Frustrated with my PCP

Hello everyone, I hope all of you are doing well...  :)

In 2014 I finally found a PCP that would run labs that were very similar to Vita Ladys and a few others on here.

Before this my old PCP would only order what she thought I needed.       She ordered CMP  and CBC ,

 Iron, B12 , Vit D, ....She insisted the rest were not needed........I hated to leave her as she had been my PCP for many years, way before my RNY, however I was really unhappy that I could not get other labs done.. So in 2014 I changed to a PCP that my friend has....( not a gastric by pass friend) , I had my friend a explain my situation and how he felt about all the labs, his answer to her to pass on to me was, he would order whatever I wanted, so since then I have had full labs done, yearly and a few at the 6 month mark ....Now this year he sent me the lab slip and it only has CBC, CMP , Iron and IBC, Ferritin, TSH, B12, and Vit D............I called and was given the reason that the past 2 years worth of  labs have been perfect for things like Vit K, E, A, Copper, Selenium, Zink, Protein, Calcium, etc.... ..........So I am back to what my orginal PCP was ordering....I am going to ask  for the labs I would like, which is about 20 or 22,   I think, ...I don`t know what I am going to do if he refuses...

Any ideas on how to approach him or if he refuses?

EDITED:    here is the list he was ordering

CMP Lipid Profile

CBC with differential

B12

Bili-direct

Ferritin

Iron/TIBC

PTH

Magnesium

Folate

Thiamine (B1)

B6

Vitamin E

Vitamin K

Uric Acid

Vitamin A

Vitamin D (25 hydroxy)

Zinc

Phosphorus

Copper

Selenium

Prealbumin

. 

It might be worth asking your PCP how often he will order the full panel and if the issue is related to insurance.  

I don't know how often we need things like this, so I'm not going to respond to that part, however... my thoughts on other things...

As hard as it was for me to finally come to this conclusion, doctors work for US. Yes, they are medically much more informed than we are, and went to school, and have practiced a lot. Yes, we should definitely take what they say and give it some serious thought, and most of the time, follow their orders. However, if you want these tests done, then he should spend enough time answering your questions and explaining things to you so that they make sense to you. If he can only run the particular panels you want run every 5 years, then he should have already told you why. Maybe there's a perfectly good explanation? If there's not, then you should have the right to get what you want, as often as you want, as long as insurance is OK with it, and it benefits you.

Doctors are like tattoo artists.  They are our employees but they always have to follow their own ethics and have the right to refuse service.

If the tests aren't medically necessary in the doctor's opinion he has the right to say so and refuse to order them.  You can try changing doctors but honestly if your labs have been fine it doesn't seem like you need all that run again. 

Here is what I learned a few weeks ago at my RNY follow up with my surgeon... He tests folic acid.  Only that as far as the long list of less tested for vitamins and minerals. I asked him why only folic acid.  He said the following, "Folic acid is a great way to judge if you are taking your multivitamins and if you are absorbing them.  Folic acid levels like yours (mine was way above the normal range) show me what is going on with all of the things in your vitamins. I don't need to run 20 tests I can just check this and go from there. If it is high then you are getting plenty of the other things too."

Basically doctors are sneaky and know more than we can Google for.

Just my two cents

~E

I love this post for so many reasons but the first line is classic

Love what Elizabeth said. I do understand the logic the doctor's office has. Don't panic. If what you have been doing is working the chances of things suddenly tanking is small. My bariatric office doesn't even test for K or copper unless there is a reason.

Calcium and Magnesium blood tests aren't considered that reliable. If you don't have enough calcium your body will leech it from your bones. You should have a bone scan if you haven't.

Prealbumin is considered to be the most accurate for protein levels. I have had problems with my protein levels so I know this.

If you like this Doc and want to stay with him... I would ask him if he would do the bigger test every other time or every third time.

You can always supplement and add what you like through something like WellnessFx http://www.wellnessfx.com/thorne-bariatric it's self pay but if you aren't covered for whatever reason or you want them drawn more than your insurance will cover.

Here's more about the process http://theworldaccordingtoeggface.blogspot.com/2014/03/post- weight-loss-surgery-lab-work.html  

Thank you all for your replies.....I am leaning towards asking if the full labs can be done every other year or perhaps ever  year and 1/2 ..........Insurance is not a problem.

Thank you all..

I haven`t had a Bone Scan, just the Dexa Scan , I have Osteopenia.

Dexascan = Bone scan...