Question:
Do I HAVE to see the shrink my surgeon prefers? Can he refuse to do my surgery if I don't?
My surgeon requires that I use the psychologist that he recommends, why can't I use the one I did before? I had to have a psych evaluation to get insurance approval. Now my Dr. wants another one done by his recommended psychologist who is very expensive. My insurance will not pay for another evaluation. I passed the first evaluation and don't feel I should be forced to use his psychologist. Can he refuse my surgery if I don't see his person? — Janet W. (posted on June 22, 2003)
June 22, 2003
Yes, your surgeon can do just about anything he wants. He either has a
kick-back (money) involvement, or he really wants his patients to meet some
strict preparedness guidelines, and he knows this particular psych provider
follows his expectations. I would definitely stand my ground. As long as
your psych provider is a PhD or MD, there should be absolutely NO reason
you should have to go to his preferred provider. If your surgeon is
crooked, I wouldn't trust him. If he is above board but expects compliance
no matter what, well I guess it is up to you as to whether you are willing
to be controlled by him.
— bethybb
June 22, 2003
Why won't your ins. co cover at least a portion of the appointment...80% or
so? Do you have an HMO or a PPO? Good luck; I wish I had gone with my WLS
doc's psych the first time, instead of the one who "failed" me...
— rebeccamayhew
June 22, 2003
You surgeon can do anything he darn well pleases unless he is employed by
your insurance company, which is not typical. I would ask specifically why
another psych evaluation has to be done and that this is not covered by
your insurance. If he is that big of a jerk and won't budge then find
another surgeon. If he is the only one covered by your insurance then
complain to them what he is doing. I just made it clear from the start
that I was using my doctors and the surgeon said it was fine. I hope you
can work this out!
— zoedogcbr
June 22, 2003
Well, you guys know me and you won't be surprised that I had to jump in
here. First of all let me say that our surgeon requires all of our
patients to see a specific psychologist. This, in no way, makes him a JERK
and a KICK BACK is the last thing in the world that's involved. Let me
explain, as someone who works in the field, why we require the use of
certain medical professionals. We require that all of our patients see an
internist associated with the hospital where the surgery is performed. The
internist is not part of our surgeon's practice and the internist does not
pay, reimburse or kick back any type of funds to the surgeon or the
hospital. The reason we require you to see a particular internist is this:
As we all know, this is a risky surgery. If you should develop
complications while you are in the hospital we want an internist associated
with our hospital who already knows you and who already has all of your
records. This is in your best interest as a patient. As for the
psychologist - we require that our patients see a particular psychologist.
Once again, there is no payment, reimbursement or kick back involved
regarding the surgeon or the hospital. We send our patients to this
psychologist because he has made the effort to further educate himself
specifically regarding bariatric surgery and the psychological issues
associated with it. All of this is done with our patient's best interest
at heart. I urge those of you who have suggested that surgeon's are jerks
or of questionable integrity regarding the preoperative process would
reconsider your opinion. These opinions are posted as fact when in reality
they are simply an opinion and probably not based in fact. While WLS has
been around for a long time - the "program" aspect of it is in
it's infancy and all surgeons are different. Simply because one surgeon
does things differently than another doesn't make them less desireable,
knowlegeable or honorable. Let's try to stop the surgeon bashing and
realize they generally have a good reason for why they do things the way
they do. Thanks for the opportunity to vent and best wishes to all.
— ronascott
June 22, 2003
NO! If he wants to deny your surgery because you won't line a friends
pockets, get thee to another surgeon, PRONTO.
— Sharon M. B.
June 22, 2003
In a way, your surgeon is God in his world. If you want to play in his
world, then you have to follow his rules. If you don't like his rules,
then get thee to another doctor. It's simple really. There are many
surgeons, many beliefs and many diets associated with WLS. It's up to you
how you want to handle things. Best of luck - it's never an easy choice!
— [Deactivated Member]
June 23, 2003
I too disagree with the many comments here that make it look like the
surgeons are just slaves to the insurance, or money grubbers out to finance
their 'buddies' in the profession. I did my own research and the folks my
surgeon refers us to are the ONLY two in the entire metro area with ANY
shred of experience with WLS. Sure, ANY mental health professional CAN
write a letter stating that they feel you are qualified for WLS.. but their
reasons may not be the type of information that your insurance company is
looking for to give you the 'green light' for surgery approval.
There is also more to this than just administering and scoring the MMPI..
there is generally also a food evaluation test, and there is a follow up
with the provider to discuss your results and the type of surgery you
desire.
Perhaps you could have your test results from the previous round forwarded
to the provider of your surgeons choice, then just have the follow up
appointment? But it would depend on how long ago you did it too. Just a
thought.
My insurance company wouldn't pay for my testing.. but in the big picture
this was just another way for me to solidify that WLS was indeed the route
I wanted to take, and if it meant sacrificing in other areas to pay the
bill, then that's what I had to do.
Sure, folks can find another surgeon if they really want to, but in the end
you have to go with someone you can trust.. I know this sounds harsh, but
if all anyone is seeing in this is dollar signs and how fast they can have
surgery, then perhaps it's time to rethink exactly why they want to have
this done. It's utterly horrific how many posts I see here where people
seem to care more about what's going to be less of a 'bite' on their
finances than on whether their surgeon offers a good program (before and
after care) and is someone they feel comfortable trusting with their life,
because this IS the rest of your life you're talking about.
All of this of course is just my opinion, to be taken or left as anyone
sees fit. Best of luck whatever you choose to do. ~Peace
— Joscelin
June 23, 2003
Okay.. I have to clarify something here... Not all surgeons know EVERY
psych out there/in their area with wls experience. Just as long as you find
a psych you are comfortable with, and your insurance accepts should be
enough. How does anyone get experience without being allowed to experience
it? I'd go to who I was comfortable with. It is as simple as that. Hugs!
Good Luck!
— Sharon M. B.
June 23, 2003
Rona, I respectfully disagree. I feel that my treating psychiatrist of 4
years knew me way better and could determine whether I was mentally
prepared for this surgery and life change than someone who didn't know me
from adam. I have no problem if someone doesn't have a treating
psychiatrist and the surgeon sends them to his doctor of choice, but I feel
it is a slap in the face to my psychiatrist and our doctor/patient
relationship to say he can't do the evaluation as good as the surgeon's
doctor. JMO!
— zoedogcbr
June 23, 2003
I understand many of your responses supporting the surgeon's wishes to see
his specialist but in this case the other eval is already done. If there
is something wrong with it then he should call and talk with the evaluating
doctor. Not jump dump it in the garbage and start over. I'd insist they
submit with that eval, assuming it was a supportive evaluation.
<p>I also go forced into a situation where I had to use a local
internist while I was in the hospital as my internist did not have
priviliges at that hospital. I was fine with this till I met the guy, then
I tried to get another doctor. I doubt he could have saved me if he had
too. He didn't even ask many questions and I have a very extensive and
complicated medical history. When my surgeon found out I was making waves
about this doctor and wanted to change he was way less than pleased and
personally talked to me and pretty much made it clear that if I changed he
would have postponed or cancelled my surgery, which I did not want. He
gave reasons that this internist is familiar with working with the
bariatric patients etc and that he is used to all these co-morbs and it's
no big deal to him. That's exactly what my problem was - nothing was a big
deal to him, much less worth discussing. I let the surgeon have his way
but made it clear to my mom if there were any issues I wanted my internist
contacted immediately, even if it meant paying him out of my pocket. At
least I know he would pull out all the stops to save me and thoroughly knew
my medical history. Needless to say it was not a pleasant time whenever
the internist came to see me. If he said 10 words to me the whole three
days I was there that would be a lot. He didn't even give me discharge
information. Obviously he got wind of my opinion of him. To this day if I
never have him again, it will be just fine with me. If I end up having any
PS and they require an internist I will definitely get someone else.
— zoedogcbr
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