What do you do when your PCP won't give you a referral to a plastic surgeon?

My PCP seems unsympathetic to my desire to have reconstructive surgery. I'm having lower back and hip pain as well as pain in between my shoulderblades and shoulders. My RNY surgeon feels it's related to my excessively loose skin, heavy breasts, and hanging pannis. Instead of a referral to a plastic surgeon my PCP referred for physical therapy!! What do I do now? I selfpaid for my RNY and was hoping to get my insurance (PacifCare) to at least pay for a breast reduction and abdominoplasty.

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