Hi Merri Ellen:
I found your response very encouraging! You didn't say at first that your doctor was doing barium studies before the procedure, that makes a difference in his attitude. If I were in that situation I would feel differently about the same doctor doing the procedure. Your response also makes it more likely for me to request that barium studies (or something like that)be done before the colonoscopy. In other words, I would not feel silly requesting it.
As far as your managed care experiences, it just demonstrates again how very individual everyone's situation is. Health Care "reform" in the U.S. has only resulted in mass confusion, in my opinion. They say it saves money in the long run, but I really wonder.My situation is a little different in that the problem appears not to be the adhesions, but something else. So I don't have to search far and wide to find someone with experience in treating my problem, which appears to be sacroiliac dysfunction. I have opinions from several doctors that my problem is the SI joint, yet my pcp does not follow their suggestion except very generally, such as prescribing celebrex. (doctors he sent me to, by the way). Also, the group I have in mind has a website and a large advertisement in the phone directory so I can't believe they are not interested in self-referrals. If that is the case, then they are wasting their money targeting the public rather than other professionals. There have always been doctors who require referrals from a patient's pcp, at least in my area. Doctors such as cardiologists, neurologists, surgeons have always required referrals, but even this is changing with some doctors. Your response has encouraged me to work with my insurance company. What I plan to do is to call my pcp office this week, tell them I would like to see a certain doctor based on the recommendations of the various specialists I have seen. If he won't refer me,(and he might) I will self-refer (which means paying 25% since I have made up my deductible This is what I used to do). Office visits are manageable, but paying 25% of any tests or procedures would be a financial hardship so I will then ask my pcp to reconsider and refer me back to this doctor. If he doesn't agree, I will contact the insurance company and explain my dilemma (that I am following the recommendations of doctors that my pcp has sent me to in the past) and ask them if they will cover whatever is recommended. (The doctor I have in mind is within the network) I really doubt they will, but I will try. And I will also look for another pcp. Thanks for sharing your experience.
Chris S.