Need Help With Asking PCP Again for a Referral to a Specialist

@fiesty76- You are entitled to a referral or maybe you need a second opinion? There are crazy laws about referrals and insurance. I think that you live in TX.
https://dshs.texas.gov/medical-advisory-board/laws-rules.aspx
Does this help at all?

@merpreb, Thanks, Merry for your quick response and TX advisory gov. link. The link covers more legal information on a wide range of topics but nothing found on how to make a 2nd request, without upsetting the doc,for a specialist referral.

Hoping someone in groups with more finesse than I can suggest an approach to get my need across without offending the doc.

@fiesty76 Sometimes you just have to be blunt with doctors but it's always best to have a planned approach when discussing a referral request. I found a really good description of how to approach your doctor but it does come from a legal website. It's a one page read with some good thoughts and questions which should not upset your doctor. Excerpt from the page with the link under it.

"As a patient, here’s what you can do to prevent referral issues:

Don’t accept the first answer. We often back down when our doctor doesn’t seem to be concerned and minimize what is happening with us medically. After all, they have the medical degree. Understand you are in the best position to know what is happening with your own body and when it is unusual or concerning.

Speak up. If you are having unusual symptoms which concern you, but your physician dismisses them as “minor,” ask for a referral anyway. If needed, make another appointment to discuss. Calmly ask why your physician doesn’t feel a specialist is needed and share why you do.

Assess the relationship. Understand the relationship you have with your primary care provider. If you’re not comfortable and see signs you’re not being listened to and understood, consider finding another provider sooner rather than later. The stronger your connection, the more likely you will be heard when the time comes to be referred to a specialist."
- When Your Physician Won’t Refer: https://www.thomaswicklaw.com/blog/physician-wont-refer/

@fiesty76- John really hit the nail on the head with his post. Why do you care if you upset your doctor with something that you feel is necessary? When I felt like this a friend of mine said, " You pay for the insurance that pays his fees". Well, ok that was a bit cold of an answer but it made me braver. But in all, it's true. Asking for something is not an offense.

Check your insurance policy or call their support line for their referral rules. In many policies, you don't need a referral if you have seen that specialist (or another like one) within a set period of time.
Sue

@sueinmn- Especially with Medicare!

@johnbishop, Thank you, thank you for your response and excellent link! My doc and I have had a good overall relationship and have talked about other shared interests over the several yrs she has been my pcp so that was another reason I was so surprised when she declined making a referral. I don't like confrontations in general and really don't like needing to change docs but have done a few times much to my benefit healthwise after long deliberations. Reading the article gives me more confidence to repeat my request with additional reasons for thinking it might add more tools for my "bone box". You've added more calm to my day!

@merpreb, I so agree with what you wrote about John. He's another of our group treasures! Thx for responding. My doc may have been having a frustrating day...3 unsuccessful tries on diff days from her end for Zoom finally resulted in using the phone which certainly couldn't have added pleasure to day's schedule.

@fiesty76, you'll notice that I moved this discussion to the Bones, Joints & Muscles group and the Endocrine System group. I did this so that you can get tips from members who have sought to get a second opinion from an endocrinologist.

No help at all. Switch.