Question:
My doctor does not want me to have the surgery. He says everyone that has it

ends up gaining their weight back. I don't believe him but what I am afraid of is, do I have to have a referral from him to have the surgery. He is my primary doctor and he is not going to give me a referral to have it since he doesn't believe in it. I have a consultation appt. set for April. Will I HAVE to have a referral from my primary doctor?    — Judy W. (posted on October 17, 2001)


October 17, 2001
You need to call your insurance. There are several of them out there that do not require a referral. I made sure my doctor was WLS freindly before seeing him. Change your PCP now if that is the case and it should take affect on the 1st. That is what I did. Good Luck
   — Kelly C.

October 17, 2001
Unless there is a life threatening reason for NOT HAVING this surgery that your primary care doctor knows about regarding YOU personally, GET A NEW doctor. That is HIS opinion. Your pcp should work with you not against you. The first surgeon my pcp(=primary care doctor) recommended had that same attitude. He was uncertain about doing it and thought diet and excerise LAUGHS OUT LOUD cause if that was the case DUH why would I be in his office now thank you). So I told him pcp I didnt like that doctor, I got a new surgery and I'm having surgery on Nov 1. Yes your pcp must give you the referral or your insurance will not pay. So dumb the doctor and get one that will work with you. Depending on where you live, I would ask around or even ask on here if anyone who is having his surgery and leaves near your area, could recommend their primary care doctor to you. good luck 0)
   — Gwen M.

October 17, 2001
Find a NEW primary care physician. I have almost finished all of my testing. My surgery is scheduled for Nov. 8th, and I haven't even told my primary care physician yet. He will know soon enough. I have to get a final approval from him.
   — Dianne K.

October 17, 2001
Your doctor sounds ignorant about the issue (unfortunately NOT uncommon). I actually never even saw my PCP until 1 week before surgery for the pre-op physical. My surgeon did the referral. I'd say call your insurance provider first to find out what they require. If you MUST get the referral from your PCP, then change PCPs. If it takes a little extra time then remember it's better late than never. Don't let an ignorant doctor discourage you. You know what you need. Good luck!
   — Anne B.

October 17, 2001
So, which surgery is he referring to? Some surgeries were mechanically flawed, could not work. Some surgeries work, but only in the updated models. Some post-op plans work, some don't. He's right. He's wrong. He's scared he won't know how to treat you afterward. One that IS certain, your comorbs will take you out FOR SURE. If you want to proceed, you may have to change docs. Sounds like this one is against you, whether or not you have surgery.
   — vitalady

October 17, 2001
I would use this opportunity to educate him by printing out as many supporrtive articles as possible, including letters from WLS and patient testimony. Then I would tell him that I was disatisfied with his practice of medicine based on unfounded superstition and that I wanted him to review the articles and reconsider his opinion. Depending on the severity of your morbid obesity, I would tell him that failing to refer you, given your condition may be considered medical neglect or worse malpractice and that you would feel the need to file a complaint about him to the local medical society and change physicians to someone more knowledgable. Of course, if you have to do that, you probably find a new one anyway because he ain't gonna look to kindlly on someone threatening his good standing because of his ignorance. Of course, that wouldn't stop me. I would file the grievance and see him one more time just to see the look on his face. But then again, I have anger issues. Consider that when reading my suggestions. Good Luck!
   — merri B.

October 17, 2001
Yes Merri you do have anger issues. Her Dr has a right to his opinion based on his experiences with his patients. We are all free to change doctors, but this is not negligence.
   — faybay

October 18, 2001
I had the same problem with a pulmonary doc I needed for approval, and changed sleep study hospitals to be rid of the imbecille. The story is in my profile. I will educate the jerk, do what I am going to do..... Once I am near goal I will pay out of pocket and see him with a before picture just to show him what surgery can do. Hopefully this may save someones life that he might otherwise discourage on WLS. Change pcps and see your old one next year when you have lost a lot. Or just tell your pcp you will leave if he doesnt provide a referral.... $$$ will motivate him to refer you. Doctors are businessmen and look at the bottom line.
   — bob-haller

October 18, 2001
I had an issue kinda like that - My doc was afraid to give me the referral, but she said I was the boss and did it. She said 'I hope you can prove me wrong.' And since then she has used me to learn how this works. Im sort of her 'case study' if you will... I gave her research, had my surgery reports sent to her, etc..It wasn't her fault, she just didn't know. I know how you feel though - sometimes the docs are just asses and like to play Insurance God.
   — jammie B.

October 18, 2001
In January 2000, I switched insurances and my pcp. I thought about the surgery from the time the insurance came into effect on 01/01/00. When I went to the doctor, he wanted me to go on Xenecal and diet, he did not believe in this type of surgery. In september of 2000, I went to see Dr. Gonzales and we talked about everything concerning the surgery and my health. I told him my pcp was not for the surgery. I will tell you what he told me. Find you a doctor who will support you in the type of surgery. My words of advise is you are going to need all of the emotional, medical and pysical support you can get from your medical team. Everyone has to work for a common goal-Your health and well being. From your surgeon, to your pcp, to the hospital staff during and after surgery,to your social support and you yourself . I remembered an internist who took care of my grandmother before her death and how compassionate he was. I went to him and he asked me why I was switching pcp's. I told him my game plan and if he was behind me. He said yes without hesitation. I love both my surgeon and pcp to death because I know they are behind me 100% and have my health as their #1 concern. If your pcp is not willing to provide you with that referral, ask around and find a doctor who will. Also, ask your insurance company if you need a referral. When I had BC/BS in the yr 2000, I did not need a referral from my pcp to see a specialist.
   — Jan M.

October 20, 2001
Merri, keep on being angry!! People in power need to use that power wisely. Doctors need to keep up with the times and make educated decisions. Judy, hope you find a new PCP quick! And be sure to look into DS; RNY does have a much higher regain rate. Chris
   — blank first name B.

October 20, 2001
Whether or not you need a referral depends on your insurance company. I did not need a referral for my visit to the surgeon and subsequent surgery. Check out your insurance plan; you may not need his approval at all.
   — Kathy W.

October 20, 2001
Personally I would get another doctor. I go to a clinic and they are always changing my doctors, however if possible I ALWAYS prefer women doctors. Usually they listen better, don't jump to conclusions before they hear "all" your simptoms and are allot more gentle when handling you. At the time I requested WLS I was looked at by a woman doctor I had never had before, however I had been at that clinic for around 15+ years so they had all my records with all the horrific weight gains (diets too) along the years. After my WLS I again had the male nurse practisioner that I almost always have. He laughed at my problem with swollowing big pills when I was in my dangerous low potassim phase. He said, You wanted the surgery you got it! A week later (after not taking those much needed horse pills) I got a woman nurse practisioner and by God she listened! And most of all she "cared"! I'm sure there are some woman doctors who are not good but I've had only one of many women doctors that I did not like. I think it was Julie who also mentioned something positive about women doctors. Sometimes men doctors think things are in a woman's "head". Anyway you WILL need a doctors approval, personally I would'nt waste my time with the doctor you currently have. "Nor would I try to change his mind". (It would be fun to see him a year or two after surgery, if no more than for revenge.) Kidding. But do find another doctor. Someone mentioned about finding people in your area who have had the surgery and go with their doctor. That sounds very reasonalbe. Life's to short to waste your time "trying to educated" some "doctor". Besides by getting another doctor you will probally get better care post op too and have better support from him/her.
   — Danmark




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