Annoying bureaucracy HMO and Frustration

The head PS dude of HMO system will not give approval for me to see my PS in hospital (three hours away from my home by buses) unless I see him first and he only sees people once a week at a specific clinic from 8am-11am! And this is just for the dog-ears on the breast lift survey - not for the thighplasty I want and was scheduled for, and nothing to do with the cysts (yes i know cysts are usually benign but I have pain and discomfort) in my breasts.
And the CYSTS: I have a breast surgeon apptmt on Th afternoon. I am way after menopause due to a total hysterectomy in May 2005; all previous mammograms were totally fine. And I have a continual dull pain in right breast that sometimes is sharp and burning. My substitute GP (mine is in vacation) does not think anything will be done for the cysts as there are many and the larger ones are not that large. He did not even recommend any treatment got my pain/discomfort! So I hope to know more on Th afternoon.
In the meantime I am asking my PS (he also has a private clinic) how much it will cost privately for him to revise the dog-ears and am awaiting his answer- and I think he is waiting on breast surgeon report.
Mikimi in Israel

sorry for that