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Need Help With Asking PCP Again for a Referral to a Specialist
Diabetes & Endocrine System | Last Active: Mar 7, 2021 | Replies (75)Comment receiving replies
@fiesty76 That you like your doctor makes it that much more difficult to possibly change but you have to do what's best for your own health. I had a great relationship with my prior PCP so it was a very difficult decision for me to make, but he dropped the ball on a few things, so after much thought I decided I needed to change. I didn't want him to drop the ball on anything else. It was odd because he was usually very diligent, sometimes he seemed to be too diligent and overly careful, and I still don't know if I made the right decision because my new doctor does not seem very caring.
Relationships with doctors can be very difficult. You want the best doctor possible but it also helps if you have a good rapport with the doctor. I think though that you should definitely insist on your doctor giving you a referral if one is needed. If you are on Medicare you don't need a referral unless the doctor you want to go to insists on it. Some do.
I am always wary of doctors who do not want to refer, are they trying to play God and not giving the specialist their due? Thankfully that is not a problem I have had, all of my doctors are happy to refer me to someone who is a specialist in whatever the problem is.
JK
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@contentandwell, Yes, JK, having a good relationship with the doc does make a decision to change much harder...especially for one who dreads change anyway. smiles Thanks to the confidence building suggestions from you, @johnbishop, @merpreb, @sunnyflower,@sueinmn, @colleenyoung, I am happy to report that my pcp approved my second request for an endo. referral! Started with 1 Big Thk U and 1 Big Request, I read to doc my "Plea statement/reasons for referral request" lol and she said "yes" to the referral! BIG relief and you guys get the credit.
No reference to her earlier denial and the fact that she had a young intern shadowing her may have contributed. I also said another opinion might not change anything during my yr off from Reclast but it would help "the worry wart's" peace of mind to know I'd tried all I could to add to my bone tool box. I wonder if she realized how stressful her first denial was and if reading out my family history and reasons for wanting another opinion made the difference.
Had placed 2 direct calls to Endo. offices about requiring referrals and accepting new patients and both required referrals and had closed practices.
A good friend suggested that the denials might be due to the fact that I was in a "managed care system". That sent me for more info. on "managed health care" and I learned more from: https://www.fool.com/investing/general/2015/10/06/what-is-managed-care.aspx.
My state retired teachers plan started at retirement with Aetna, moved to Humana, and recently changed to United Health. The last two are Medicare Advantaged Plans. I'm still not sure if it is just a local decision to require doc referrals to specialists or my particular ins plans but neither of the 2 endo offices asked about my ins. just my name and birthdate.
Local friends with other ins and direct requests for other specialists have also been told referrals were needed. It seems odd that members in other locations have suggested that Medicare patients might not need a referral. Just happy that the doc agreed to the request and will now play a "wait & see" about how the next year goes. Sending cyber hugs to each of you for your help and reassurance. Fiesty