Question:
Has anyone else had their PCP against their decision for WLS?

I live in a very small community (there is only 1 hospital within 100 miles). When I approached my PCP about WLS 4 months ago, he shut down the conversation quickly, saying it was too risky. He has had at few of his patients go to local surgeons and ended up in ICU for months- or worse. I decided that I really do want WLS and have pursued it through a reputable surgeon in a major metropolitan area that has plenty of experience (I meet with him in 2 days). I really respect my PCP and know that I will need him onboard for my recovery and aftercare when I come home. Should I call him tomarrow, before meeting with the surgeon, and tell him of my plans and try to get him to agree with my decision or should I contact him after I return from my meeting? I called my insurance company today and they said that I do not need a referal from my PCP, only a diagnosis of MO that can come from my surgeon.    — Patrice (posted on April 14, 2004)


April 13, 2004
Ask your perspective surgeon for the name of a supportive PCP in your area. Going to a major metropoltian area for surgery is likely a good one, as often they have better results. I would switch PCP if necessary to get better aftercare.
   — bob-haller

April 14, 2004
I'd change PCPs. You shouldn't have to play games to get the medical care you need. There are plenty of PCPs who will support your quest for good healthy, find one.
   — Angie M.

April 14, 2004
Ask you prospective surgeon if he would be willing to speak with your PCP. Then, tell your PCP that you've made up your mind and you are educated about the risks. Explain everything as you have here. Then, ask him to reserve his judgement until after he speaks to the surgeon. You should make it clear that you are not looking for his approval, you have made yur decision. You are looking for his support though. Good luck to you. I guess if he throws a fit or doesnt listen, it's time for a new PCP. I'd let him know that too, if that's what you decide. It really is important to have a PCP to support your aftercare program.
   — LMCLILLY

April 14, 2004
My PCP was against the WLS, he had reversed several. I had the surgery and went back to see him. He was blownaway. I look so healthy and I am down 40 pounds in 2 months. I made a believer out of him. I had to , because I hate to be told " I told you so ".
   — Loriann J.

April 14, 2004
My PCP was not adamantly against the surgery, but he wasn't for it. As it happened, I went with my elderly mom to her appointment with him the day after I got out of the hospital. He couldn't get over how good I looked then. It so happened that another of his patients, this one was also a brittle insulin dependent diabetic, had surgery with the same surgeon as I the day after I had surgery. The diabetic man went on to lose enough weight he came off the insulin. (I work with his wife). I did very well also. My doc is now a believer in this surgery for those who persue it!
   — koogy

April 14, 2004
I had this happen and I changed my PCP. Take your health in to your own hands. Just because they are an MD does not give them the right to decide my course of action to address my morbid obesity. I am guessing MD's that do not support this may have never had a weight problem.
   — Jackie P.

April 14, 2004
My PCP didn't want me to get it either. As a matter of fact, I wanted to do it earlier and he talked me out of it to try yet again, another diet. I put everything I had into this diet, but like all the rest it didn't work. So, the next appointment I made was for the WLS. Finally, my PCP agreed that I had done everything possible and he blessed my decision!! And it has been the best decision that I have ever made for myself!! Good Luck!! Danette
   — Danette C.

April 15, 2004
I let 2 PCPs talk me out of this over a few years. In the meantime, I put on over another hundred pounds and developed an array of painful problems. Unfortunately even some PCPs have outdated ideas about this surgery and can be susceptible to the same bias against obese people that we find everywhere else in society. The facts are simple--less than 2% of people 100 pounds or more overweight can lose the weight and keep it off without this surgery. And if they don't lose it, they WILL have a host of health problems. I think your idea to see a surgeon on the outside is a great one. I don't think it should matter when you tell your PCP, as long as you are firm in your decision. If you think he won't respect your decision and support you, go to someone else. There is no place for that kind of pissyness in the medical profession. It's your body! Good luck!
   — christied

April 16, 2004
I'm four months post op. When I approached my PCP about WLS over 3 years before I had it...he, too, strongly discouraged me because of risks (even though I had few co morbids..no diabetes, heart disease, etc.) and 'bad experiences' his practice's patients have had with WLS (several fatalities at highly regarded university based programs) After unsuccessfully following his advice (AGAIN) to 'try harder' at diet and exercise for several years , I finally decided that I WOULD have WlS. I chose to first meet with the surgeon to discuss surgery, options, etc., but had meeting set with my PCP within a week aftewards. When I met with him to ask his support, he agreed. It was interesting to me that even though he's been my PCP for 14 years (I'm 50), when he read the diet/weight loss summary I'd prepared for his convenience in helping with my documentation and referral letter, he said, "Oh, I didn't know you'd done this, I didn't know you'd done that (OP therapy weight loss program, physician supervised liquid protein program, etc.) Don't give up. Your PCP CAN be educated, and it sounds like you've already done your homework in selecting a good surgeon/ program. I can't WAIT for mine to see me...but I haven't needed to see HIM yet!
   — Karen F.

April 18, 2004
Thank you all for sharing your experiences and advice. I went to the consultation with the surgeon 3 days ago. I am going to go ahead with the LAP RNY. I do need my medical records from my PCP sent to my surgeon, so I have decided to contact my PCP before faxing in the request for medical forms. As I said before, I really respect this doctor and would rather not find a new PCP but you are right, I will need to find a new PCP if he does not support my decision. He was quite overweight up until late last summer when he lost a LOT!!! But when I asked him what he was doing, he said he did not reccomend it. I believe his weight loss was mostly stress related. So, he does know what it feels like to be on both ends of the weight spectrum, and I think that may even give him the "I did it, you can too" attitude. I am just curious as to how long he will keep it off. (I've already been where he is now - SEVERAL TIMES)
   — Patrice

May 3, 2004
Hi, I feel for you. You can check out my profile. I had to move on to another PCP. K
   — Kimberly S.




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