My Doctor Won't Order My Labs X Post

Ladytazz
on 6/16/11 10:45 am
  I have my one year check up coming up so I sent an email to my surgeon's NP to request labs based on Vitalady's recommendations.  I had these run in Jan. and I would like to keep a close eye on things to see if there changes.  I would like to catch any changes before they get out of hand.
This surgeon is not really thorough about checking labs and they would only check the minimum if I didn't request more.
My surgury is a revision from a very malabsorptive procedure and while I don't have as much malabsorption I am unsure how much I do have and at least for the first 18 months to 2 years I want my labs done every 6 months.
I got a message from the NP saying that they would run the bariatric labs but I needed my PCP to order the other ones so I sent him an email with the list.
This is what he wrote me:

Congratulations on another year after surgery. I am glad the bariatric surgery clinic is checking your malabsorption labs. Many of the labs you are requesting are included in their testing, and the other are either not indicated or were checked 1/20/2011. The labs ordered for the bariatric clinic are the ones that are needed for monitoring of malabsorption.
Please call with any questions.


I want to write him back and tell him that I don't care if I had them run 6 months ago, I want them run again.  I believe my insurance will pay for it so that shouldn't be a problem.
What arguement can I use?  I shouldn't have to beg for labs to be run if I think it is best.

WLS 10/28/2002 Revision 7/23/2010

High Weight  (2002) 240 Revision Weight (2010) 220 Current Weight 115.

MsBatt
on 6/16/11 1:02 pm
You already know I don't have a very high opinion of your WL surgeon. But---it's he I would be talking to about labs, not your PCP. Your WL surgeon *should* be far more aware of your personal malabsorption problems, given all he's done to try to correct them. HE is the one who needs to be running the full VitaLady panel, and copying the results to your PCP.
Jackie McGee
on 6/16/11 1:06 pm - PA
"Hi. Just wanted to remind you that I'm basically your customer. As your customer, I can request that things be done whether you believe they're necessary or not. My insurance will reimburse you, so you're going to get paid. Please do as I wish or I'll find another doctor."
beemerbeeper
on 6/16/11 1:15 pm - AL
Get another doctor.

~Becky


Ladytazz
on 6/16/11 1:42 pm
 I just sent my doctor an email insisting that he order the labs I requested.  I pointed out my history and my need to be able to keep close tabs on my levels so that I could react proactively to any potential problems as they arise and not when they become difficult to manage.  I pointed out that my insurance would pay for these as medically necessary to maintain my health.  If he refuses I will contact my surgeon and if he won't order them I will be looking for another doctor to follow up my care.

WLS 10/28/2002 Revision 7/23/2010

High Weight  (2002) 240 Revision Weight (2010) 220 Current Weight 115.

MsBatt
on 6/17/11 6:40 am
Good for you!
Ladytazz
on 6/17/11 6:54 am, edited 6/17/11 6:57 am
 I just heard back from the PCP, says he won't order them.  Time for a new PCP.  He said to go through the bariatric clinic.  I will try again and if not then I need a good bariatric surgeon to follow my care.  Any suggestions for Portland, Oregon?
ETA I just called my former PCP and she is accepting new patients again.  They have to get an ok from the office manager so hopefully I can go back to her.  She was honestly the best doctor I have had.  When I got very sick with rare complications after my first surgery she was able to get me diagnosed by referring me to a specialist who just happened to see the same problem in one other bariatric patient and was able to confirm what I had.  I trust her completely.

WLS 10/28/2002 Revision 7/23/2010

High Weight  (2002) 240 Revision Weight (2010) 220 Current Weight 115.

MsBatt
on 6/17/11 7:06 am
I hope you can go back to your old PCP---she sounds like what you need. I'm VERY thankful that my PCP listens to me about my DS. I was her first DSer, but she has others now, that I recommended her to. (That's not very grammatical, is it? *grin*) But when I decided I needed more tests than were being run, I carried in VitaLady's list and she never blinked an eye.

Be sure they use the insurance code ICD-9-CM Diagnosis Code 579.9 Unspecified intestinal malabsorption.
Ladytazz
on 6/17/11 7:12 am
 They already have me listed with Malabsorption Syndrome from last Oct.  That should not be a problem.
I just sent my bariatric clinic another request for the labs.  Not feeling too hopeful.  Time to start looking for another bariatric surgeon to follow me.

WLS 10/28/2002 Revision 7/23/2010

High Weight  (2002) 240 Revision Weight (2010) 220 Current Weight 115.

beemerbeeper
on 6/17/11 8:39 am - AL
Good for you.  I hope you got back in with your excellent pcp.  Not quite sure why you also need to be followed by a surgeon.  If your original surgeon is a good surgeon can't he still follow you for any surgical complications/needs?

That's what I do.  My pcp does everything except anything surgical.  If I had anything surgical I would call my surgeon.

~Becky


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