Question:
What do you do when your PCP won't give you a referral to a plastic surgeon?

My PCP seems unsympathetic to my desire to have reconstructive surgery. I'm having lower back and hip pain as well as pain in between my shoulderblades and shoulders. My RNY surgeon feels it's related to my excessively loose skin, heavy breasts, and hanging pannis. Instead of a referral to a plastic surgeon my PCP referred for physical therapy!! What do I do now? I selfpaid for my RNY and was hoping to get my insurance (PacifCare) to at least pay for a breast reduction and abdominoplasty.    — LLinderman (posted on November 8, 2002)

November 8, 2002

   — Amber L.

November 8, 2002
I would find me another PCP that has more knowledge about WLS and it's after effects.
   — babrewer

November 9, 2002
If your PCP is not giving you a referral you have one of two choices. You can demand that he give you a referral to a plastic surgeron since he is your PCP and you pay premiums out of your paycheck every month to receive medical care or you can find another PCP. Just let him know that you prefer to proceed with reconstructive surgery. Never let anyone bully you when it comes to your health care. While the physical therapy may be good for some people, we know that the hanging skin causes stress on back and joints. If we know this, the physical therapy will do no good until the skin is gone. You have to do what is best for you and if your present PCP is not familar with the whole redundant skin issue that people who have lost massive amounts of weight have to go through then it is time to move on. My suggestion would be to try to search for people on here who live in your city and have gone through this process and see if they can give you some names and numbers of WLS friendly PCP's who are not against reconstructive surgery after weight loss. Good luck. Never let anyone tell you what to do with your body.
   — Skyedancer4u1

November 11, 2002
I'm not sure what type of insurance you have. I'm assuming it's an EPO, HMO or POS (point of service) plan. They would be the only plans to require you to get a referral. If you have a PPO plan, you can go to ANY doctor you want. If the PCP won't give you a referral and you truly need one based on your health insurance, I would find a new PCP or tell him you will if he won't give you the referral. Explain to him that after this massive weight loss would he really want his body to look like this with all the massive amounts of excess skin?? Highly doubtful. People need to remember that doctors are NOT gods and should not be treated like that. Question your rights and what's best for you and if you don't like the answers, go to someone else.
   — Patty H.

November 11, 2002
Linda, Does your insurance require that you have a referral from your PCP? I had breast reduction and went straight to the plastic surgeon. I never even mentioned it to my PCP. My insurance companies (I had 2 insurances, BCBS Federal Plan and Champus) covered all of it.
   — Hackett

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