Question:
My medical groups approval board will not approve surgery.

My PCP has written a recommendation for me to see a gastric surgeon for a consult. However the Sutter medical board must also approve this. In order for this to happen - I also need a letter of recommendation from the Sutter Weight- Loss Specialist (I saw him last year and I think he will write a letter of reference for me) and then the review board approves me to go for a consult. The review board believes the surgery must be a last resort (a very subjective term). No one knows who exactly this medical board is - however, they hold the purse strings. I have been told that they do not approve many of these surgeries. I meet NIH criteria but this does not seem to be the issue. The gastric surgeon's office says that they will have no problem getting the surgery approved by my insurance (pacifiCare) but tecnically, I cannot have an appointment with him until the Sutter board approves me for a consult. Has anyone else had this problem? What did you do?    — Deborah J. (posted on February 26, 2000)

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