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Primary Doctor Clearance????



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My primary doctor says she does not want to clear me for the lap band surgery because since I am not going through my insurance, then she said she has nothing to do with the surgery and that I should tell my surgeon to find a doctor to clear me. I am healthy, I do not have any co-morbidities. I spoke to my surgeon and he said that if my labs are within the gneral anesthesia guidelines, then I would not need a doctor to clear me. Has anyone had surgery without clearance from their primary? My surgery is scheduled for next week, I really hope I don't have a problem with right before surgery.

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My primary doctor says she does not want to clear me for the LAP-BAND®® surgery because since I am not going through my insurance, then she said she has nothing to do with the surgery and that I should tell my surgeon to find a doctor to clear me. I am healthy, I do not have any co-morbidities. I spoke to my surgeon and he said that if my labs are within the gneral anesthesia guidelines, then I would not need a doctor to clear me. Has anyone had surgery without clearance from their primary? My surgery is scheduled for next week, I really hope I don't have a problem with right before surgery.

If you are self pay, why would you need a primary care doctor to clear you? I went through my insurance so I needed my primary care doctor to refer me to the surgeon. But if YOU are paying for the surgeon, I don't see why the primary would need to be much involved at all.

Your surgeon is a medical doctor who can determine if you are healthy enough to undergo the surgery.

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I think there is a difference between the "need" for a PCP clearance for insurance purposes, and whether your doctor provides care for you - the person- as you undertake this life changing event. Case in point, I had a hysterectomy. My PCP was *not involved* as my Gyn handled all of it. However, my PCP asked me if I had any questions he could answer, visited me at the hospital *and did not charge me for a consult*, inquired how it went at my 1st appointment after the procedure, etc. All part of "taking care" of me.

I, personally, would not go to a PCP who only looks at my care in terms of is the insurance reimbursing them for a signature on a form....but that's just me.

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I did not have to go through my PCP. I went straight to the lap-band surgeon. A few years ago I did bring up my weight to my PCP and he told me to go to weight watchers and that it was working well for his wife.

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Even with full insurance coverage, my PCP didn't factor in at all. I mean, I told him I was doing it, but that was the extent of the matter. In fact, I haven't seen him lately; he doesn't even know I've already had it done.

The PCP really plays no role.

I'm not sure I'd feel safe, personally, going into this surgery without pulmonologist and cardiology clearance, though. I thought I was comorbidity-free, and found myself needing bronchodilators for the couple of weeks on each side of the surgery because of something found in pulmonary function testing---something I was completely unaware of.

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I think there is a difference between the "need" for a PCP clearance for insurance purposes, and whether your doctor provides care for you - the person- as you undertake this life changing event. Case in point, I had a hysterectomy. My PCP was *not involved* as my Gyn handled all of it. However, my PCP asked me if I had any questions he could answer, visited me at the hospital *and did not charge me for a consult*, inquired how it went at my 1st appointment after the procedure, etc. All part of "taking care" of me.

I, personally, would not go to a PCP who only looks at my care in terms of is the insurance reimbursing them for a signature on a form....but that's just me.

Hi Karlsmom,

I understand what you are saying. But I interpreted the OP's question to be whether or not the PCP's clearance is needed for surgery. If not jumping through insurance hoops, I don't think the PCP needs to be involved if she does not want to be. I believe the surgeon can decide if the patient is healthy enough for surgery, or if cardiac or other studies are needed.

If the PCP is not being supportive or is refusing to care for the patient after surgery, then a new PCP can be found. It is the patient's right to decide the best course of treatment.

Case in point..I had a PCP who was fresh out of medical school. She was all of 103 pounds. When I asked about WLS I was told, "Oh, you don't need that, it is all diet and exercise. It's an easy fix."

Uh, no, it isn't an easy fix...put on 100 pounds and try for years to take it off, then we can talk. Or at least work with patients for a few years and see their struggles before you say something like that.

So, DH had a PCP he really liked. I changed docs. I didn't know it before I saw him the first time, but he was also obese. He's more mature and been in the biz much longer. We are a much better fit.

I say he -was- obese because he had gastric bypass about a year after I had my band surgery. By the same surgeon I used.

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I am self pay so I never went to my PCP at all. She has no idea I am even doing this. As cocobean mentioned, the surgeon is a doctor and can determine if you are qualified for the surgery.

I don't think my PCP would be anything but excited to see me get this done, since I am obviously overweight.

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