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

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

@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.

@sunnyflower, Yes, I failed to mention earlier that nurse reported tech problems with "patient portal". Thanks for the good wishes and more help from endocrinologist. I so agree that everything is a "risk/benefit" decision in choosing medical directions.

Realizing yrs ago that I had more trouble making decisions than some others, I bought "Yes or No" by Spencer Johnson; Had read his "Who Moved My Cheese" and gave this one a try. Can't remember much about the book now but it started me on what has now become a habit in helping guide me toward better choices with the Pros and Cons lists I do whenever stumped on whatever issue.

If you are like me in becoming attached to especially helpful professionals and having to find a new one when they retire, move or die is hard. Change itself can be difficult and finding a good fit with someone new isn't always easy.

Thanks for your response and best wishes for a good relationship with your new doc as well.

This is my experience too. I thought it was just me. I'm fairly knowledgeable about how to find doctors and I used to pride myself on my ability to evaluate doctors based on their education and experience. Now I have difficulty finding GOOD doctors (knowledgeable and able to communicate with patients). I think that doctors have so many patients to deal with and limited amount of time. Even though many have nurse practitioners or assistants who see some patients and take some of the burden off doctors. Even these doctors don't seem to have the ability to perform the referral process. I have asked my pain doctor to refer me to a mental health professional twice. She's passed on my request to one of her assistants and they have never found any one or told me anything. Based on my own experience in looking for a mental health professional - there just aren't many in our area and we are just miles from one of the largest medical centers in the world - Houston Texas. I don't want to have to actually go into Houston for this kind of care but other places I've lived had more qualified mental health people. Here we have a plethora of people who I would call "counselors' - not even qualified "psychiatric social workers". Just social workers and religious counselors. Yet I read yesterday that there are 100s if not thousands of doctors who cannot get jobs because there are not sufficient numbers of residencies slots, which are necessary for graduates of medical schools to get experience to qualify them to practice. As my husband explained it hospitals don't have enough money to hire doctors or to fund residencies. This is probably due in part to cut backs in Medicare payments to hospitals. So I guess this situation is complicated and due in part to politics that put re-election over human lives. In every political campaign the encumbent or the candidate promises to cut taxes and Congress thinks they can keep cutting taxes without any consideration to what those cuts mean to programs that people need. I've probably made a lot of mistakes in this description, but I see this happening to our physical infrastructure and our medical infrastructure and other social programs. Others may be able to shed more light and more accurate explanations of why medical care in this country costs more and yet we have higher mortality and morbidity that other countries.

I’m a tad older and actually remember when your primary doc would suggest doctors for you to see and set it up as well. I worked at a hospital and had an in to good physicians; unfortunately that is no longer true. Now have to search with our friends and family if you have any. It’s difficult. Good luck

I make all such requests including reasons by portal/email. Not only might the provider have more time to consider/research your request, but you also have a written record. I’ve not had to do this, but you could even send a request to the specialist and ask them to contact your provider! After all, the worst they can do is say no!

@sru97 I too try to do most of my communication through the portal so there will be a written record of it. Plus, if you speak to an office administrator or a nurse you have no idea how what you said could have been presented to the doctor.
JK