Protocol for changing Rheumatologist

[Snerd]

Hello! I am experiencing ongoing conflict with my rheumatologist. My insurance is a huge networked operation, and there are other rheumatologists I could see. What is The protocol for changing doctors? Do I discuss it with my current doctor and ask him to refer me or do I talk to my GP and ask him to refer me? Or maybe just talk to member services to accomplish it? What is your advice? Thank you.

[PMRpro Ambassador]

Only people from the USA will know that - most of us are in Europe, especially the UK and there isn't the same choice. I imagine the people to ask are the helpline for your insurance policy. I'm sure they have rules about how it should be done.In the UK it would be the GP who deals with referrals unless you find a doctor who does private work and doesn't insist on a GP referral but I don't think that that often applies.

[Snerd in reply to PMRpro]

Thank you!

[fmkkm]

Hi,My first GP who diagnosed GCA(with a little help from me and Dr. Google) referred me to a Rheumatologist. He immediately put me on plaquinil. I took one pill and woke in the middle of the night feeling awful. I stopped plaquinil, continued with the prednisone and cancelled my next appointment. I found a rheumatologist with Duke who specializes in GCA. My appointment was 6 months out. My GP was angry and sent me an email that she did not want to support me and issue the prednisone for 6 months while waiting for the new appointment. So-I also had to find a new GP. In the end I had two docs I could trust. I probably could have handled it better, but it appears Doctors can be a little territorial so make sure you are prepared to explain your position.

I can say, I am so thankful for PMR/GCA HU for getting me through this time.

Best. f/m

[Stellamavis in reply to fmkkm]

Me too on the last part of your post..it’s been so informative for me.

[GOOD_GRIEF]

In the USA contact your insurance company. They should have a list of rhumys in your area who accept your coverage. As to whether you'll like any of them, that's a different matter.

It's a good idea to have sketched out your goals for your treatment, as well as your experiences so far. Also ask about the extent of their experience treating patients with your condition, their usual recommendations regarding medications, diet, exercise and dealing with side effects, the frequency with which they'll want to see you, and how responsive you can expect them to be when you run into trouble. It's also most important to determine whether you're actually being heard, and whether what they say about treating you make sense to you.

Generally, you don't have to justify your decision to seek services from another provider within your insurance company's group. Seeking treatment outside may not be covered, or may only be partially covered. Understand that this may extend to medications, testing, imaging etc. depending on the policy, as they may not honor orders written by a doctor outside the network, even if they are fulfilled by providers inside the network.

[mgrogers99]

I asked my primary doctor for a referral for a second opinion from another rheumatologist. When I saw the new rheumatologist I asked if I could change to her practice and she consented. I only wish I had done it a year sooner!

[Snerd in reply to mgrogers99]

Thank You! That is helpful.

[Snerd]

I really appreciate your response! Helpful.