Need Help With Asking PCP Again for a Referral to a Specialist
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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Dearest fiesey76, I am so sorry to hear what You are going through. I would suggest You get a hold of your insurance company and ask them what your patient rights are. Ask them if You have the right For a second Opinion . I could be wrong But I think everyone does. Ask them How to get a referral To another doctor Of the same or a different specialty. Any doctor should not have a problem giving a patient a referral In most cases. I will be upholding you in prayer That this turns out exactly as you want and need. And, in a very timely manner. Please believe me when I tell you I am too familiar with the stress and anxiety That doctors can cause a patient . It is okay for you to advocate for yourself . A doctor should not mind this And if they do then it could Mean that their ego is too big and it's time to move on and find another doctor which I know Is in and of itself Anxiety and stress producing. I worked with probably over 80 different medical providers Over a 20-year. And almost every one of them if not every one of them Would not mind A patient wanting a second opinion or To see a specialist. Warmest wishes and please keep us posted on what happens . Sunny flower. 🤗
Amen! @fiesty76, @merpreb @fiesty76, I hadn't seen the other messages advising you to talk to your insurance to see what Your patients rights are Before writing my message so sorry for the repeat! Warmest wishes to all of you, Sunny flower @johnbishop
@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.
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.
@sunnyflower, Yes! A big thank you to @johnbishop, @merpreb, @sueinmn, and @colleenyoung for each of your suggestions and help. While I remain nervous about the doc visit, I am more calm, confident and hopeful that I'll receive a referral because of your encouraging patient guidance. Will report back how the visit goes and sincerely sending each of you a cyber smile for your day.
Let me know if there is anything I can do to help you. You will be in my heart and my thoughts and my prayers! I can't wait to hear how it goes and last night I was praying that everything would work out for you and will be praying that your calmness remains. Believe me, I have so many specialists, I understand completely how stressful and anxious doctors can make patients. Just try to remember they are people too. I know it's hard when they hold the quality of your life in their hands but really God is in charge of all things so I will keep up the prayers. Many blessings, Sunny flower. 🙏🤗
I strongly urge all patients/potential patients to:
1. Keep a pain diary as that will indicate patterns, specific pains, particular information, times of day etc. It is also more helpful for the doctor/specialist than an emotive generalisation in the surgery
2. Carefully plan an email to the doctor/specialist BEFORE you attend the consultation. In this email you can put your pain diary (or a summary of it) and list the specific questions you want discussed. This is good to do with your carer, loved one or trusted friend.
Great info robin615! I know the courts give a lot of validation to these diaries/documentations and having worked with probably over 80 providers in 20 years, I know most of them appreciate and respect them. It makes for a more productive, efficient visit.
I was taught in our health care cooperative business literacy training that studies show that patients forget everything they want to ask the doctor and /or what the doctor tells them due to anxiety, stress, intimidation, etc.
It's a good idea to leave substantial space below each item you want to discuss and each question, to write down what the doctor answers and/or tells you even though they give you a discharge summary on your way out. I have found those to be significantly lacking. The said that patients only hear/process incoming info for something like the first 7 minutes when talking with the doctor. I am not positive on the exact time but it was short.
Warmest wishes for all the best, Sunnyflower
Yes, Sunflower. In a book I am writing ("The Inevitable Journey – Living With Terminal Illness in the Family") I make the points that notes should be made in the consultation and anything the carer or loved one does not understand leads immediately to a query seeking clarification. Afterwards, head off for coffee or whatever, so the two of you can immediately double-check on what was said in the consultation, the response(s) to the emails that had been sent prior to the consultation and the action(s) that you now know will follow.
Your PCP may be doing you a favor. The 5 yr risk of a broken hip for age 70+ females with osteoporosis is 13%. That is, in the next 5 years 13 out of every 100 such women will break a hip. That’s 2.6 breaks for every 100 people each year, or 97-98 of those 100 people with osteoporosis will not break a hip. Reclast reduces the risks by 45%. 45% of 2.6 = 1.17, bring the one year risk down to 1.43. Reclast increases the odds that you will NOT break a hip from 97-98 out of 100 to 98-99. Who cares? With odds like that, you are almost guaranteed not to break a hip next year. You might draw the short straw, but odds are overwhelming that if you stop Reclast for a year, you will be OK. more importantly, if you take some substitute, if it helps at all, and almost certainly won’t, the help will be trivial.
Drugs are tested on large groups of people, and the FDA approves them if they meet a statistical standard for reducing a problem in a large group. The group effect does not apply to any individual. You are an individual, not a group, and the best that can be said for what Reclast does for you or any individual is that it gives your chances of not breaking a bone in one year a trivial boost. . All you get out of it is a very, very small lowering of your risk of breaking a bone.
Reclast does not go away when you stop taking it. The persistence of a drug is measured by its half life– how long does it take for half the dose to leave the body. Reclast lasts so long that it seems its half life is unknown, but is thought to be “in years”.
Let’s turn it arund. I think I saw that Reclast is recobbended for a bone density t score of -2.5. My last bone de