Insurance and Doctors

Earlier I promised to tell you what my insurance company required before they would approve weight-reduction surgery.  Four things:
First, a letter of approval from my primary-care physician, PCP.
Next, a similar letter from my cardiologist.
Then, an evaluation from a psychologist based on at least 3 interviews and 2 personality analyses.
Finally, an educational program with a dietitian three months long, with four visits, dietary instruction, logging of food consumed, teaching and training, with acceptable weight loss during this time.


We'll review all of these over the next week or so.


I had wanted this surgery several years ago, and started then to meet these requirements.  But when I talked to my then-PCP about approving it, he stunned me with the vigor of his refusal.  "Absolutely not!" he said.  That surgery is unproven, and for you, unnecessary.  There is an element of danger in any surgery, and you are not heavy enough to justify the risk.  I will never approve this for you.


Though disappointed, I accepted his counsel and dropped my plans.  And then was stunned again, several years later, to find he was leaving his PCP practice to join the Bariatric Center of a major hospital.  He was going, I realized, to specialize in that "unproven, unnecessary" program with "an element of danger."  How about that?


He and I have never spoken since that day.  And I left with this intent:  Dammit, I would have weight-reduction surgery, and I would not be talked out of it.