Checking in with your doctor's office - how often/ how easy

This is a small rant and also a question. Forgive the rant part but I'm so frustrated with trying to manage my own care.

Story is this:
I have a fabulous doctor. He is widely respected and a top guy. He is also older and has no interest in updating his office -- either how it looks or functions.
He told me that my problem has been that I haven't been good about following his directions in the past. I agreed. I kinda drop off the radar and just adjust things on my own and then see my local doc and next thing I know I'm on a different course than what he ordered. It was a fair criticism of what I'd been doing. So I said, this time I will follow everything perfectly and check in regularly.

The problem -- there is no email, very little faxing, and an office staff I have to go through. I never get to actually speak to him by phone.

The office tells me that I MUST get my blood checked every week but then they send the prescription snail mail and I don't have it. Now I have to call and beg them to fax it to the lab before I get to work in the AM.

The office never tells me when to check in next. I have to remember to ask questions about every detail because no one will offer any info.

Example -- I was on Cortifoam 2 times a day. The message from the doctor was to start Rowasa at night. Well, I got off the phone and thought -- Wait, do I keep the Cortifoam in the morning and just substitute the Rowasa for the night dose?

So the question is --- How often do you call your doctor when you are changing meds or tapering pred? Do you just keep bothering them on the phone?

Email would be so much easier for their office. I don't know why they insist on using snail mail for prescriptions and having all these phone conversations with me.

I hardly ever talk to my GI on the phone. I call the office, ask to speak to his nurse who in turns asks the doc about my concerns or questions and then calls me back. They have a great nursing staff there and I have never been disappointed with they fast reply. And if I forget to ask something, I just call them back. It takes a little while but I usually hear back from them within the day.

As for the lab slips, they ask whether or not I want them mailed or if I want to pick them up. I usually just pick them up because the lab and my GI's office is in the same building. But the few times I asked them to mail it, I usually get it within a day or two.

I hardly ever talk to my GI either. Now if I have a question I call his nurse and she relays the question to him. It was the same thing with my peds GI. If I wasn't doing well he would personally call me back at the end of the day. As for lab reports I get them electronically on some website.

Sorry but I can't go to a  doc who is behind the times no matter how well repspected he is.  You are so right in that it's the little things that help make a doctor's office work in general.  My current GI doc is great and works in one of the most cutting edge teaching hospitals in the country.  They have a secured website that allows for direct e-mail to and from my GI doc.  I have sent him over 25 e-mails over the last two years and he always answers within 48 hours.  No nurses for me.  Only when he is on vacation.  I love the direct contact with my doc, even if it only involves a quick sentence or two.  As far as labs go a fax is a must.  To not have a fax is just so 70's to me and I wouldn't tolerate that.  I respect you because you can contintue to see this GI care for top quality treatment but my only advice is to go somewhere else, a place that has a DSL line.

MyUC

Your gastro should at least have e-mail in this era! What is his problem? Another thing he might get: a menu driven phone that enables patients to target Rx requests, billing inquiries, or requests for lab test results to specific extension phones. I find that more effective than having to hang on the main line waiting for one person to pick up at a busy office. My gastro treats lots of Crohn's so has always carried a pager and more recently, a Blackberry, and uses the latter to check e-mail practically 'round the clock. RE altering meds on your own: IBD-saavy gastros do not go for that! / Old Hat (30 yrs with left-sided UC; presently in remission taking brandname Colazal)