Re: more...Re: Just to not lurk

[Guest guest]

Now I'm wondering (since I'm just obstinately fixed upon having a laparoscopic procedure- I can't seem to talk myself into the open one) if since no one in network does the laparoscopic procedure I can get it done out of network for in network coverage. Anyone got any experience with this? It looks like I can have an open duodenal switch in network but I'm unwilling.

more...Re: Just to not lurk

At 8:23 PM +0000 5/14/01, spiritdivine@... wrote:

.... My PCP acted as if I was

being obstinate and unreasonable and said, "Why don't you just go geta gastric bypass---you wouldn't have to appeal, you could get one intwo months, it would take care of the problem." When I pointed outall the re-dos I see---he said, "Well, they are getting better allthe time at these and I am sure there won't be so many re-dos in fiveyears."...as if he has some special knowledge or has done the

research (which he hasn't!).

My PCP pointed me at a WLS clinic in downtown Washington where only open RnY is done. Seems that the surgeon there had some local publicity, and that's about all that my PCP knew about WLS. So, I had to do the research and educate both of us, and my cardiologist as well. Happily, both are genuine folk who do not purport to know it all, even though both are highly regarded within their specialties, and both were grateful for the information. in fact, my cardiologist's nurse is going to have a procedure (a VBG) with Dr. Elariny in a day or so, largely as a result of my having made them aware of Dr. E. My PCP at first asked me why I did not choose to have surgery with the specialist to whom he had pointed me, and that is when my information flow back to my PCP began. Result: when my PCP wrote the Letter of Medical Necessity for my insurance application, he specifically named the BPD/DS and Dr. Hazem Elariny (which pleased Dr.E .no end, BTW!).

My point: it is up to us to do the research and to assist our medical "team" learn what is out there. Problem is that too many of them have a God Complex and will not learn from lay people. The answer: get a new PCP when and if possible.

--Steve-- ----------------------------------------------------------------------