Question:
My doctor does not want me to have the surgery. He says everyone that has it
ends up gaining their weight back. I don't believe him but what I am afraid of is, do I have to have a referral from him to have the surgery. He is my primary doctor and he is not going to give me a referral to have it since he doesn't believe in it. I have a consultation appt. set for April. Will I HAVE to have a referral from my primary doctor? — Judy W. (posted on October 17, 2001)
October 17, 2001
You need to call your insurance. There are several of them out there that
do not require a referral. I made sure my doctor was WLS freindly before
seeing him. Change your PCP now if that is the case and it should take
affect on the 1st. That is what I did. Good Luck
— Kelly C.
October 17, 2001
Unless there is a life threatening reason for NOT HAVING this surgery that
your primary care doctor knows about regarding YOU personally, GET A NEW
doctor. That is HIS opinion. Your pcp should work with you not against you.
The first surgeon my pcp(=primary care doctor) recommended had that same
attitude. He was uncertain about doing it and thought diet and excerise
LAUGHS OUT LOUD cause if that was the case DUH why would I be in his office
now thank you). So I told him pcp I didnt like that doctor, I got a new
surgery and I'm having surgery on Nov 1. Yes your pcp must give you the
referral or your insurance will not pay. So dumb the doctor and get one
that will work with you. Depending on where you live, I would ask around or
even ask on here if anyone who is having his surgery and leaves near your
area, could recommend their primary care doctor to you.
good luck 0)
— Gwen M.
October 17, 2001
Find a NEW primary care physician. I have almost finished all of my
testing. My surgery is scheduled for Nov. 8th, and I haven't even told my
primary care physician yet. He will know soon enough. I have to get a
final approval from him.
— Dianne K.
October 17, 2001
Your doctor sounds ignorant about the issue (unfortunately NOT uncommon). I
actually never even saw my PCP until 1 week before surgery for the pre-op
physical. My surgeon did the referral. I'd say call your insurance provider
first to find out what they require. If you MUST get the referral from your
PCP, then change PCPs. If it takes a little extra time then remember it's
better late than never. Don't let an ignorant doctor discourage you. You
know what you need. Good luck!
— Anne B.
October 17, 2001
So, which surgery is he referring to? Some surgeries were mechanically
flawed, could not work. Some surgeries work, but only in the updated
models. Some post-op plans work, some don't. He's right. He's wrong. He's
scared he won't know how to treat you afterward. One that IS certain, your
comorbs will take you out FOR SURE. If you want to proceed, you may have
to change docs. Sounds like this one is against you, whether or not you
have surgery.
— vitalady
October 17, 2001
I would use this opportunity to educate him by printing out as many
supporrtive articles as possible, including letters from WLS and patient
testimony. Then I would tell him that I was disatisfied with his practice
of medicine based on unfounded superstition and that I wanted him to review
the articles and reconsider his opinion. Depending on the severity of your
morbid obesity, I would tell him that failing to refer you, given your
condition may be considered medical neglect or worse malpractice and that
you would feel the need to file a complaint about him to the local medical
society and change physicians to someone more knowledgable. Of course, if
you have to do that, you probably find a new one anyway because he ain't
gonna look to kindlly on someone threatening his good standing because of
his ignorance. Of course, that wouldn't stop me. I would file the
grievance and see him one more time just to see the look on his face. But
then again, I have anger issues. Consider that when reading my
suggestions. Good Luck!
— merri B.
October 17, 2001
Yes Merri you do have anger issues. Her Dr has a right to his opinion
based on his experiences with his patients. We are all free to change
doctors, but this is not negligence.
— faybay
October 18, 2001
I had the same problem with a pulmonary doc I needed for approval, and
changed sleep study hospitals to be rid of the imbecille. The story is in
my profile. I will educate the jerk, do what I am going to do..... Once I
am near goal I will pay out of pocket and see him with a before picture
just to show him what surgery can do. Hopefully this may save someones life
that he might otherwise discourage on WLS. Change pcps and see your old one
next year when you have lost a lot. Or just tell your pcp you will leave if
he doesnt provide a referral.... $$$ will motivate him to refer you.
Doctors are businessmen and look at the bottom line.
— bob-haller
October 18, 2001
I had an issue kinda like that - My doc was afraid to give me the referral,
but she said I was the boss and did it. She said 'I hope you can prove me
wrong.' And since then she has used me to learn how this works. Im sort of
her 'case study' if you will... I gave her research, had my surgery reports
sent to her, etc..It wasn't her fault, she just didn't know. I know how
you feel though - sometimes the docs are just asses and like to play
Insurance God.
— jammie B.
October 18, 2001
In January 2000, I switched insurances and my pcp. I thought about the
surgery from the time the insurance came into effect on 01/01/00. When I
went to the doctor, he wanted me to go on Xenecal and diet, he did not
believe in this type of surgery. In september of 2000, I went to see Dr.
Gonzales and we talked about everything concerning the surgery and my
health. I told him my pcp was not for the surgery. I will tell you what he
told me. Find you a doctor who will support you in the type of surgery. My
words of advise is you are going to need all of the emotional, medical and
pysical support you can get from your medical team. Everyone has to work
for a common goal-Your health and well being. From your surgeon, to your
pcp, to the hospital staff during and after surgery,to your social support
and you yourself . I remembered an internist who took care of my
grandmother before her death and how compassionate he was. I went to him
and he asked me why I was switching pcp's. I told him my game plan and if
he was behind me. He said yes without hesitation. I love both my surgeon
and pcp to death because I know they are behind me 100% and have my health
as their #1 concern. If your pcp is not willing to provide you with that
referral, ask around and find a doctor who will. Also, ask your insurance
company if you need a referral. When I had BC/BS in the yr 2000, I did not
need a referral from my pcp to see a specialist.
— Jan M.
October 20, 2001
Merri, keep on being angry!! People in power need to use that power wisely.
Doctors need to keep up with the times and make educated decisions. Judy,
hope you find a new PCP quick! And be sure to look into DS; RNY does have a
much higher regain rate.
Chris
— blank first name B.
October 20, 2001
Whether or not you need a referral depends on your insurance company. I did
not need a referral for my visit to the surgeon and subsequent surgery.
Check out your insurance plan; you may not need his approval at all.
— Kathy W.
October 20, 2001
Personally I would get another doctor. I go to a clinic and they are always
changing my doctors, however if possible I ALWAYS prefer women doctors.
Usually they listen better, don't jump to conclusions before they hear
"all" your simptoms and are allot more gentle when handling you.
At the time I requested WLS I was looked at by a woman doctor I had never
had before, however I had been at that clinic for around 15+ years so they
had all my records with all the horrific weight gains (diets too) along the
years.
After my WLS I again had the male nurse practisioner that I almost always
have. He laughed at my problem with swollowing big pills when I was in my
dangerous low potassim phase. He said, You wanted the surgery you got it!
A week later (after not taking those much needed horse pills) I got a woman
nurse practisioner and by God she listened! And most of all she
"cared"! I'm sure there are some woman doctors who are not good
but I've had only one of many women doctors that I did not like. I think it
was Julie who also mentioned something positive about women doctors.
Sometimes men doctors think things are in a woman's "head".
Anyway you WILL need a doctors approval, personally I would'nt waste my
time with the doctor you currently have. "Nor would I try to change
his mind".
(It would be fun to see him a year or two after surgery, if no more than
for revenge.) Kidding.
But do find another doctor. Someone mentioned about finding people in your
area who have had the surgery and go with their doctor. That sounds very
reasonalbe. Life's to short to waste your time "trying to
educated" some "doctor". Besides by getting another doctor
you will probally get better care post op too and have better support from
him/her.
— Danmark
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