Question:
My PCP has some nerve!
I have met the qualifications for surgery EXCEPT 12 more weeks of supervised weight-loss attempts. (I have already done this MANY times before, but I only have 2 months in the last calendar year). Talk about nit-picking. Anyway, I went to see my PCP Thursday and explained to him about needing three more months to fulfill this insurance obligation for WLS. Do you know what he said? He said, "I've never heard of anything like this. You aren't going to be motivated to lose any weight. Frankly, it would be a waste of my time and I'm not going to have any part of it". CAN YOU BELIEVE THAT? What a jerk! Like this is something I want to do? Like I want to wait another three months? Pig. My question is: isn't he required to do this? I mean he's contracted with my ins company and I gave him a copy of my denial letter explaining what I need as far as monitoring. I cringe at the thought of having to switch pcp's, move medical records, etc. Anyone have any ideas for me? K — Kimberly S. (posted on March 25, 2003)
March 24, 2003
Could you go through your OBGYN for this monitoring? After all weight has
a lot to do with female issues. It is worth a call. Then I would work on
finding a more friendly PCP!
— Pookie B.
March 24, 2003
Obviously not WLS supportive, find a NEW PCP.
— bob-haller
March 24, 2003
I absolutely love my PCP and would be very reluctant to change. However,
if she had not been supportive, I'd have switched. My insurance required 3
years of 'dieting' although I don't think it said it had to be physician
supervised and I had to have been MO for at least 5 years. The only person
who had that information was my PCP, so if she had not been willing to
cooperate, I'd have gone to another doctor and had them get my medical
records from her. She was very supportive and is now very pleased with my
loss.
— garw
March 24, 2003
i can't believe that! girl go find you a wls friendly pcp. you are going to
need the support of you pcp, your going to need to get labs and check-ups
and you need your pcp to be there for you and to understand what you are
going through! i hate that you had this experience! it was not very
professional. hope you get this resolved.
— TIFFANY R.
March 25, 2003
Your PCP is an ass. You do not have to tolerate his attitude. I would
personally file a complaint and change doctors because he obviously will
not be assisting you because he has no faith in you and you do not need
that kind of negativity. Medical records being moved around is not much to
deal with when you find a doctor who will support you. Just my opinion.
— Teena A.
March 25, 2003
HI!
Sorry you have to go through all of this to qualify for WLS! I had a
similiar problem with my FORMER PCP AND I MEAN FORMER!!! He flat out told
me that I would never qualify for this surgery and he refused to write me a
referral to the surgeon and after pleading with him and sending him
numurous letters telling him all of my weight loss pain, misery and
experience. He refused to look me in the eye on my doctor visits to him!
He totally made me cry and depressed and over the thanksgiving and xmas
holidays I was totally upset, depressed and I almost given up on WLS. Not
to mention that I was getting bigger and bigger by the week, and that jerk
of a pcp prescribed me several weight loss pills and instead of losing
weight, I gained weight. He even witnessed how bad my asthma was getting
and he still would not recommend or give me a referral!
I cried and cried and I prayed on this and finally, I COLLECTED MY MEDICAL
RECORDS FROM HIS OFFICE AND GAVE MY GOODBYES! He had the nerve to cop an
attitude because I informed him that I was going to another doctor in
another network! After leaving his network, I called all over Chicago and
talked to several doctors to see if they were WLS friendly and lord and
behold I found a wonderful doctor who wrote me a referral to the surgeon
the very first time I went to her office!!!!! She gave me a sleep study
referral and any other test that I needed she helped me in any way she
could!!!
I am a much happier person now and the pain is gone!!! I thank god each and
every day!!! Now, 115 pounds lighter and 5 sizes less, I am starting a new
beginning and my once out of control asthma and other major co-morbidities
has disappeared and I look like a totally better and different person! I
get several compliments daily and I love it!!!!!
I have not weighed this less in over 25 years!
THE BOTTOM LINE..........CHANGE YOUR PCP!!! YOU DON'T HAVE TO EXCEPT HIS
NEGATIVE ATTITUDE! GOOD LUCK!!SHIRLEY
— Shirley M.
March 25, 2003
Hi-- sorry you were treated so badly but please remember this: your PCP and
any other medical professional WORKS FOR YOU!!! You pay for their services
and if they do not provide those services, why go back? Do not put up with
this crap from anyone, ever. I think you should immediately find a new PCP.
Changing is not too bad, just call the PCP's office, tell them you are
coming to pick up your medical records on a specific date, pick 'em up and
shop around for a new doc. You may have to pay a fee for the records. Do
not let an ignorant MD screw up your chances to be healthy. Maybe before
you go to a new PCP you can check out the AMOS library and find a
WLS-friendly PCP in your area. I would also suggest writing a letter to
your new PCP to take with you (don't mail it, just bring it
along)documenting why you need this surgery (include all your co-morbs,
diet history, etc). Also, does your insurance company accept Weight
Watchers as a "supervised" diet-- it might be cheaper and less of
a hassle than going to the MD every month. By the way, congrats on almost
being done with the supervised diet-- You can do it!!
— lizinPA
March 25, 2003
Wow, unbelivable. Sounds as though your PCP might be really uninformed. I
don't know that I would stay with a doctor who was not informed on a
surgery that I was considering, and who was not willing to find out about
it. After all, your PCP is one of the individuals who will be monitoring
your progress after surgery...wouldn't he want to know as much as he could
about how to treat you? There are many PCP's in the world. PCP's who are
willing to go to any length's to help people with a disease. I encourage
you to look for one. Ask your current PCP's staff to make a copy of all
your records and then take them to your new PCP yourself. It's easy. Good
luck to you in finding the support that you need and deserve. You are
starting your journey!
— Susan F.
March 25, 2003
The nerve of that jackass! 1.File a complaint with your insurance company
ASAP. 2.Get all your records and find a new PCP. Look in the peers section
to find a WLS friendly PCP in your area. I'm not sure about what your
insurance company accepts as supervised weight loss attempts but mine
(Cigna) accepted Weight Watchers, Jenny Craig, TOPS ect...just as long as I
went to weekly weigh-ins. Dont give up and Dont let that jerk get you
down.
Sidney Open RNY 10-23-02 down 70+
— Siddy I.
March 25, 2003
Been there, done that....go to my profile page to read the story. However,
the good news is that my PCP from h*ll, left the practice and I have a new
PCP who is supportive of my plans for WLS. I agree with everyone else -
GET A NEW PCP!
— Debbie B.
March 25, 2003
What an a-hole.
— Iris B.
March 25, 2003
Thanks everybody for responding. My husband was so surprised by my PCP's
response. He figured doctors are in it for the money and will see you for
as many office visits as you like (more money in their pocket). I'm so
glad I found this website. Sometimes it just feels good to have someone on
my side. I called my PCP's office back today and got ahold of their
'referral coordinator'. She was so nice and seemed to agree that her boss
is an @ss (without coming out and saying it). She called Cigna and is
waiting for them to call her back. She is going to try and convince them
not to stall by making me wait three more months...that's really all she
can do. I appreciate her willingness to at least make the call for me. I
should know something in the next 2 days. I'll be making an appointment
with another doctor in the meantime. Sheesh!
— Kimberly S.
March 25, 2003
Just work with one of the nurse practitioner's in the physician's practice
for the next 3 months. Most like the FNP won't give you the same crap and
they are licensed medical professionals allowed to prescribe meds etc. and
the FNP is working under the direction of a MD. I would think this should
cover everything if the referral person isn't successful. Good Luck and
get a new doctor!!!
— zoedogcbr
March 25, 2003
It seems that your PCP is not anti the surgery but disgusted by the
insurance companies games. I had to change insurance to get the surgery and
therefore had to change PCP (my old one was supportive just didn't take new
insurance). I had picked out my surgeon and called his office for a
referral to a PCP that takes my insurance. Worked great. Best of luck.
— Sunny S.
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