hurdle in my way

My husband and I went to a seminar, picked our surgeon, checked with our insurance company if surgery was covered and made the first few appointments with the nutritionist, surgery center etc...  there is just one big hurdle in my way. I need to get my pcp to fill out the paper work and sign off. No big deal right?  Well... I haven't been to my pcp in like 15 years. Yes I know I know. But in general I really don't get sick more then a pain in the butt cold. So I haven't really felt the need to go. I've always gone to my obgyn so I figured that was good enough. So here I am nervous as heck to walk into my doctors office and ask him to fill something out after a 15 year drought of seeing him. I've also been on a diet my whole entire life but none have officially been supervised by the dr. Any advice on how to handle this awkward situation when I have my appointment this week?  I will really be heartbroken if he says no. 

Maybe your obgyn can do the form?  And if you PCP does not do that - it would be time to find a new doc. 

Good luck.

I was going to say the same thing.  Several years ago, my then ob/gyn was my PCP (she did my general annual exams when I was there - and my insurance company allows ob/gyns to be designated as PCP's).

if not, and if your PCP won't do it, then like others said, find a new one.  I bet lots of them are OK with bariatric surgery nowadays.  It's kind of become a routine surgery and it's much safer than it was years ago.

I wouldn't worry about your PCP saying "no" -- if he does -- then get another doctor.  Seriously.

If you needed a heart bypass which was confirmed by a cardiologist -- and your primary doctor said, "I don't think you need one -- you should try fixing your heart on your own.  How about a low fat diet!" -- you'd not be nervous or upset -- YOU'D BE IRATE AND GET ANOTHER DOCTOR ASAP.

Your bariatric surgery is life-saving surgery.  Being obese isn't a moral failing.  Being obese is a medical problem requiring intervention to improve your quality of life.  Currently, bariatric surgery has the highest success rate in giving us the best level playing field to regaining our health.  Needing help via surgery isn't up for the doctor to decide because you're "worthy" or not  -- especially if a bariatric doctor has already determined that you are a good candidate.  Your doctor has no right to keep you from acquiring the best health you can achieve.  

So, if your doctor denies you necessary heart bypass or gastric bypass -- you indignantly leave his/her office and find a doctor who will support your decision.  

Just my humble opinion.

Don't worry about getting the form completed.  Your doctor will talk with you,  review your health history and do a brief exam (height, weight, pulse, temp., blood pressure).  I'm sure he'll have no problem doing the paperwork.

As far as the supervised diet  that is generally an insurance company requirement.  You could arrange that with your PCP.  But call your insurance company and find out exactly what they require.  Generally it's six months to one year.  And that's about how long it takes to get through the surgeon's pre-op screening.

Best of luck to you and your husband.

Kat nailed it.

sure the appointment might be awkward, the first couple of minutes, but you have nothing to be embarrassed about. You are taking control of your health, and well being. Any reasonable physician will be on board with that. And if yours isn't, find one who is. It won't be a long search.

Im in Canada, so the process is a bit different, but here, what hala said is correct. A specialist can make the referral as well. So maybe you can do an end run around your pcp.

Good luck, and don't let this slow you down!

If your PCP says no, ask your surgeon for wls-friendly PCP names. Or go to a bariatric support group and ask who other people used to get their insurance letter signed.

Your physician will want to do a physical and blood tests for sure since he hasn't seen you. That's only fair since he can't make a diagnosis unless he knows what is going on with your body. Most insurances require that you be on a supervised diet AND that you have comorbidities like HTN, Diabetes or other conditions caused by your weight. His staff is used to filling out insurance paperwork but they usually will not do it unless they have the tests and exam to show what is actually going on.

I didn't qualify for insurance to pay so I ended up having to pay for most of the surgery (three hernias help cover a little part of the charges). It still was the best thing I have ever done for myself!

Good luck on your journey.

Ceci

I had the same situation, the only doctor I had seen was my gynocologist.  I really never got sick, and when I did, I just went to the doc-in-a-box places.  When I was thinking about having wls, I made an appointment with a well-liked family medical group and became a patient there.  On my first visit I advised the doctor of what my plans were and what I needed from her.  She gave me a physical and did the things requested from the insurance company.  I had no issues there. 

I agree this the others who say to find another doctor if one says no.  The surgery is a life-saver.  Good luck finding the right doctor.

As others have said - you shouldn't have an issue or just get a new PCP.  You haven't seen this person in 15 years, so what's the issue.  See one that knows your surgeon and they work well together.  Right now on my work desk board is the name of 5 PCPs I got from my surgeon.  My current PCP is a hold over from when I was a child and he retired and now I'm seeing the person who bought his practice.  She's okay, but I'm not crazy about her.  If I had to go to the hospital she couldn't even see me as she doesn't have rights where I'd go.  I'd have to travel 20 miles to a hospital and none of my bariatric folks would be connected to me there.  So it will be time soon for me to switch and it is likely time for you to move on.  Use this as a lever to find a new doctor who you want to engage with vs. avoiding for 15 years.