Will they accept a ‘Peak Expiratory Flow Rate’ (PEFR) in place of the FEV1? The tests give very similar information (although they are not the same).
The advantage of having them accept a PEFR is that all you’d then need is a so-called ‘peak expiratory flow meter’ which should be available at all medical supply stores and probably even good old drugstores (people with asthma use them at home all the time). I don’t know the cost where you live, but in Canada, they run around 30 bucks.
Call your local office for your Member of Congress. Explain the difficulty in meeting the needs as part of the application process for a federal government position. Stress the urgency of fulfilling the application process as soon as possible.
While we are talking private doctors and your Member of Congress might be told to get stuffed by the doctors, it is an election year, job creation is high on the election agenda, you are talking a federal position, and it does not hurt to have someone else helping you.
Absolutely contact your sister. If you just need a referral from a doctor, that should do it.
Wait, you sister is a doctor? Why haven’t you had her order the test?
Is he in solo practice, or would someone else in his office be willing to see you? Or even to recommend someone who might do the test?
Broom, I sent you a PM with my doctor mother-in-law’s office number.
What a frustrating situation 
My internist actually does have a small electronic version of the machine that measures all the peak flow / FEV stuff. Not the big one that you can see the cylinder going up / down; IIRC it’s a much smaller thing, perhaps even handheld (and no, not a peak flow meter, it measures more than that).
Anyway - it sounds like you’re on the trail of some people who might be able to sort you out. GOOD LUCK!!!
I’ve no experience of Stateside health care but if doctors behave in the same way as they do in the UK I suggest calling your sister. Not to do the test - a 2000 miles is long trip for one test! - but can you ask her to ring a local doctor for you? The chances are she will get straight passed the gatekeeper and can then ask for the local doc’s help with your problem. I would expect the local to help as a professional courtesy - especially if the test is as simple as you say.
I don’t really understand how they can have a doc give you a physical, but that doc can’t write an order for the special test they REQUIRE you to have before starting work. It doesn’t make sense. I’m not saying they should be paying for it, but if it’s a requirement for the job, why the hell isn’t the guy who gave you the physical able to give you a referral? Not to do the test, or pay for it, but to write an order on a piece of paper you can bring to a hospital to get the test done.
I second this. A doc who’s examined you would have to spend another 20 seconds writing the order on a prescription blank.
Not only that, but with the history of asthma, just an FEV[sub]1[/sub] doesn’t make much sense; really pre- and post-bronchodilator spirometry is what’s needed, otherwise it’s just a waste of time. A normal FEV[sub]1[/sub] doesn’t say anything about an asthmatic other than they’re not having an attack at the moment. A normal Peak Flow would demonstrate the same thing.
I hope you get what you need, and if you’re ever imprisoned in Wisconsin I’ll make sure you get your spirometry, but what they’re asking for doesn’t seem to make sense to me.
I like MarcusF’s suggestion. See if your sister can help you out - see might not be able to “treat” you or refer you herself (since there are ethics guidelines against treating a family member except in an emergency), but she might be able to help you break the gatekeeper barrier.
Duckster’s suggestion to contact your member of Congress also seems like a great idea.
Try clinics associated with BIG medical schools. Not familiar with Chicago, but in St. Louis this would be Barnes-Jewish (BJC). Chicago probably has an equivalent. The prices are cut-rate, and they often specialize in dealing with those without insurance. You will be dealing with doctors in training at the intern/resident level, but that’s not necessarily a bad thing.
Another thought - look into getting into an asthma-related research study. Ongoing study listings can be found for sure at nih.gov (I think you can search by location; look under ‘clinical trials’). Studies usually are free to participate or even pay a little, no insurance is required, and all testing is provided by the study. My daughter was recently interviewed for a study relating asthma and GERD. My father did one on hearing aids. There’s some time and followup commitment required from you for this option, but it can’t hurt to look in to. Another place to check for study listings would be the web sites of whatever big university in your area has a medical school and does ongoing research. In my area, that’s Washington University. Chicago surely has something.
Man, if I had a nickel for every time some guy tried to feed me this line…
No, they will not. They are very specific.
Conflict of interest - it is unethical to treat one’s own family members, and in some instances illegal.
Thanks, I may need that.
Since she’s only been an MD for about 11 months I question how easily she could network for me and convince a doc here about this. On the other hand, it would be nice to see my sister again!
It’s the Federal government - if it’s not in the contract it can not be done! Actually, the form letter they gave me shows about 14 rather common conditions that would require further testing of this sort (only the asthma applies to me) so this must not be too uncommon. No, it doesn’t make a lot of sense to me, either, but I didn’t write the rules. Since I’m not allowed to discuss the details of their hiring process let’s just accept this bit of insanity as a given, OK?
Yeah, I agree, it’s nuts. I questioned it, too. The person I talked to agreed it’s nuts, nonetheless, it is what it is. C’mon, you work for a bureaucracy, you know how rule bound they can be.
So maybe I should say “spirometry”? Because the specific thing they as for is “Pre and post-bronchodilator FEV1” but maybe saying “spirometry” would make more sense to the doctors?
Stupid, but true - sometimes wording is crucial.
Thank you Dr. Mercotan, but do forgive me for wanting to avoid being in a position to partake of your professional services - this prospective employer would prefer my criminal rap sheet to remain a pristine blank. 
Naw, if I wind up in your office I’ll be much more concerned about my food allergies and the prison cafeteria than medical testing… unless, of course, it’s to establish I really do have food allergies.
Thanks again, everyone, I will follow up on some of this today, as I happen to have the day off from paying work. Maybe I’ll get this taken care of shortly, I sure hope so.
Couple of possibilities:
book an appointment at a walk-in clinic, especially one that advertises physicals for school athletes. When you’re face to face with the doc, ask for a referral for the test. It’s a lot harder to turn down someone when they’re right in front of you.
see if there are any “employment testing” clinics in your area. Usually, they take urine and blood samples for drug testing, but they might just have the other stuff on hand. I remember one place I went to was able to give me a color vision test.
I really hope you get this figured out, Broom. I’ve been pullin’ for you the whole time.
Another thought: what about calling your state or county public health department? They might have some thoughts on how to get this done.
It might make things easier to request “Spirometry, pre- and post-bronchodilator”, Broomie. That’ll include FEV[sub]1[/sub] and other pertinent measures.
I’d offer to do it for you in my office even if you’re not convicted of anything, but running the gauntlet to get you in as a visitor would be a bit daunting, too.
But if everything else goes tits up as regards this testing, give me a PM. I’ve a few connections at a few other clinics. One north of Chicago, near Waukegan, AAMOF.
I can give you my advice here, but first it’s obvious you’re pretty frustrated with this process and that’s understandable. But it is important to stay calm when you’re talking to these administrative types (not that you aren’t).
Here’s what I would do (and as an emergency physician you can’t imagine how much this pains me to say):
Take a Saturday (or whatever other day you’re off work) and go to a local Urgent Care Center. Preferrably one near or attached to a hospital. I wouldn’t bother with the main ER if possible (your wait would be LONG) but you could go there as well if you run into resistance at an UCC (they aren’t necessarily required to see you under EMTALA). You will see a provider of some sort if you walk in the door. Here is exactly what I would say:
You will be a breath of fresh air to people who are used to dealing with people seeking drugs and making stupid requests. Further, since you’re willing to pay your bill in cash, you will be a quick buck in their pocket. If you walked into my ER and I wasn’t slammed with sick patients, I would have you in and out in under 5 minutes. Speaking of which, if you absolutely must go to the ER, go early in the morning (like 5-6am). That’s the least busy time and a doctor at the end of his shift would be able to see you fast.
Sounds like you’ve made a bunch of phone calls and it’s difficult for you to get time off work, but you’re going to get a lot more done in person.
OK, I’ve an appointment on August 5th at 10:30 am at Rush Presbyterian St. Luke’s Pulmonary Function Lab for spirometry (yes, apparently there WAS an issue with a “magic phrase”!)
It will cost me $302.50 and that’s WITH the 50% discount for being “self-pay” and offering to pay it all up front. (Not to mention the $14 for round trip transportation, but I can make a day in the Loop of it, have lunch with friends, play tourist, etc. so it won’t bite so bad).
I might pit my dealings with the billing department - I swear, I’ve dealt with more straight-forward used car salesmen.
>sigh<
Yes, I can come up with $300 but that’s about twice what I was expecting - why should I be surprised? I suppose I could shop around for the same test for less money but I’m exhausted by this process.
I’ll see if I can find a local lab that will do this cheaper now that I have an official note from an official MD. Otherwise, I’ll just eat the cost. If it gets me a better job with more pay and health benefits it will be worth it. But if anyone happens to know of a pulmonary testing facility in NW Indiana who will do this for less please let me know, thankyouverymuch.
Really, folks - thanks for listening and your suggestions. I seems I may have gotten over this speed bump.