My internal medicine doc here in Houston insists that I get an INR check done monthly (aka pay him a monthly bribe) in order to get my Warfarin prescription renewed.

I've had the exact same prescription since 2004 (one 5 mg pill daily), when I found out that I had inherited the Factor V blood clotting disorder (thanks Mom). My first INR check before I started on the Warfarin was 0.07.

Up until I moved to Houston 4 1/2 years ago, I was getting my INR checked about every 3 months (as directed by my doc at Banner Baywood Heart Hospital in Mesa, AZ).

My target range is 1.9 to 3.0.

The highest that I have had in 13 years is 3.3 (three months ago). This happened after I had a reading of 1.3 following an out of state trip when the Doc wouldn't renew my prescription since it had been five weeks since my last INR check. I ended up going four days without the Warfarin. He then had me taking an extra half pill twice a week for the next month which, as I expected, screwed up my next INR check.

The lowest that I have had in 13 years is 1.1 (two weeks ago). This happened after I was in Phoenix for the holidays and the Doc wouldn't renew my prescription on Jan 3rd, since my last INR check had been on Dec 1st.

Now that the doc has once again screwed up my INR be preventing me from renewing my prescription, he allowed me to get ten pills so that I am forced to pay him twice this month. Each INR check costs me $20 out of pocket.

Other than problems caused by the Doctor Clowny, I have gone 174 months with my INR check always between 1.9 and 2.5 with it hitting 2.7 once, and the exact same prescription.

Can anyone recommend a good internal medicine specialist in the BCBS network, on the west side of Houston (or Katy). I prefer one who thinks with his brain, not his wallet?

My other option is to do a quarterly drug run across the border for some Warfina from Mexico. That is what I was taking for about three years in AZ when I had really crappy health insurance (along with quarterly INR checks).