Omni Docs.....AAARRRGGGHHH!!!! (LONG)

Do any of you have a love / hate relationship with your PCP? I sure do! I love my Dr. Or - well I "used to" anyway. I have been researching WLS for over two years now. I've discussed it with my Dr. many, many times. Each time we've had the discussion, she has tried to talk me out of it. She says there are too many complications, that people always gain the weight back, that we just don't know enough about long-term consequences, that my insurance won't pay for WLS anymore, etc... Finally, I told her that I have read everything I could get my hands on. I understand the risks, and the complications, the life style changes, and that I KNOW my insurance company DOES still pay for WLS. I also told her that I felt like I have only two choices at this point - to NOT have WLS, and continue to gain weight, and certainly die much too young because of my co-morbidities, or to HAVE the WLS, and at least have a chance to have a normal life. She finally gave in and gave me a prescription for Xenical, which is the only thing left that I need to qualify, according to MY insurance company. Then she tells me that before she will request a referral for the surgery, that I must also complete a diet program through a local hospital. The program consists of full liquid diet, nutritional counseling, lab work, etc. It takes several months to complete, and costs OVER $3,000. This is NOT required by my insurance company. It's only required by the group of physicians that she is affiliated with - OMNI!!!! I finally said "that's enough." I called my insurance company, and requested a new PCP - a NON-Omni PCP, effective 8/1/04. I have truly been torn about changing to a new doctor, though. I hate to start all over with someone new. Well - today, I found out that I absolutely have done the right thing. I have OSA and use a Bi-Pap machine. Last night, my gel-filled mask sprang a leak! The covering has deteriorated and the gel is oozing out. The paperwork said never to use the mask if this happens. I called my PCP (still the OMNI doc for another week) and requested a referral for a new mask. The Dr.'s office says "you got your mask last August, and YOUR INSURANCE will only let you have one per year." So, now I'm supposed to wait three weeks with an unusable mask before they will even request the referral, which will then probably take another week! I absolutely cannot sleep without the bi-pap for a month. I called my insurance company, and guess what I found out!!! It's not "my insurance company" that won't authorize the replacement. It's the "OMNI" docs that set that rule up for their patients. AAARRRGGHHH!!!! I am SO glad I've finally realized what a run-around I've been getting. Maybe, now I can actually get someone who cares about me and my health - more than their bottom dollar!!!!

Sorry you are having such a hard time with your pcp. Mine was very supportive. In fact when I broached the subject with him he jumped on it. Said it would be great for me.

Hey. I hope you don't get upset....I'm from Texas.hehe I just wanted to say hi and tell you that you are lucky to get rid of the old pcp. I'm glad to know that we aren't the only people in the U.S. who have to deal with crappy docs. Just sorry that any of us have to pay the price for the ins and then have to put up with the docs. Cyn

Im so glad you found a new doctor! ive never heard of OMNI< so i cant help ya there!!! just thankful that you found this out!! dang!! who the heck do they think they are, anyways??? good luck with all of it hun!!!