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

Posted by fiesty76 @fiesty76, Feb 1, 2021

I am struggling to find a way to bring up again my request and need for a referral to an endocrinologist for help during this year of being off of Reclast for my osteoporosis. When I made the request in our brief phone visit, she brushed me off saying there were only 2-3 meds I've not been given and to just continue the yr off until I can resume taking Reclast.

I was truly shocked that she wouldn't provide a referral because when I'd asked for a referral to a nephrologist, she provided one. When I said I'd read of additional supplements to add during this interim, she said: "You take a multi-vitamin and it contains the supplements you mentioned". Mine doesn't and those it includes are tiny amts. I'm wondering if she just wanted to keep the phone visit brief and while I don't want to offend her, I could profit from additional help from an endocrinologist. Any ideas about how to approach this diplomatically and obtain the referral?

Interested in more discussions like this? Go to the Diabetes & Endocrine System Support Group.

@dorisena

My fear of being put in a facility provides my determination. I live alone and if I don't cook, do laundry, and take care of myself they would put me somewhere where I can be cared for because they aren't going to come in an do my care and chores for me. I like the cooking, I like the laundry, and only hate the sweeping and dusting. They do pay my bills for me and keep the checkbook balanced. Some doctors don't count chores as exercise. I do my stretching while I wait on the toaster to pop or the microwave to cook some food. I do exercise in the shower carefully. Mental exercise is also important so you can concentrate. I do Sudoku puzzles. I like math. I can't walk far but I try to increase the distance a little outside. I would prefer to walk with someone. My grandchildren will walk with me to buy something.
It is a struggle but it is better than a wheelchair, I think. I use a walking stick instead of a cane. Dorisena

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@dorisena, As another live aloner, I can relate to what you wrote. As a senior, staying independent is a primary goal for me as well.

I especially liked what you wrote about your exercises while doing chores. I recently clipped 2 balance exercise pages to my kit. cupboard doors ... easy to see and do as I prepare meals or kit. cleanup.

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@fiesty76

Hi, @susu2, Like you, I'm not great about prodding myself to start some projects I know will help my health...especially exercising alone. So, last yr I set one goal for 2020 to walk 3 x's/week on specific days and to "reward" myself each week with some small treat for ea. week I "did the deed"...lol I found naming the specific days helped me stay on track.

Another tool I use frequently is setting a timer for "dreaded tasks", easily put off like paperwork prep for IRS, etc and then Stopping the task when the timer goes off. Otherwise I tend keep going and quickly face 'burn out'.

@becsbuddy, started a walking/exercise group and there are participants in the group at all stages and abilities. Have you checked out that group? Usually can get to it from the Daily Covid 19 group. P.S. I'm a "sitter, beginning knitter and avid reader" too but have to restrict time alotted to each otherwise, I would become a terminal "couch potato". Smiles.

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I confess I have that attitude of "I've worked hard all my life and i deserve to sit and rest" which is bad for this time of the year and my forced isolation. I bought one of those exercise steps they use in physical therapy to use in my closet so I can reach to hang up my clothes on the top rack which was built for my husband's shirts, not me. It is a safe step so I can reach the top rack. So now i think I may go in the closet and do the step exercises I learned when I had my knee replacements. It is good for improving balance. Dorisena

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@dorisena

Thanks, I need to be on the team because I get lonely living alone and being cooped up by the weather and the pandemic. Dorisena

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Hi, dorisena, I think winter and the pandemic are making more people feel more lonely than usual, especially those of us who live alone.

Participating in the varied forums has helped me because it changes my focus as I read what others share. The diversion and different interest forums always make for a nice break in my day's activities while at home most of the time. In addition to the forums I follow, I sometimes scan through the different topics in the Daily Covid forum for info. that I might miss otherwise. Are there specific interest grps you follow on Connect?

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@fiesty76

Hi, dorisena, I think winter and the pandemic are making more people feel more lonely than usual, especially those of us who live alone.

Participating in the varied forums has helped me because it changes my focus as I read what others share. The diversion and different interest forums always make for a nice break in my day's activities while at home most of the time. In addition to the forums I follow, I sometimes scan through the different topics in the Daily Covid forum for info. that I might miss otherwise. Are there specific interest grps you follow on Connect?

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Yes, I am an avid reader of many topics and keep up with the Covid news daily. I also keep up with nutrition guidelines and have done so since I was a young person. The lifestyle changes being forced on us these days are for our safety, but inhibit our initiative and desire to enjoy life with other people as I have done for so many years, especially my volunteering. At age 85 it may be too late to get back in the game enough to be satisfied. I am working on it. I have knitting and sewing I can do, and my piano to play. But I am a people person who thrives with communication activities. I am glad to have this opportunity to connect on this site. Dorisena

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SHe not worried about offending you is she? Get another PC. Don't be nervous about seeing the Doctor, Remember she works for you. Good Luck

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Your comment brought a chuckle and shake of the head, @londonwc1. Thank you. She did agree to recommend a specialist but haven't received the referral yet. I'll wait another week and recall her office if I've not heard.

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How horrible. I hope someone on this website has good advice.

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Frankly, I think my primary doctor referred me to a nutritionist because he didn't want to deal with the needed nutritionist advice and knew Medicare would pay for it. And he referred me to a endocrinologist because I asked for it and thyroid issues are difficult to assess, I have read. I have a history of rejecting medications he has prescribed for other problems, mostly blood pressure and arthritis. I can get an appointment with an orthopedic firm without referral because they have 60 doctors and seem to give appointments for all phone calls, even though it may take some delay. If you tell a doctor that a medicine gives you upset stomach or something, that helps to encourage them to give you to another doctor. Try using the side effects as a complaint, which you have already done, I think. I live close enough to a metro area that doctors don't mind you going elsewhere so much because they have plenty of business.
Right now doctors are not that busy in their practice so they will talk to you on the phone and be helpful, I have found. Dorisena

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@dorisena

Frankly, I think my primary doctor referred me to a nutritionist because he didn't want to deal with the needed nutritionist advice and knew Medicare would pay for it. And he referred me to a endocrinologist because I asked for it and thyroid issues are difficult to assess, I have read. I have a history of rejecting medications he has prescribed for other problems, mostly blood pressure and arthritis. I can get an appointment with an orthopedic firm without referral because they have 60 doctors and seem to give appointments for all phone calls, even though it may take some delay. If you tell a doctor that a medicine gives you upset stomach or something, that helps to encourage them to give you to another doctor. Try using the side effects as a complaint, which you have already done, I think. I live close enough to a metro area that doctors don't mind you going elsewhere so much because they have plenty of business.
Right now doctors are not that busy in their practice so they will talk to you on the phone and be helpful, I have found. Dorisena

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@bustrbrwn22 and @dorisena, Thank you both for your responses.

Someone mentioned that specialists requiring doctor referrals here might be due to my having "managed care" ins. I've read that if a Medicare recipient, which I am, a patient should be able to see a specialist without a referral. I really don't know if this is just a local "custom" or for other reasons. Whatever the reason, it causes delays and puts the burden on the patient to receive additional care. My Reclast infusion stopped in August has left me by mid-Feb. to my own wits for additional help.

Our city of over 250,000 has 2 large hospitals (one a teaching facility) and a third heart hospital. We are considered the "medical hub" in this part of the state. It would be interesting to ask a specialist I see what drives the need for referrals here.

I do know that my pcp's clinic has a much longer wait time now in calling for an appt. or request for a return call from nurse. Usually, my calls are returned the same day. The 2 call requests for a nurse to return my calls since my last annual visit on 2/2 have not been returned. While mine is not a critical or emergency situation, it is worrisome. Thanks for a chance to vent...smiles

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@fiesty76 Conditions here are similar. I suspect the COVID19 virus is partly to blame, but probably a shortage of medical staff. Many of our doctors have decided to retire because they couldn't deal with all the rules and regulations and paperwork - couldn't deal with the government telling them what to do. Too bad, because they were experienced, knowledgeable, and cared about their patients. We now have a ton of nurse practitioners and physician assistants, who, although very caring and committed, are not doctors. Been waiting for an opening for an MRI and CT scan, but the wait has grown even longer for doctor's appointments. Suspect also that our area is not nearly as attractive to medical folk as the big city medical centers, although the wait for appointments there is long also.

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