Question:
Any advice on...

my first appt with new PCP? My surgeon is requiring me to get a letter of medical necessity from my PCP. I have just changed insurance carriers so this is the first visit for me wtih this new PCP. Sadly, the PCP I had before, with Kaiser, would never have written. I have copied the paperwork that I filled out for the surgeon which gives info on my health and family too. This PCP was referred to me by the surgeons office, are my chances pretty good that she will write the letter I need?    — Lynn W. (posted on January 5, 2003)

January 5, 2003
Do you have a history of previous WL attempts with your other PCP? I know that was a big deciding factor with mine 3 years ago when both my husband and I approached him about it. At that time he really didn't know a lot about it, but told us that he trusted us to have done the research and know what we were getting into. He wrote very good letters explaining how we had been patients of his for many years and had tried all of the other WL methods with no lasting results. NOW that we have been sucessful with WLS, he recommends people to BTC where we had our surgery and he also has them call us. I lead the support group in our area and I know of several people that he has lead to us. Just be honest with your new PCP and MAKE him/her understand what a struggle this has been for you. Good luck.
   — livnliter

January 5, 2003
You say that the surgeon's office referred you to the PCP. I don't think you have anything to worry about. Your surgeon would not be sending you to an "unfriendly towards WLS" PCP.
   — Cindy R.

January 5, 2003
I agree that your surgeon would not steer you wrong but it may take a little while and more than one appointment before you new PCP will write it. All of your records from your last PCP need to be transferred to the new doctor so she can get a handle on your overall health history. I would expect an initial office visit, then you sign a release for her to get your records and then probably a follow-up visit in a few weeks to a month. A slight delay but not bad if she will support it. It's interesting your surgeon requires a letter from the PCP. I flooded the surgeon with medical history info and office notes and lab tests and he proceeded with the approval request. I actually did ask my internist to send a letter but he is so swamped that he did not get around to it until about the day I got my insurance approval. He really did apologize about it as he is in support of what I want to do. Now if I would have needed a letter from him I would have written the dang thing myself and asked him to sign it or sat in his office till it was dictated. Good Luck!
   — zoedogcbr

January 5, 2003
I also had to have a letter of necessity for insurance requirements for my HMO by my PCP. I too, had never been to this particular PCP. I just went in and said to him that I needed a referral letter for WLS, that this is what I wanted to do, that I had done all my homework, etc. He just said ok, as long as I knew what was involved, he would refer me. I think just being firm, and knowing what you want will go a long ways. If they think you are unsure, they might hesitate too, since this is such a huge step to take. Good luck in your journey!!...Teresa H...post op 25 days with Lap...-25 lbs.
   — teresa H.

January 6, 2003
This web site has some pretty good advice for educating your PCP. You can find that info (complete with a link to a sample letter to them) at: http://www.obesityhelp.com/morbidobesity/m-ins-pcp.phtml
   — Steve O.