Is Proper Care Possible When You Live With Psoriasis?

In my twenty years of living with psoriasis I can say that I have had proper medical care for maybe six years of this journey. It is so frustrating. Most of the time I know far more about psoriasis than the doctors that I see. I can’t tell you how many doctors I have had. In all those times I feel like two of the doctors were the best.

If I was able, I would go back to seeing one of those two. The problem is, I am on Medicaid. The dermatologist I am referring to has a private practice. He will not accept Medicaid. In fact, in the entire state of Louisiana no private practicing dermatologist or rheumatologist will accept Medicaid. Because of this fact I am only able to get care in one location. It is a nightmare.

Where do I go to receive treatment?

My only option for psoriasis treatment is to go to a clinic in what is considered a low-income hospital. You might be wondering why that is a nightmare for me. The clinic I must go to is labeled Specialty Medicine. My first thought was okay Specialty Medicine so that covers getting biologics.

The problem is the doctor that comes in to see me is an intern. I see that intern for six months and then they rotate out. That means the next intern that comes in I must explain my whole journey again. Where I have psoriasis, where else did I have psoriasis, what treatments have I been on, have I had a punch biopsy done to confirm its psoriasis, etc. That is usually followed by "I’m not sure what you have is psoriasis." Are you kidding me? Twenty years of psoriasis and this is STILL happening!

My last appointment

The nightmare continued. The intern that came in for this appointment was the same one I saw last night. We do not have a great relationship. She wanted me to show her my active psoriasis areas, so I did. I preceded to tell her that one area was doing better as it actually had cleared up somewhat. Mind you it had been 3 months since she last saw me. Her opinion was that no it had not changed at all. She then went to get the rheumatologist on staff because she is only an intern. That is not a misprint. Part of my nightmare is that this place does not even have a dermatologist on staff. To my dismay here they went in discussing that I had eczema on top of my psoriasis. This was followed by we need to do a punch biopsy.

Always a punch biopsy. I have had three done I refuse to have another done. The last one was on top of my foot. It was not pleasant. To say I was a little upset is putting it mildly. I then stated to them: 1. I will not have another biopsy done and 2. I have never heard of anyone having eczema on top of their psoriasis. No, I do not feel like I am getting proper care at all. Remember I said the rheumatologist on staff came in as well? Not one word or question came from her about how my psoriatic arthritis is doing.

I'm stuck

My only option is to try to get off Medicaid if that is possible. But what if I need it again? Would I be allowed to be back on it? If I can cancel Medicaid, it would mean I could be on Obamacare Insurance which would allow me to see any dermatologist or rheumatologist I want. However, it would also mean I would have to pay out of pocket. I have never felt as disheartened about my medical care as I do at this moment.