Nov 112012
 

“You need to get a pregnancy test.” – Family Practice office to 8 month pregnant mother who came in to get a referral to an OB, as her family had just transfered to a new military base.

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 November 11, 2012  Family Practice Doc, OB, prenatal  Add comments

  39 Responses to ““You Need To Get A Pregnancy Test.””

  1. Because women come in all the time with fake prosthetic stomachs

  2. Unfortunately this happened to my cousin also. They had just transferred military bases, and she was 7 MONTHS PREGNANT WITH TWINS, and had her large stack of medical records IN HAND. This is just another example of the government wasting time and resources.

  3. I understand that a new doctor needs to see proof of pregnancy. There was that woman recently who got c-sectioned and it turned out wasn’t even pregnant. BUT…if you get a heartbeat with a doppler, that should be sufficient to prove the pregnancy exists. Palpation should be able to prove the pregnancy exists. Medical records from another doctor should be more than sufficient to prove the pregnancy exists.

    If the doctor’s insists on repeating the test despite another practice establishing the pregnancy’s existence, you have to wonder if they’re doing it just so they can bill for it.

    • If it’s on a military base it’s not even so much “so they can bill for it” but more “check off each box.”

    • There was that woman recently who got c-sectioned and it turned out wasn’t even pregnant.

      What?!

      • They really WILL section anyone…

      • Google it! Found the story – apparently it happened in Nov 2008.

      • I believe the circumstances surrounding the not-pregnant c-section were that the woman was having a false pregnancy (psuedocyesis: all the progressive symptoms, no fetus) and went in to the hospital. A new resident or student performed a sonogram on her but did not have the experience to diagnose a pregnancy by sonogram. He or she thought something was off, encouraged the woman to be admitted and induced/sectioned. No one after that fact ever checked for the baby, assuming the diagnosis was correct and that baby was actually doing poorly. Way crazy.

  4. When a pregnant woman needs a new referral and authorization for OB care off base, there has to be supporting documentation for this. It isn’t somebody in an office 2 doors down, there’s a central office for each TriCare region. They are ultimately the ones to approve or deny the request. It’s a paperwork spiderweb in an attempt to make sure problems are handled at the lowest level (ie a minor, infrequent yeast infection can be handled by family practice, and does not yet need management by GYN). It’s nobody’s incompetence, just the way the military healthcare system works.

    • Is this why your GP won’t touch you if you’re pregnant in the military?

      • The reason your primary care provider won’t touch a pregnant woman in the military is more of a continuity of care issue. It’s a way to keep close tabs on the health of Mom and Baby. It’s following a recommendation put forth by ACOG (don’t remember what year but its old). Lots of family docs (civilian especially) don’t keep up with the latest info on meds during pregnancy, so it’s recommended to have OB take care of medical problems during pregnancy, even if not related to the pregnancy. In my opinion, it’s a good thing in the long run, even if inconvenient at times.

        • The problem in the military becomes that a GP won’t see a pregnant woman at all and the OB won’t treat issues not related to the pregnancy. At three military bases, I have been sent to the ER for simple problems (strep throat, sinus infection) because there is no method to treat routine medical cases in pregnant women.

        • That is not always true. It really depends on the base you are at. I had babies at three different Army bases and each one operated totally different and had different protocols. Before you can even go in and do an initial appointment you have to have a briefing (this was the ONLY common factor at all the bases) and in that briefing it is there that you find out what that base’s specific protocols are. At Fort Benning, I went to an actual OB clinic but saw a different doctor for each and every single one of my appointments. I NEVER saw the same doc twice. At Fort Carson, I saw a midwife consistently but in the Family Practice Clinic. At Fort Jackson, I was referred out to a civilian OB who WOULD NOT do any care for normal everyday colds or medical care. I had to go back to post and go in for normal routine care from my PCM for that.

          • Maybe Army and Air Force do things differently? And we all know there’s sometimes a disconnect between what the policy states and how things are actually done.

          • I’m in Germany right now…3rd baby, but first with the military. My PCM is through the Family Medicine clinic – they were happy to do OB care for me, and many of their patients DO stay with OB care. But I’m a VBA2C candidate, and thought it would be easier/better to just go with the OB office since I’d be seeing the midwife there for most of my visits, and be able to “finalize” plans/details with the people who would be present for the TOL/delivery. If I needed to, I could see the Fam Med clinic for other ‘routine’ care like like cold & flu symptoms.

  5. They did this to me, but I was 16 weeks. They wouldn’t take any of the files from the prior OB (who were not military doctors) I had to completely start over.
    And then to top it off, I went for my first appointment (by then I was about 18 weeks) and the nurse looks at me like an idiot and says “What took you so long to come in?”

    • Ach, good grief! What did you say to her?

      • I told her I already had multiple visits to a OB back in Alabama and she just said oh.
        She also tried to give me prenatals and I was like yeah thanks but I have those already.

    • I was 18 weeks, with a letter from my German OB (moved OCONUS) and they said that none of that mattered and I needed to have a pregnancy test “for the records” olakiedokalie. I was asked when my LMP was and told them. I got “well, that’s a LONG time” “Yes…like I said, I am pregnant” “Oh, so you know you’re pregnant already” :headdesk:

  6. Pregnancy test for 8 month pregnant woman:

    1. Place hand on belly.
    2. Wait for baby to kick you.

  7. If you need to revert to a pregnancy test to confirm pregnancy doc… well… your competency is severely lacking and I am questioning your ability to diagnose any other condition related to this pregnancy.

  8. If this doctor is unable to diagnose a pregnancy that is well into the third trimester, then he or she has no business being an OB, or even a doctor for that matter.

    • We need a pink link to clarify, but the post states it was the family practice office. To me, that means the person sitting at the front desk, who often has no medical training at all, and just goes by the checklist given to them. I don’t read the OP as the family practice doc requesting the pregnancy test.

  9. In general, low risk pregnant women are seen in the Family Practice Clinic at military treatment facilities. A family practice doc is often your Primary Care Manager, so you must see them to get a referral to any other clinic. Tricare Prime is a very standard HMO as far as all that goes. They have to have any reason for a referral properly documented. Is it ridiculous when talking about a woman who is eight months pregnant? Of course. But it is a huge HMO and cutting corners in one area could lead to cutting corners in more serious areas and none of us want that. It is part of the reason I switched to Tricare Standard, which operates as a Preferred Provider Organization, it means I might have copays, but I don’t need referrals.

  10. The government does this too.
    The receptionist at my OB told me that I might qualify for Medicaid, so I went to the public health building to apply. They told me I needed written proof of pregnancy to even fill out the paperwork. I drove back to my doctor’s, got the form, and got back in line at public health.

    I had my son ten days later (he was three days overdue).

    So, yeah. I was TOTALLY faking my pregnancy so I could get health insurance assistance.

  11. …and you need to get an eye test! :P

  12. Key word, military! When they did this, they just asked for a urine sample at the new GP office, didn’t tell me what for and I didn’t ask… the doc comes in with my results, doesn’t even look at me, and goes “Congratulations! Your pregnant.” I looked down, looked up, and said “Ya think?!?” 7 months and I was very noticeably pregnant!

  13. This happened to me, as well. It through me off reading it, because I was thinking “I don’t remember submitting this” I don’t know if it is nice to know I’m not alone in this… or worrying.

    Military… we moved shortly after I learned I was pregnant. It took going to two different (Tricare approved) doctors(last minute), and none counted as ‘proof’ of pregnancy. Finally finding out that Planned Parenthood would be good enough for ‘proof’ and was able to use their pee test to get into the correct housing. Then after getting here, there is waiting to get an appointment, blah…

    We knew I would be going back to Home State for pretty much the entire second trimester. So… Call Tricare, make sure I would be covered in Home State. Since they are the same ‘reagion’ as were we PCSed, no problem…. so they claimed.

    Get to Home State, can’t get an appointment. Avalible appointments are weeks out, not approved, ect. Finally, manage to beg/threaten my way into one appointment. Get threatened by that Doctor, as well as she made comments about my scars, ‘bacne’ and thighs.

    Get back to our new home, am 7 months… and am told I need a pee pregnancy test, then to be seen by a GP, then need to be approved for OB/Midwife care, and that it could be a month till I saw a OB/Midwife. *headdesk* I argued, said I wanted to see a midwife, and I was 7months, I brought my prenatal paperwork, and they said they would get me an appointment with the off-base mid-wife group. But first I had to still give the group’s OB my info, to make sure I didn’t risk out of their care. I was approved, and Tricare… auto-approved me for an entire pregnancy’s worth of visits. Icing on THAT cake… is the WITHDREW the payment that went to the abusive Home State OB! So now I’m argueing with them & tricare to pay for that visit.

    Oh… and after all that, I ended up with an Unintended Unassisted, LOL.

  14. I had a similar excperience. I had experienced a molar pregnancy and was seeing my OBGYN for that. I was getting blood work every week. I was then cleared to TTC again, and concieved right away. I went back to my OBGYN for blood work to confirm the pregnancy, then another blood work a few days later to make sure my numbers were not too high (an indicator of molar)…. then I had to go to the base (hubs is military) for a pregnancy test, to send me back to my OBGYN. Even though I had 2 blood works confirming with my OBGYN. I had to pee on a stick at the base for them to say “your pregnant, go back to your OBGYN”….. you know how long that took? 4 hours. 4 hours to pee on a stick.

  15. I’d gotten pregnant while stationed at one base, PCSed to another base in another Tricare region, and was seven months pregnant by the time things settled down and I could get to the Family Practice Clinic to see about getting a referral to an OB. We were PCSed to a training unit where there are no OB docs. Which honestly, I thought was awesome… because I was horrified with the care I’d received at the previous base. It was terrible.

    And I had been in or associated with military life for many years by the time this happened and been a medic in the Army myself. I understood how Tricare operated, but sometimes people really, REALLY need to apply common sense first. There was sufficient information to verify that what I was telling them was true (by this time our records were all electronic), but one of the biggest problems in the military medical system is that it just does NOT know how to function outside of its regulations. This is just a simple example of that.

    • If there was no OB care at the MTF, then they probably needed to do it to get a referral started to get you treated off post. All the places I’ve been that send you off post for OB/GYN care have to set up the referral.

  16. This happened to me with my first pregnancy. My husband enlisted in the Air Force, and then we were surprised by a pregnancy a few weeks before he left for BMT. I was about 5 months when I finally got to move and be with him. It’s just how the military does it, not that big of a deal. It’s because Tricare is sometimes a pain in the butt. And it depends on the base you’re at and if you have a clinic or a hospital as to whether you get a referral to an off-site OB or midwife. Personally, I feel very fortunate to have good coverage (even if it’s a little inconvenient sometimes) and to have the choice between an OB or a midwife. AND if I get sick, my primary care provider will still see me. It’s not as stupid and horrible as everyone is making it out to be.

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