How about using his/her own best judgment and experience and keeping your patient's interest as top priority no matter what insurance says or what "institutions" suggest ? Or at least inform your patient about options and recommendations ,old and new, and letting than patient decide - as YOU did for yourself. You made decision of not having biopsy, you were offered one. It makes it completely different case, I am sorry. I had doctors who prescribed to me meds. "off label" because they knew I would benefit even though "it was not recommendation" and I have doctor fighting for medication for me that was not covered by my insurance. I had doctor removing extra tissue for analysis even though only one sample was required. Etc, etc. When doctor knows and cares and loves his/her job and puts patient's interest above all, doctor finds the way - ALWAYS. Can honest mistake happen - of course !!! When it IS honest though than "I am so sorry" sentence with full explanation follows, not a BS of "it would not make any difference". (???) I will refrain from using derogatory "names" for that doctor here, but I have plenty. Phill, we will have to agree to disagree about this. I would also appreciate if you stop discussing this issue with me , I know that perhaps you are trying to help, but you are not helping me. I am just reliving this trauma over and over again when you write. We have completely different views about life and relationships in general. I really appreciate you posts that are related to PC and treatments and I will always read them : ). I wish you only the best and I wish you compete and forever healing .