153) Dr. Visit with Moritz

Aug 13, 2007

Central Texas Kidney Associates: Walking into the doctors’ offices I am aware that I haven’t been here in ages. There’s a new receptionist, although I hear Connie the Nurse in her office talking to someone on the phone. I sign in and pay my co-pay and have a seat. Pretty soon Rick the Med Tech comes out and says “Hi… long time, huh?” or something similar indicating relationship over time and some pleasure at reconnecting. He takes me down the hall to a lime green treatment room that reminds me of offices in Mexico or the Carribean.

Rick does all the normal checkup things like review my meds, take my BP, and the less formal things like asking me if I noticed how he has changed since we last met. He reports he has lost some weight and looks good (although he always looked good to me). We talk a bit about my experiences with dialysis and he informs me he has read this blog. [Hi Rick!] Rick leaves and I wait for Dr. Moritz…

I stare around this treatment room… lime green with natural wood beam and plank ceiling… and one good-sized brightly colored framed painting-print of one of those post impressionist scenes of a patio or tropical something where the only thing that makes an impression is the large blotches of hue with lines around them that indicate it actually is a scene. A few posters of kidneys and kidney parts that I imagine the doc pointing to with one of those telescoping pointers as he is educating someone. And of course, the little kidney models that almost look like little colorful sculptures on legs… I remember his showing me how my kidney was abnormal on one of these things ten years ago now…

Finally Moritz makes an entrance, wearing his customary Hawaiian shirt, khakis, and health shoes. In response to his salutation I say, “I have some feedback and a few questions for you”. He sits and exhibits expectant silence by cocking his head ever so slightly… and, I continue to recount my dismay and displeasure at hearing from the dialysis center staff that I was reassigned to another doctor (ref. May 2007, Post # 130) without asking my permission or giving me notice. And, evidently, without any consideration of the relationship I’d built with Moritz over 10 years! I recount that even though some people might think of him as obnoxious or tactless, I happen to be okay with those qualities in him and I believe we have had a good doctor/patient relationship over the years. And, I am NOT interested in being transferred to another doctor! Moritz listens to me quietly, waiting for me to completely finish my tirade. So, I continue, “I don’t mind Rowder signing my scripts but I am not going to consider him to be my nephrologist. On my insurance and in my mind you’re my doctor.” He replied with the following statements (maybe not in the particular order I report them here).
• “I was on vacation when they made those changes
• He has 25 years more experience than Rowder (in response to my interjection that I don’t think Rowder is as smart as Moritz)
• Dr Rowder is an employee of “the group” (indicating the partners in CTKA)
• With “groups” a necessary difficulty is that the group overtakes any individual doctor’s intentions and that all the doctors, individually, if asked, would say they know that group procedures are not best practice.
• The whole TTS 3rd shift was switched to Rowder because they needed to find something for him to do when they hired him and the group wants one doc per shift at the center.
• It has been the procedure in the group to write a letter to folks to explain changes like this, but they just didn’t get around to it this time
• Moritz is now handling MWF 1st and 2nd shift only.

By now he and I are talking into the last half of an hour and I tried to summarize our discussion and left it at telling him that I think I have to write a letter to “the group” explaining my complaint and recommending they make some changes in how they do their business.

So, on with the doctor’s visit. Moritz addresses my medical questions (explaining some things and looking up some things on his laptop) and concerns, changes a prescription, adds a prescription. Now I’ve been in there almost an hour and as I’m leaving I’m thinking that was good use of my $30 co-pay. I wonder if they assigned me the usual 15 minutes or if they never assign anyone for a 15 minute with Moritz, cause I know he always goes way over with most people who can get past his ‘directness’.

I am satisfied with our conversation even though Moritz didn’t give me any indication that he could/would change me back to him. However, on their computers he is my doctor, but when he printed out a script for me, it came out with Rowder’s name on it and that causes him some bewilderment. And, as I said to him, from my view, he continues to be my doctor.

Notes: In at 164 lbs, 5’11 1/2“
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