I'm in a HMO and it is so different from what everyone else has here it seems. I just saw my surgeon for the first time today since the surgery (and that day was the first time I ever saw him). I had a slap tear repair, biceps tendon re-attachment and subacromial decompression and rotator cuff repair. Absolutely no PT during the 7 weeks. So now I have limited movement and pain still. Got told today that yep the pain is due to not being able to move my arm and that PT should help. I won't be seeing the surgeon anymore and just feel like I got left out in the cold. Thank goodness for this site to find what others are doing so that I have some sort of guidelines on this. I don't know how much PT I'll get, my first appt is next Friday. One question for others here: did anyone have problems with their wrist being painful too? Thanks so much.
My appts are very short and I don't get to ask a lot of questions unfortunately, not to mention I don't have much of them anyway.

ariel, sorry to hear that.. it seems like you're not being very well taken care of. perhaps you should be a bit more aggressive in your dealings with your HMO? going 7 weeks between surgery to followup seems wrong to (granted i'm no expert!)

i had my surgical follow up at 9 days - doc wanted 7 but we had scheduling issues. i was in therapy on day 10.

hey ariel,

I had a slap II repair with 5 anchors and I had a similar problem as you with the HMO. It took forever just to get the PT referal from my doctor. What you need to do with HMO's is be extremely proactive. Keep calling your doc to get your therapy and appointments in. They are all about getting you in and out as quickly as possible, most of the time not caring what you have to say. So keep pressing the insurance company and doctors because you need to get into therapy ASAP because it will be harder to get your ROM back if you don't. My doctors probably think I'm the most annoying person in the world, but hey atleast my ROM is getting better! Good LUCK with recovery!

-Mike

Ariel, so sorry to hear of your plight. In an HMO, your insurance co. sold out to the IPA (Independant Physician Association). The IPA "owns" you now so your ins. co. is really nothing more than a sounding board that doesn't care and won't do much.

They will have the attitude of "ain't it a bitch, those SOB docs" but will do little for you. Your Ins. co. has no culpability (thanks, Knox-Keene Act)! Only your doc does, professionally. Where this might go if you are strong, is that it degrades to malpractice against your doc but only if you can prove your doc did wrong (which is really hard in an HMO). Might be a cause for abandonment though.

In a way, Mike is right, you need to need to become the "squeaky wheel" with your IPA. You'll get nowhere otherwise. The calendar metrics which you've cited are all wrong but very "managed care." Should be a clue for anyone who wishes for national health care and those who support it! Be careful what you wish for...

You can push and push hard you should do, but your HMO almost answers to nobody so you are kind at their mercy. Your state might have an HMO complaint hotline, so check that out too. But that will be a long process...

BI

Thanks for the feedback on HMO's. Everything said is so true - they're great when you're well but another story when help is needed. I'll try to be more assertive and hope for the best. In the meantime I downloaded some exercises to do so that I could at least be doing something on my own. It's awful to be left alone like this, never knowing what is normal or what to expect. Thanks again for the feedback.

Ariel,

I am sorry to hear about your issues with the doc. That would be difficult to not have anyone to bounce questions off of. I, too, am seven weeks post op. I had a bicep reattachment and labral repair. What compelled me to answer is your wrist pain. I have been experiencing wrist, hand, elbow and forearm pain as well in the past few weeks. When I ask my PT about it, she just looks confused and states that this is not necessarily "normal" but that anything in the body can make anything hurt, if that makes sense.

I return to the doctor on Wednesday of this next week. I am going to ask him why the pain is there. I will let you know if he says anything helpful. I am blessed with a great doc, so hopefully he can shed some light on the issue.

Good luck in PT!
Tammy