MRI was completed during a recent Hospital stay... partly by request of my mother. Stubbornness along with denial, as well as, poor cognitive insight related to atrophy of the brain is preventing my dad from seeking medical assistance from a neurologist. My mom and I need to attend a consult with a neurologist to know what to expect and to get a more specific diagnosis. Are we able to do that without my dad's presence?
You have to be informed to make decisions, so I think attending the appointment, even w/o your father present, is justified. Just be sure to check the authorizing language.
If you think the neurologist might not agree, take a copy of the authorizing document with you for the appointment. You probably should also explain that your father's position is not conducive to making decisions that might have to be made, and your presence and decision making capacity facilitates getting the care he needs, so it's part of his "continuing care" requirements.
I've found that doctors are much more approachable these days, and I've been able to get them to return my calls to discuss specific issues. You might try leaving a message for the doctor, or even dropping off a letter explaining the circumstances.
Staff members probably aren't authorized to make these kinds of decisions, but doctors are.
Another option is to go with your father; his "stubbornness" and "denial" may make it very clear why you and your mother need to be involved!
So perhaps emphasize to the staff that you are willing to pay for the office visit up front and you might be able to get what you want.
Nomad, you raise an interesting issue, one about which I know nothing as I always accompanied my father on appointments. However, we've never been billed for telephone conversations when I've called PAs or spoke to doctors outside of the office.
Jess, just another thought. If the MRI was done at a hospital, there would be a report on it by whoever interpreted it. The neuro doctor would explain in understandable language. And, assuming he/she has access to hospital records (as do physicians here) if he/she practices at that hospital, then the interpretive report would be available through hospital records.
You could request that from that medical records department at the hospital.
That's what I've done. Then I could research all the terms I didn't understand and ask the follow-up doctor to explain the significance.
Now that said, I have found that specialists tend to be more willing to converse on the phone if you are hippa approved. My mom's cardiologist called ME to let me know the results of her device check and to call in a script for a blood thinner. No office visit required.
The chain docs offices with pa's and np's as your pcp, it's all about billing insurance.
I don't know if this might be more palatable to him: explain to your father that this is a follow up to the MRI scan, i.e. without going into detail about what you think the neurologist might be looking for, and that now he's spent all that money on the scan he might as well hear the results.
Most HealthCare PoA documents are intended to empower the POA only when the patient is no longer conscious (or at least, not presently competent). If the patient has not been adjudged incompetent by his doctor, then the POA-person generally has no powers. Many doctors will discuss with the family anyway, especially if the doctor sees that there is at least a question about competence, and also if the family member has accompanied the patient to the doctor in the past.
Be aware, though, that asking to see the doctor without the patient present, especially to discuss brain imaging or cognitive impairment, can be seen (by the patient, for sure, and sometimes also by the doctor) as 'trying to railroad the patient into treatment or a facility without their consent.' If you wouldn't want a spouse to do that to you, don't encourage a spouse to do that to him.
Note the wording on POA and HCPOA documents sometimes authorizes the designate to act immediately (regardless of patient's condition) but other times requires the patient be declared incapable in some way. The former is far more helpful to a caregiver than the latter.
With the proper legal papers, I've found almost every medical provider is happy to include me in my Mom's appointments. But it's still necessary that my Mom be present because insurance covers her, not me. In most cases, I've been able to let the provider know (at the appointment or maybe ahead of time) that I would like a few minutes alone with them. Rarely has anyone been hesitant about discussing things with me alone. It's pretty clear after a few minutes with my Mom that she's not able to convey meaningful information or understand what the doctor has to say.
So make sure the provider has appropriate health care authorization papers then let them know you'd like a few minutes alone with them at your Dad's appointment. Usually that works.
Good Luck!