@doctorboo1 I am so sorry that you are dealing with a difficult situation regarding your treatment. Do you receive care at a COE (Center of Excellence) for HCM? I believe you can self-refer (request an appointment) at Mayo - here is where you can do that: https://www.mayoclinic.org/diseases-conditions/hypertrophic-cardiomyopathy/request-appointment/ptc-20122124 Be sure to select Rochester. When it was time for me to have a septal myectomy, my cardiologist here in Upstate NY referred me, sent all of my test results and whatever else they needed. I was accepted as a patient within a couple of weeks. It is definitely worth every ounce of effort to advocate for yourself; you deserve the very best care possible. Is there a different cardiologist near you that would work with you to get this done? In the meantime, you can decide to go to that website link and start the process on your own. Wishing you success in accomplishing this!