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?

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What I notice in the doctor's offices is a change in employee staff, both office and patient care. They are not the trained nurses we had in years past, but young people just beginning their employment. They don't seem to stay long and six months later there are new people working there. One thing that I think is complicated for current doctors is that they must search the web to decide on medications for the correct diagnosis, and pills seem to be their first choice for remedies. The obesity problem in medical staff doesn't seem to be addressed by the doctors, as I observe the staff crossing the street from the hospital going to the fast food restaurant on their breaks. It would be helpful to have good role models in the health industry. My doctor is thin, however. Dorisena

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@trishanna

@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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@trishana, Yes,unfortunately I'm also hearing of more doctors leaving the profession as well due to increasing rules and regulations. It is troubling that as more and more n.p.'s and p.a.'s are becoming the norm, it becomes harder to see the physician specialist.

Was happily surprised to finally receive a call back from my pcp's nurse yesterday. She said they'd had tech. difficulties with their patient portal and agreed to put a copy of my lab report in the mail. When asked about the status of the endocrinologist referral, she said that although the doc had noted the referral request, it had not been sent to the referral group. After asking me the "reason" from doc for referral and checking with my ins., she reported that ins. would cover and that I might expect a referral in the "next week or two".

Over the yrs, we've established a great relationship and I asked if she and the other phone nurse had received the Moderna vaccs. I was very surprised and disappointed to hear that both had decided to "wait awhile". While I see reports that docs are readily taking the vaccs and are encouraging everyone, when eligible, to get theirs, I am also hearing that many nurses and other health professionals are not. I just cannot fathom this. I appreciate your response, Trishana.

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@dorisena

What I notice in the doctor's offices is a change in employee staff, both office and patient care. They are not the trained nurses we had in years past, but young people just beginning their employment. They don't seem to stay long and six months later there are new people working there. One thing that I think is complicated for current doctors is that they must search the web to decide on medications for the correct diagnosis, and pills seem to be their first choice for remedies. The obesity problem in medical staff doesn't seem to be addressed by the doctors, as I observe the staff crossing the street from the hospital going to the fast food restaurant on their breaks. It would be helpful to have good role models in the health industry. My doctor is thin, however. Dorisena

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@dorisena, We are seeing so many changes in our medical system and staffing that at times I long for my decades long relationship with my family physician who treated the "whole person" and would make specialist referrals whenever needed the same day. Patient care has changed so vastly since his retirement, 15 yrs ago, he would be astounded at the changes.

While obesity is an alarming issue in the U.S. and much is published regarding its prevalence, suggested treatments, etc, I was taken aback at my doc's reply when I asked for help with my unintended large wt loss. Her cavalier response, "I wish I had your problem!" really upset me. She did order labs and scans to determine the cause, which none revealed, sigh. However, suffering a 30 lb wt loss over a year, is nothing to make light of and hers seems to be the prevalent opinion. Dietitians and self-research reveal little other than eat more caloric foods, ets. Well, I Know to do that.

No intention to discredit what you wrote at all, Doris, just using this as a place to vent...hope you understand my frustration. Whether over or under weight, I hope all of us will continue to self-advocate and research ways to stay as healthy as possible. After all, we are the "stars of our own parades of life", yes? Smiles and good wishes to all.

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@fiesty76

@dorisena, We are seeing so many changes in our medical system and staffing that at times I long for my decades long relationship with my family physician who treated the "whole person" and would make specialist referrals whenever needed the same day. Patient care has changed so vastly since his retirement, 15 yrs ago, he would be astounded at the changes.

While obesity is an alarming issue in the U.S. and much is published regarding its prevalence, suggested treatments, etc, I was taken aback at my doc's reply when I asked for help with my unintended large wt loss. Her cavalier response, "I wish I had your problem!" really upset me. She did order labs and scans to determine the cause, which none revealed, sigh. However, suffering a 30 lb wt loss over a year, is nothing to make light of and hers seems to be the prevalent opinion. Dietitians and self-research reveal little other than eat more caloric foods, ets. Well, I Know to do that.

No intention to discredit what you wrote at all, Doris, just using this as a place to vent...hope you understand my frustration. Whether over or under weight, I hope all of us will continue to self-advocate and research ways to stay as healthy as possible. After all, we are the "stars of our own parades of life", yes? Smiles and good wishes to all.

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I am on this website to share what works for me in reversing diabetes and to seek ideas that improve our health. I hate bringing up policy matters, because it is the job of the medical industry to serve our needs in the best way possible. But sometimes we notice that methods of delivering good health care could be improved. So I am at home, not feeling well, and waiting for the phone call to diagnose my issues after six months of dealing with health problems, plus the pandemic. Help is a bit slow in coming these days. It is easy to get referrals in my area, but sometimes I think the elderly are tossed around between medical practices. Dorisena

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@fiesty76

Thank you for taking time to respond, @sunnyflower. Goodness! you've really had doc/patient experience! I'm really hoping that a second request will result in a referral.

I appreciate what you shared and have typed out what I want to say to Doc. My own 7 fractures earlier from a fall; my mom's 3 falls/3 hip surgeries...sister & cousins on maternal side, bone surgeries...live alone...reduced social circle due to moves and deaths, wear med. alert and I.D. bracelet; on bone meds for yrs and feel especially vulnerable during this yr off, etc; a second opinion would ease my mind one way or the other.

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Dear fiesey76, I haven't been around for a bit. Are you ok? I hope and pray so. You are in my heart and prayers. I just hate what you're having to go through and Hope things have been better with your situation? Warmest wishes, Sunny flower

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@sunnyflower

Dear fiesey76, I haven't been around for a bit. Are you ok? I hope and pray so. You are in my heart and prayers. I just hate what you're having to go through and Hope things have been better with your situation? Warmest wishes, Sunny flower

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Always glad to hear from you, @sunnyflower. Yes, I am doing well; have had the 2nd Moderna Covid vacc and my pcp agreed to place a referral to the endocrinologist for me. Nurse called back yesterday to say that my annual lab report would be mailed and that I might get a referral appt. in a couple of weeks. Things are looking up. Hope you are doing well too?

Weather is playing havoc across the U.S. so hope you and all are staying as well, safe, dry and warm as possible!

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@dorisena

I am on this website to share what works for me in reversing diabetes and to seek ideas that improve our health. I hate bringing up policy matters, because it is the job of the medical industry to serve our needs in the best way possible. But sometimes we notice that methods of delivering good health care could be improved. So I am at home, not feeling well, and waiting for the phone call to diagnose my issues after six months of dealing with health problems, plus the pandemic. Help is a bit slow in coming these days. It is easy to get referrals in my area, but sometimes I think the elderly are tossed around between medical practices. Dorisena

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@dorisena, Like you and me, so many others I hear from often feel as though we seniors (although you may not be a sr) are treated less pro-actively than younger patients. It may be because we have more health issues and their time is limited or it may just be because they figure we are old and not as treat worthy as younger patients. Here is hoping you get a phone call soon with help for your health issues. All types of medical care and treatment seem to be moving more slowly now than before the pandemic. Hope you are feeling much better soon!

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@fiesty76

Always glad to hear from you, @sunnyflower. Yes, I am doing well; have had the 2nd Moderna Covid vacc and my pcp agreed to place a referral to the endocrinologist for me. Nurse called back yesterday to say that my annual lab report would be mailed and that I might get a referral appt. in a couple of weeks. Things are looking up. Hope you are doing well too?

Weather is playing havoc across the U.S. so hope you and all are staying as well, safe, dry and warm as possible!

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So glad you got the referral!! I'm surprised you can't get your lab results online through secure messaging like I do. Hope this endo is a perfect fit for you and that you get some clarity on the direction you want or feel you should take. Unfortunately, working in patient care for over 20 years and being a patient myself for longer than that, I've learned that everything in medicine is a risk/benefit ratio and often seems like a no-win. A tool proven valuable in my life for making decisions is to write the pros/benefits and cons/risks to a situation such as whether or not to take a medication for example. Make a pro/benefit column and a con/risk column. So you may have 8 pros/benefits in that column and maybe less or more cons/risks in that column. Then assign each pro/benefit and con/risk in their columns, a numerical value of meaning or importance to you. Then add up the scores at the ends of each column and you will be able to see which direction to go. If the pros/benefits outweigh the cons/risks, then you would take the medication. If the cons outweigh pros/benefits, then you would not take the medication. We just have to hope and pray for the best outcomes b/c our decisions will never be without some risk and even the pros/benefits can be uncertain. We can only do the best we can do.

As I mentioned quite some time ago, I had a total of three endocrinologists who wanted to start me on IV bisphosphonates, starting over 5 years ago and then 2 who did ever since he and my next one retired or left or move their practices. Now my third one is moving on. I love her! She is so sweet, patient and kind and spent so much time, so many times, teaching me about bisphosphonates, even sending me links to trials, etc. That's where I learned that most of the trials are sponsored/paid for by the manufacturer of the drug! That blew my confidence in the trials!

I chose to beef up w/ extra nutrition and I changed my bone health supplements, instead of taking any medication. We'll see what my next scan says but it won't be for a while; about 1.5 years.

Warmest wishes and prayers, Sunnyflower

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@sunflower. Like your idea of the pros/cons method of deciding about medication, but I may adopt it for some other medical decisions I have to make. My onc just stood up for me. While the surgeon wanted to do a big surgery immediately based on little information, and used fear as a motivator, my onc has quietly ordered a whole slew of tests to get me enough information so that my decision will be based on fact, not fear. Bless him for understanding.

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@trishanna

@sunflower. Like your idea of the pros/cons method of deciding about medication, but I may adopt it for some other medical decisions I have to make. My onc just stood up for me. While the surgeon wanted to do a big surgery immediately based on little information, and used fear as a motivator, my onc has quietly ordered a whole slew of tests to get me enough information so that my decision will be based on fact, not fear. Bless him for understanding.

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Amen! Good onc!!!!! Yay! I wish you all the best and yes, that tool can be used in a lot of different life situations. Business people, managers, you name it. Take good care and keep us posted. I'm not on very much but will be upholding you in prayer. Wishing you many blessings and warmest everything, Sunnyflower

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