What a mess, but calm enough to post about it now....

Ok, so in August I called my primary and made an appt, told them when making the appt that I was coming in for a physical so I could get a referral to surgeon for gastric bypass. They said fine, no problem, appt for October 6. Well last Monday I called and reconfirmed, and they said yes, we have you here Mrs. Thompson, your coming in for a physical and referral. I was happy. They reminded me to fast after midnight, so they could do labs. NO PROBLEM. Wednesday they called me and reconfirmed. Thursday morning I went, paid my copayment, then they inform me that it is an additional $20 for labs, as they are so expensive. Well that ticked me off cause I was not told about that originally, and I didn't have it with me, made arrangments to bring it by the next day. take me in for my appt and I was 3 lbs more than i thought, so now I am 243. Did my blood pressure and it was great, 114/80. never have had blood pressure problems, bet if they would have taken it 10 minutes later it would have been alot higher though.... Doc comes in, said how can I help you, what is hurting, I said my heart hurts because I feel at this time I can not enjoy life, he asked me to explain and I told him until I lose this weight I can not enjoy my teenagers, and feel i won't be around for any grandchildren when that time comes. He then asked... WHAT DOES THAT HAVE TO DO WITH ME???? I said well i am here for a physical so I can get a referral to the surgeon for gastric bypass. His next comment made me hit the roof, and almost him, but i restrained.... "I don't care if your 500 lbs and 5 ft tall, you will never get a referral from me, I do not believe in the surgery, it is an easy way out, and if you diet and exercise you can take the weight off with otu the surgery, but your just wanting to take the easy... lazy way out." i stood up, demanded my copayment back, stated I would never be in his office again, that i had looked into, thought, and prayed about this for the past 2.5 years, and HE will not stop me. mind you I had my 3 page list of weight tracking, diets, ups, downs, and sideways. I left there and drove in tears to Cleveland Clinic. I went straight to Dr. Rosenthal's area. Showed the receptionist my insurance card and said I need to know the name of a primary that I can visit that does referrals to Dr. Rosenthal. I explained what had happened. She then gave the name of a Dr. right there at Cleveland Clinic. I went to her receptionist, and told them what had happened. She said that she could get me in THIS Friday but i have to talk to Humana first. Well I had been on the phone many times with Humana about the coverage, just to make sure I had everything ready. I explained what happened, and they changed my Dr. effective IMMEDIATLY. they are now looking into taking the original dr off of their list, as he is going against his contract billing extra for labs, that is supposed to be included. This has had me upset since last weekend, and I have had a headache since, probably tension, but either way, it hurts. I can not believe a dr would treat someone that way. Hoping now all goes well on Friday.

Hi Leeann, I am so proud of you!! I would have been angry too, especially waiting as long as you did for the appt. But, you go girl and be proud! You did exactly what I would have done. Standing up for youself and making sure that you got your co-pay back was an excellent thing to do. I am also glad you reported his "extra" charge for the labs to the insurance company. That is fraud and doctors can be dropped by insurance companies for cheating their patience by adding charges that are covered under the plan. I would love to have his phone number to call and let his staff and him know that this is not "an easy way out." This is hard work and sometimes not fun to deal with. When everyone else around you at celebrations are loading up their plates and I have to be happy with my little bit (and I am usually) or eating cake and sweets in front of me. That is hard sometimes. Not to mention the discomfort from constipation at times, taking vitamins (remembering them), drinking water all the time til you're sick of it, making sure I keep moving... Well, he needs to research for himself and see that major surgery is no picnic. However, the benefits outway the cons. I am no longer on diabetes medication, I am moving around without being out of breath as much and loving life more. As each day progresses, I realize that this is not easy, but it is working for me. I just want to give this quack a piece of my mind!! And let him know that I would never refer a friend or enemy to this insensitive moron!! I am glad you found a new PCP who is going to see you much sooner! Take a deep breath and feel good about how you handled yourself. And remember, everyone you tell about his insensitivity will be one less patient he ever has. That would be revenge enough for me!!!! Lori 293/259.8/140

Congrats to you for standing up for what you want. I hope all goes well and you get your referal soon. Kat

WOW Leeann, Way to go standing your ground! I have the Humana Gold Classic insurance & I read you had Humana too but another plan. But FYI - I read your documenting your diet history. I did too by way of Weigh****chers BUT none of my doctors along the way made any notations in my medical records. SO I'm now having to do another 6 months supervised diet c/o my NEW PCP via my Surgeon, as like you the old dork MD, said lose 75 pounds then maybe we'll discuss any WLS. And Humana requires the diet. Dr.Rehnke has me on a Super Atkin's Diet with no carbs at all. I feel like I'm in Heaven - eggs, meats (& fish) and cheeses. One month gone as of October 24th. Both my PCP & Surgeon will both Document because Surgeon has the digital scale as the PCP doesn't. But there's this little Clause in the Humana paper work Stating that during this 6 month diet if I lose 10% of my initial BMI at the start of this diet I can be deined the WLS. Starting at 600 lbs. - BMI 76. So at the earliest my Open RNY will be in April - May '06. Please keep your OH profile entries going. I plan on following your Journey Always with caring thoughts, Mike

Leeann, take a deep breath and congratulate yourself, because you just lost a LOT of weight - the exact amount that doctor weighs!!!! I don't know why some things happen, but it's going to be fine and you will be fine, too!!! Jan

God Bless your heart... I feel so bad that you were treated that way.. But you know what? If he was that bad and inconsidrate you need to find another Doc anyway.. Iwill pray that all goes smoothly for you and everything just falls in to place and you are approved asap..So keep your chin up and don't give up... Cyndee

This negative event will hopefully have a positive outcome for you. Blessings, luvitsunnyv

you go girl!!!!!! i had dr rosenthal as well... good luck to you

Thanks everyone, Alexis, I KNOW YOU.... we met at Fawn's party, I sat next to you. On another note, I have Humana POS, I did call and ask about the weight loss diary, and all information that would be required, and they told me, 5 different times, that as long as the doc deems it medically necessary, meeting the 40+ BMI and or at least 100lbs overweight then I would qualify. I do have the diet for my docs info though. So they can see I am not looking for an easy way out, which I know by far this is NOT EASY. Probably the hardest thing I will have ever done in my life, but I am more than ready. Thanks for all the support ya'll.

OHHHH YES!!!!!!! what a trip.... you will do fine.... hopefully ill see you at her next one ;) alexa