Finding an after-care physician

[Kimberly Saunders Moyer 3]

I am considering having a sleeve procedure done in Tijuana. My biggest concern at this point is finding a physician locally to provide any aftercare or treat any problems that may arise. How do I go about finding someone who will treat me after after surgery out of the country? I am assuming the surgeons here don't appreciate "picking up" after someone else's procedure. Any thoughts?

Kimberly

[Recycled 2,182]

Most physicians understand the concept of WLS exclusions with insurance companies. And if they can't relate to the cost difference and the ability to afford surgery, well then....screw 'em.

Besides, the surgeon doesn't really do much in the follow up department anyway. My only follow-up with the surgeon was at 2 weeks and amounted to about 3 minutes of greetings with a quick "you're doing great" and he vanished like a magic act.

I did all my pre-op visits with my PCP and will continue to do any WLS follow -ups with him as well. I'm sure you could talk with your PCP about after care.

[rhw94123 115]

Good luck with your research. Really, as much as people move around these days, imagine if physicians refused to care for people who had had procedures from anyone other than themselves or close colleagues.

Here are some points I've focused on and role-played-in-my-head to get in the right frame of mind to talk to a potential new PCP or other medical professional:

* Would I be sheepish & apologetic about asking if I'd merely had my appendix out out of state and needed some follow-up care?

* What if I had ear tubes in, placed in Canada, and needed someone to take them out for me

* Maybe I should try to come across like I had the surgery from someone two states over [or from a deceased surgeon or whatever]

* Or maybe I should say I had surgery in the "San Diego Metro Area" (Tijuana is part of that).

* Or I could say I had surgery from a physician who lives " out of the country" now

* What if I'd been on a humanitarian work year in Mexico and just happened to have the procedure there? It shouldn't matter whether I traveled there specifically for surgery or whether I got it while there on other business.

I bring all of this up because when I needed to talk to my doc I kept thinking it would be way easier to say one of THOSE things, and then I had to ask myself "why?" Many of us are so apologetic about having left the country specifically for an elective surgery-- we need to give ourselves pep-talks & try not to put up with judgment from professionals who are supposed to be judgment-free. (When I gave myself that pep-talk I came across as very matter of fact--not inviting any judgment or seeking my PCP's approval, etc. -- and I think things went better as a result.

It is very late and I am very tired. I will probably delete this tomorrow, but it makes perfect sense to me right now, lol.

Edited May 7, 2014 by rhw94123

[Mississippi Girl 124]

don't delete it RHW! It makes perfect sense to me. You put a twist on this that a lot of people including myself need to consider. After all, the doctor is working for us. Right? I, personally, don't see the big deal. I know U.S. physicians hate to lose out on the money but getting some of our business is better than none of our business. I've never understood why people are so intimidated by doctors. You hire them to do you a service, just as you hire an attorney, maid, dry cleaners, etc. It is what it is! Hopefully I can find somebody to treat me shall I need assistance.

Happy Losing,

Mississippi Girl.

[mentalistfan 189]

You could get care here but I heard that your insurance doesn't have to pay for it if they didn't pay for the surgery, but i don't know for sure.

[rhw94123 115]

With the Affordable Care Act (Obama Care) you're not supposed to be denied care or even coverage (there's a difference !) because of a pre-existing condition. Being in a state of having had WLS is a pre-existing condition. Of course, various quadrants of the insurance world are phasing in to the ACA at different paces and manypeople with company-supplied insurance just have their old policies and will for some time to come given all the extensions.

I happen to have a new, individual ACA-compliant policy (through the infamous exchange, lol) starting 1/1/14 that says WLS surgery is not covered, but revisions or adjustments to WLS are covered if they remedy a life-threatening situation. (Similarly, a ruptured breast implant is not covered if it just LOOKS weird, but if there is a resulting toxic silicone leak or something, a revision might well be covered.)

I spoke to my PCP about this and told him that I would be hitting him up at each visit to consider whether anything going on with me should be documented IN CASE OF a possible future complication. Similarly, I resolved to always bring up any pain or reflux problems or whatever whenever I saw any doctor (if it were real--not saying I plan to make things up) in any context (Urgent Care, oral surgeon, whatever) so that I would have records to retrieve if I needed to make a case in the future.

A side note- Every state has to eventually cover help with Obesity under Obama Care, but it can be as little as allowing 3 nutritional visits per year (which is the minimal route that my state took). But some states went the deluxe route as far as Obesity goes and they have written coverage of WLS in to their ACA-compliant policies (and those states' premiums tend to be higher for now, too, until their populations start to be healthier because of having been covered, etc., etc.).

[Kindle 8,667]

My surgeon's office (Obesity Control Center in TJ) has actually been great with post op questions and concerns I've had. Miranda, (the nutritionist), Dr. Martinez and Dr. So have all replied promptly to phone calls and emails. As for any actual complications that require hands on treatment, do you have a PCP? My PCP is fine with doing any postop stuff (or referring me to a specialist if needed). Even my OB/Gyn volunteered to arrange for any of the routine postop bloodwork I need. I haven't had any surgical problems, but it's nice to know they've "got my back"