.  There are people who can’t see the doctors they want, people being refused life-saving treatments, people who’ve lost their insurance or never could afford it at all.   

So this brings me to my dilemma.  Wakingupslowly wants us to contact our congressperson this week about insurance reform.  I’d like to get involved, but what should I say?  What plan will fix it so that office workers in Ohio aren’t second-guessing our doctor in Texas?  What plan will end the catastrophic mismatch between people who are desperately ill and people who are desperately interested in saving money?  What plan will reach the underinsured and the uninsured, the ones who can’t get treatment at all? 

If someone would just walk me through it, I would lobby until I had no breath left.

UPDATE:  Remember that commercial where the doctor is giving surgery instructions over the phone, and the guy is sitting at his table holding a kitchen knife and saying, “Shouldn’t you be doing this?” 

We are giving our own IVs!  The nurse just came out, inserted the port, and instructed us in all of the procedures:  sterilizing the –  I don’t know what to call it – the tiny screw-top spout thingie, flushing the line with saline (making sure to get rid of that air bubble first), sterilizing again, attaching the steroid pump, sterilizing again, flushing with saline, and flushing with heparin. 

The nurse is available by phone if we need her to walk us through it.  Or, if we really have a problem, they’ll send her back out to do the procedure for us, but, “Really, this is so easy, anyone can do it.”