Convincing my PCP

I have an appointment thurs with the pcp and am a bit nervous and not sure how to word things. For those that don't know, I had seen a bariatric surgeon but decided he wasn't really for me and started looking more into my options and decided on the DS. The only surgeon in my state that will take my insurance that does the DS is not located in my town; it is 8+ hours away. I called the surgeons office to confirm they would accept my insurance and the receptionist said that she didn't see any problems and I am registered to attend a seminar on jan 7th.

The way my insurance works is that in order to see the surgeon, I have to have a pre-auth from my pcp. I had previously had this already when I went to see this other surgeon. So my question is do I need to ask for a second opinion? It took them 6 months just to do the referral before to the other surgeon, I am just wondering that if they do agree to do this for me it might take them that long again. My insurance requires 6 months supervised diet but that wasn't the reason it took them that long. I had gone in with a year or more supervised diet and they still didn't want to do anything. They led me around for 6 months saying they were working on it when they really weren't. I figured I would go in there and tell them I want a different procedure done, get the dr to write a new referal or something and give them the fax/phone of this place and dr info telling them this is who to do the referral for. But I have a strong feeling she is just going to tell me to stick it out with this one and not listen to me. Before, I couldn't even get any other tests like a sleep apnea or egd test, or even blood work results. I have even been told they didn't have time to renew a referral when i told them a week before it expired. The receptionist from the old surgeons office had to get it extended just for me to go see them. Needless to say, the office workers don't do their job well. And I can't change my dr or I have to start everything all over again. Plus, this is the first dr to say yes to bariatric surgery since I have  been trying since 2008, going from dr to dr. As soon as I have the surgery, though, I definitely plan to change!

So you see my dilema. I am not sure the process I need to go through to change surgeons. Should I call the insurance company and ask them? Technically the old surgeon doesn't accept my insurance anymore anyways lol. Also, how do I nicely convince the office to do this for me if they say no? There is no office manager to complain to so I can't threaten them with that. Also, what if the doctor says to keep with the other one? Or even try to tell me that I don't need it? How do i convince them that this is the right one for me? Should I go in there with printouts on the internet and make a friendly debate about it? I am so worried they are going to tell me no and am freaking out about it. 

It is not your doctor's decision to make. It is yours. The referral letter does not have to come from a PCP (this may not be the case with your insurance so check first.) Do you have a gyno that you are comfortable with? If your only option is to continue with this doctor, you will need to advocate for yourself. Might as well learn how to do it now.  Print out the journal articles on DSFacts.com that show the long term success rates of the DS. Prove to her this is the better surgery for you and let her know you have a deadline that she has to meet. Call the office EVERY DAY until you have your letter.  Tell her sticking it out is NOT an option. If you still get nowhere, I don't see where you have a choice but to switch doctors now. You will need to cut your losses.

I don't see why changing surgeons should be an issue with the insurance company since this new surgeon is in your network. I am guessing they will tell you to get the letter from your PCP

The whole process I have been telling them what to do basically. I came in the first time with the doctor info all ready for them, everything my insurance required, and what they needed to do. I even wrote them a letter expressing my concern that they would hurry up with it already lol explaining why i wanted the surgery, how long i'd been overweight, all my comorbids, etc. I have no problem being angry or rude or straightforward, but they do have my information and I don't want to slow them down farther.

I plan on going in there with the new dr info, and research on the DS, ready for the debate, just wasn't sure if that sounded like the best idea or not lol.

As for other drs, I don't have any other specialists I see at the moment, so this dr is my only option at the moment. Before when I called everyday, they would hang up on me at times, or even hang up on my husband (I had him pestering them too lol) or they would tell us they are working on it when they werent. I do think it is time with a gamechange with this office lol. No more bs'ing me around. I have no problem showing up to the office if they hang up on me lol. I think I do need to be more frank with them but without being rude if possible. After all, I am fighting for my life here.

I have the appointment, they never ask why you make it lol. And I plan to arrive with a stack of info on the DS hehe. Good way of wording the asking for a new surgeon. Thank you. I will use that.

What DS surgeon are you going to use?

If your pcp is not helpful get a new one. I wouldn't have put up with the stuff you've already put up with.  You have a lot more patience than I do.

~Becky

I haven't really had a choice until now to switch doctors. I had gone to all of the drs in my network (which wasn't much of a choice) and all of them were anti-bariatric surgery. I still don't know if there are any new ones out there but there pretty much all like this. Last time I even had to wait 2 hours in the waiting room just to see the doctor. But if that's what it takes to get this surgery, I'd gladly do it. Frankly, I'd do anything to get this surgery, it's that important to me.

In fact, this is not the worst of the doctors I have been to. In 2008, when I fell off a bike and injured my back, the doctor then said 'you just need to lose weight.' And when I went in for a sinus infection it was 'you just need to lose weight'. And when I asked bariatric surgery she didn't like it but said to try 6 month diet. I did. She said give it another 6 month. I did. The whole time I was on 1200 calorie diet with exercise. Then she said no that she had a patient who was having complications (turned out she went to another country and it wasn't reputable) and she said 'doctors dont like to do it on patients who have depression'. And the whole time I never got more than an xray for my back. That to me is worse then putting up with some office bs lol.

The only choice of surgeons was Dr. Crookes. USC is the only one in california that will take medi-cal (medicaid) and financing isn't an option at this point in my life.

I like the idea of showing up at the office every day. They can't hang up on you. You can also make a complaint to the medical board in CA. That should get their attention. I think there are other places to complain to but other CA residents will need to chime in and direct you.

Yes and if I have to show up I won't be in a good mood because it is very painful for me to walk lol. I will definitely be disgruntled lol

Call your insurance company and talk to them.  You already have one referral to the surgeon that you are not going to use (because you YAY chose the DS).  Maybe that referral is a generic one for bariatric surgery?  Since it is the insurance company you ultimately need to impress, I would talk to them and forward all the DS statistical data/information to them as well.