PCP discouragement

[NanaB73 3]

First of all, my PCP is terrific. She's been amazing for myself and for my mom, who I am a caretaker of. We've been blessed over and over again by the level of her care.

But......I've been moving forward to VSG in Mexico. I do not have other health issues to speak of, so have not really involved my PCP in this decision. I did mention 2 months ago that I was thinking of it, and she told me she is not against it, that she had even considered it for her own mom. She did speak of the challenges and cautioned me, particularly emotionally since I have dealt with depression. And I understand that.

Since I am now ready to schedule my surgery I wanted to let her know and make sure she would do my aftercare. I called and left a message and her nurse called back with dire warnings of the dangers and a very strong "Dr.O does NOT advise this". She wants to see me if I decide to go ahead and I dread it terrible because I know she will try to talk me out of it.

This will not stop me, but I feel discouraged about it today.

Can anyone speak to this?

[Sosewsue61 3,185]

Maybe she is just against doing it in Mexico? I would wait and get it straight from her instead of her staff. Flat out ask her what her specific objections are? Have you been battling obesity for years, have you dieted only to gain back more?

Some physicians are very biased. Just because she is good at being a PCP does not mean she is well informed in the area of obesity. Ask her how many obese patients in her practice have been on a program under her to lose weight and have maintained it?

[NanaB73 3]

Her nurse did mention that Dr O knows nothing about how Mexico does things.....like psych evaluations, nutrition, etc. If she does have any WLS patients, it is likely they have gone through insurance process which would look very different, I know.

At one point she wanted me to try to follow a crazy strict diet which only set off my emotional eating worse than ever. We've not explored prescriptions for weight loss or anything like that.

I have been overweight for probably 18 years and obese for 12 of that. I lose weight very slowly and gain very fast. I really feel like it contributes much to my depression.

You have a very good point of getting her opinions straight from her, rather than just through her nurse. I'm just confused by her two differing reactions and I need to ask her to explain that.

Thank you!

[dmdakd 44]

That is unfortunate. I would imagine that your PCP simply does not have experience with patients going out of the country for a procedure like this. Luckily my PCP is from India and she has had family members go back to India for major medical procedures with great success. Some doctors simply think that everyone outside of the US is sacrificing chickens to cure colds.

My advice to you is make sure you are educated in your decision, my PCP asked me a lot of questions, why did I chose my doctor, my procedure, had I researched local options, etc. She wasn't trying to talk me out of it, she was trying to ensure that I had not made a snap decision without thinking. After she was satisfied with my thought process she asked if she could do a blood panel on me and an EKG to make sure that she was comfortable with my health before surgery. These are all great things. I would be more concerned if they didn't want to know.

If during your conversation your doctor is still against it ask them why, they aren't the only people that get to ask the questions. What are their concerns, are their concerns related to your health before surgery, weightloss surgery in general or the fact your looking to do it in Mexico, do they have patients that have done similar procedures outside of the country, what is their experience with WLS in general, things like that.

Express to them your doctors qualifications, how many surgeries have they done, how many do they limit themselves per day, what their complication rates are (zero is a bad answer by the way). Again, why you have chosen this doctor.

Your doctor isn't your boss, they are your partner in your healthcare, if you approach them that way you will be surprised on how helpful they will be. I'm sure between the two of you that you guys will make a treatment plan you will both be comfortable with. I wish you luck, I know while I didn't need their blessing it sure made me feel good once I had it.

[Diana_in_Philly 1,426]

I'm sorry you are dealing with this. I realized after firing my PCP of 20+ years that she had a weight bias. She never suggested i even consider this - just stressed that I wan't trying hard enough to lose weight with the various plans she recommended. My new PCP said in our first visit - I think you're a great candidate for bariatric surgery. If you have decided on Mexico, then do it. Find a new PCP for your aftercare who deals with people who have had surgery. I have no tolerance for physicians with a fat bias

[scoutsmom 17]

If I received a phone call like that, I would also feel discouraged and frustrated. That being said, getting upset now will not help anything. You have great things to say about her and I am sure she has your best interest in mind and it's completely possible--and even likely--that she knows nothing of the process in Mexico and would feel differently if she did. If she mentions your struggle with depression, it would be wise to really examine that component with whomever has treated you for mental health issues in the past.

[NanaB73 3]

dmdakd,

You've made so many good points and I'm jotting down notes on the things you mentioned to discuss with her. And you are right, I would really feel good about having her blessing. I guess that is what I'm looking for.

I've made an appointment for next week. I'll have some time to write my questions down and get prepared.

Thank you for talking with me. It really helps!

[NanaB73 3]

59 minutes ago, Diana_in_Philly said:

If you have decided on Mexico, then do it. Find a new PCP for your aftercare who deals with people who have had surgery.

I really hope I don't have to do this, but I understand that it must happen sometimes. We need the support!

25 minutes ago, scoutsmom said:

If I received a phone call like that, I would also feel discouraged and frustrated. That being said, getting upset now will not help anything. You have great things to say about her and I am sure she has your best interest in mind and it's completely possible--and even likely--that she knows nothing of the process in Mexico and would feel differently if she did. If she mentions your struggle with depression, it would be wise to really examine that component with whomever has treated you for mental health issues in the past.

Your words are so kind. Thank you. I do believe the best about her. I hope I'm rushing to judgement here and find out next week that we can understand each other better.

I am blessed to be in therapy now and have been for 3 years. I feel like that is crucial for me and I'm so glad to have a very competent and supporting therapist.

[fruitandveggies 456]

My PCP wasn't too keen on the idea for me either (though I had mine in the states). She says as a doctor, she knows how dangerous and risky surgery is and doesn't encourage anyone to get it. That being said, she knew I'd been struggling with weight my whole life so she still signed off the okay. She wanted to make sure I was fully educated before I took the leap and I think I made her feel that I was well-informed.

The others might be right, it could be her reticence about procedures in Mexico. Make sure if she won't sign off for you that you find someone else who will if you know this is the best decision for you!

[DRoseman 34]

Thank you all for sharing your thoughts/experiences. My PCP is not keen on it either. She feels that the 150+ pounds I need to lose can be done with just diet and exercise. I've been there and done that! I gain it all back plus more! I didn't know that our PCP had to give their approval for surgery. I'm not sure mine will.

DR Potential Sleever

[Lainey H 37]

I have spoken with my PCP for the past 8 years about weight loss options and he is against them all. pills and surgery. I actually need to see him in a couple of weeks to get cleared so I'm curious what he will say. His feeling is that all these tools are temp and will go back to hold habits so need to change the habit. After speaking with a bunch of people in the bariatric world as well as other specialists, I think he is not as educated on the specifics of that world. He is a generalist and I don't think he could be up on all the data and studies on weight loss. We go to specialist for a reason.

Good luck!

[NanaB73 3]

7 hours ago, fruitandveggies said:

My PCP wasn't too keen on the idea for me either (though I had mine in the states). She says as a doctor, she knows how dangerous and risky surgery is and doesn't encourage anyone to get it. That being said, she knew I'd been struggling with weight my whole life so she still signed off the okay. She wanted to make sure I was fully educated before I took the leap and I think I made her feel that I was well-informed.

The others might be right, it could be her reticence about procedures in Mexico. Make sure if she won't sign off for you that you find someone else who will if you know this is the best decision for you!

Your PCP seems like she has the right view of the risk and reward aspect of this surgery. I'm really hoping mine will too once we sit down to talk. As I've thought of this throughout the day, I'm thinking the Mexico part of it all might be the issue.

[NanaB73 3]

1 hour ago, Lainey H said:

I have spoken with my PCP for the past 8 years about weight loss options and he is against them all. pills and surgery. I actually need to see him in a couple of weeks to get cleared so I'm curious what he will say. His feeling is that all these tools are temp and will go back to hold habits so need to change the habit. After speaking with a bunch of people in the bariatric world as well as other specialists, I think he is not as educated on the specifics of that world. He is a generalist and I don't think he could be up on all the data and studies on weight loss. We go to specialist for a reason.

Good luck!

And Good Luck to you as well!

[NanaB73 3]

4 hours ago, DRoseman said:

Thank you all for sharing your thoughts/experiences. My PCP is not keen on it either. She feels that the 150+ pounds I need to lose can be done with just diet and exercise. I've been there and done that! I gain it all back plus more! I didn't know that our PCP had to give their approval for surgery. I'm not sure mine will.

DR Potential Sleever

I don't believe they do have to on a cash payment surgery as in Mexico. I'm guessing the signing off would be needed for insurance purposes. But it would still be nice to have their approval, even if a bit hesitant, wouldn't it!

[trailtramper 107]

Thank you all for sharing your thoughts/experiences. My PCP is not keen on it either. She feels that the 150+ pounds I need to lose can be done with just diet and exercise. I've been there and done that! I gain it all back plus more! I didn't know that our PCP had to give their approval for surgery. I'm not sure mine will.

DR Potential Sleever

I was sure my pcp would say no, so I found a new one who didn’t. My hospital couldn’t refer me, but they did tell me the names of some pcps who refer patients to their Bariatric surgery center