Discussions By Condition: I cannot get a diagnosis.

urgent, please look, legal?

Posted In: I cannot get a diagnosis. 24 Replies
  • Posted By: kamsae
  • February 6, 2007
  • 06:43 PM

legally a patient can refuse a medical test or procedure, but can a doctor legally refuse to give it to a patient?

I firmly believe i have a condition that is only diagnosed by presence of symptoms and a laparocopy. the doctor will not order the laparoscopy though. is it legal for them to refuse it when you have every indication of need?

The same doctor refused genetic testing for me and my kids in 2005, told me that we were to intelligent to have the condition that i described, and that i needed parenting classes instead. she refused occupational and sensory therapy for my kids as well, based on her disbelief. a second opinion physician ordered the tests (didnt believe me but agreed to ease my worrys:) and confirmed that 2 of 3 members DID have the genetic disorder. I have read about lawsuits pertaining to this sort of thing but i dont want that- i want the test! what do i do to force it? (2nd opinion physician is out of the question right now) are there medical advocates or something?

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24 Replies:

  • Is this doctor your HMO? If you have an insurance plan, you have to read into your insurance policy to find the answer.You can get any tests that you want- but you can't expect your insurance to cover anything you want.Doctors can refuse to do things they don't want to do- some refuse to prescribe birth control because of their own religious beliefs...I don't feel like you are giving enough info- but it's okay. You need a new doctor.
    Anonymous 42789 Replies
    • February 6, 2007
    • 06:57 PM
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  • Her belief is not an absolute scientific finding. Her "belief" is just a guess. Stop relying on doctors!
    Anonymous 42789 Replies
    • February 6, 2007
    • 06:59 PM
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  • no scientific finding is absolute.
    Anonymous 42789 Replies
    • February 6, 2007
    • 07:18 PM
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  • no scientific finding is absolute.Yeah I know- science and medicine are arbitrary and based on assumptions. Medicine today is a lot like Economics : lots of simplified models. Like everyone's body is the same.That's why I like Dr. Batman and Dr. D'Adamo.watercure.com
    Anonymous 42789 Replies
    • February 6, 2007
    • 07:25 PM
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  • right-sorry, more info: the condition i want the laparoscopy for is intestinal endometriosisall symptoms match, family history includes 2 sisters (of 2) with endometriosis (1 had intestinal as well) and an unidentified mass in the abdominal/pelvic area (no tests have found what it is yet). If it keeps getting put off-it could cuase intestinal/bowel obstruction,infertility, too much damage to repair (i dont want a colostomy bag or histerectomy at 25), more pain and complications. Im scared. the genetic condition i talked about: is fragile X syndrome. can cause autism/retardation/physical/psychiatric/developmental/sensory/emotional problems, etc. myself and 1 child have it (mild symptoms) and 1 child does not. This was nessesary to know due to the treatment options specific to this condition and the risk of more children being severely affected. to the 3rd replyer- you are right. none are absolute or garaunteed-but,its currently the most accurate and only used method of determining the cause in this condition. also- if endometriosis is not found during the procedure- it would still be beneficial in regards to giving the doctor a clear view of the unidentified mass for diagnosis and possibly providing for its removal.
    kamsae 88 Replies
    • February 6, 2007
    • 07:29 PM
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  • right-sorry, more info: the condition i want the laparoscopy for is intestinal endometriosisall symptoms match, family history includes 2 sisters (of 2) with endometriosis (1 had intestinal as well) and an unidentified mass in the abdominal/pelvic area (no tests have found what it is yet). If it keeps getting put off-it could cuase intestinal/bowel obstruction,infertility, too much damage to repair (i dont want a colostomy bag or histerectomy at 25), more pain and complications. Im scared. the genetic condition i talked about: is fragile X syndrome. can cause autism/retardation/physical/psychiatric/developmental/sensory/emotional problems, etc. myself and 1 child have it (mild symptoms) and 1 child does not. This was nessesary to know due to the treatment options specific to this condition and the risk of more children being severely affected. to the 3rd replyer- you are right. none are absolute or garaunteed-but,its currently the most accurate and only used method of determining the cause in this condition. also- if endometriosis is not found during the procedure- it would still be beneficial in regards to giving the doctor a clear view of the unidentified mass for diagnosis and possibly providing for its removal. So what's so difficult? Is it your HMO? If you can pay for the test you can have it done, regardless of your insurance/doctor.
    Anonymous 42789 Replies
    • February 6, 2007
    • 07:42 PM
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  • So what's so difficult? Is it your HMO? If you can pay for the test you can have it done, regardless of your insurance/doctor. ----------------------------------------------------------------------- I cannot pay for the test alone, I have medicare and medicaid. All specialists or tests have to be reffered by or ordered by the primary physician. I have not seen laparoscopic or any other surgical procedures offered to patients without a prior physicians order-with or without the finances to pay for it. did you find it offered somewhere?
    kamsae 88 Replies
    • February 6, 2007
    • 08:05 PM
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  • So what's so difficult? Is it your HMO? If you can pay for the test you can have it done, regardless of your insurance/doctor. ----------------------------------------------------------------------- I cannot pay for the test alone, I have medicare and medicaid. All specialists or tests have to be reffered by or ordered by the primary physician. I have not seen laparoscopic or any other surgical procedures offered to patients without a prior physicians order-with or without the finances to pay for it. did you find it offered somewhere?I am very sorry.This is the part that you had left out. As far as I am aware, that's it- your doctor has the final word. But there might be a patient advocate or case worker that you can bring in to the picture Can you change your primary physician?I am sorry, but you know we don't have "health care", we have "sick care". Unless you are extremely ill, they are going to be willing to do something "preventive".Hang in there- and stay firm. Do you actually have the mass in your abdominal area together with all symptoms? What did she say about that?If this is an act now type of situation they have to help you.Best.
    Anonymous 42789 Replies
    • February 6, 2007
    • 08:23 PM
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  • yes- the mass has been there for more than 1 year now and the symptoms were mild, but increased each month with the menstrual cyle.The doctor felt it on exam and said "it feels like a hard cordlike mass and seems to be on the sigmoid colon, must be irritable bowel syndrome"(no tests). I am 100% positive that i dont have IBS but she insists that i do, gave me painkillers and was done. ive returned many times and each time given more painkillers and told IBS.she sent me to a gastroenterologist who said probably diverticulitis(no tests). but It became severe this month and i went to the ER twice. First ER doctor said "estimated 3 cm cyst on the ovary-other symptoms unexplained". Second doctor said "it doesnt feel like a csyt, its not on your sigmoid, and your ct scan was clear for cysts, tumors, inflammation, diverticuli,and abcess. I cant determine what it is -but it doesnt seem life threatening"- then gave me painkillers and sent me home. Ob gyn today said "inflammation of the ovary and fallopian tube" more painkillers and an antibiotic.They can all feel it with their hands- but dont know what it is. Im getting really scared about "it" progressing each month and nothing being done to see what its from or the extent of the damage its causing. i am scared of the next menstrual cycle as the last one was excruciating. my sisters had the same symptoms though and both had laparoscopy-both were found with endo and its explains everything.
    kamsae 88 Replies
    • February 6, 2007
    • 10:23 PM
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  • It is legal for a doctor to refuse to give a treatment or procedure if they feel it would be detrimental or unneccessary to the patient, just as it is legal for a patient to refuse treatment that they feel are not in thier best interest. If you disagree with your PCP, you should search for another doctor. It is not easy being on an HMO, but you should get a list and go through each one till you find one you like and will explain to you more fully why or why not you should have the laproscopy. If it is endometriosis doing surgery now may cause complications down the road from surgery now (adhesions, bowel obstructions). Surgery itself is a last resort and should not be used as a diagnostic tool unless absolutely necessary. I am assuming that you have had pregnancy tests and that the doctors have ruled out an etopic pregnancy.It sounds like you have lost faith in your current doctor. You are not doing yourself a favor by going back to them.
    Anonymous 42789 Replies
    • February 6, 2007
    • 11:28 PM
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  • Maybe this doctor doesn't trust their surgical skills and is putting off the lap due to a lack of their own confidence in performing the procedure. Since it sounds like you have complicated endo that may have adhesions and attachments to the bowel as well as the mass, i think you would be much better off in the hands of a highly trained surgeon that is very experienced in laps and endo excisions. Who did your sisters go to> research alternatives and put the operation on a credit card or a payment plan if you have to.
    Anonymous 42789 Replies
    • February 6, 2007
    • 11:31 PM
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  • that is a good idea, thank you :) one sister had the lap in wyoming, 1500 miles away!-great results, 4 years later and still no symptoms.the other sister was done locally- but the surgeon made a mistake on her ovary and emergency treatment and further surgery was needed.I dont know if it was related but she had 2 miscarriages after this. I definetly dont want that guy. I had to pay cash for a new doctor consult today, I was better prepared this time i think (thank you everyone). I brought a paper with all the symptoms, timing, pelvic mass concern, and family history of endo. He looked at me funny-and then referred me to a new ob/gyn who he said is experienced in laparoscopic surgery. they will call me tommorrow with an appointment date. I dont know if the new one will do the procedure or if insurance will cover it, but at least there is hope again.
    kamsae 88 Replies
    • February 7, 2007
    • 00:40 AM
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  • That is GREAT news.
    Anonymous 42789 Replies
    • February 7, 2007
    • 01:06 AM
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  • http://www.geocities.com/endovictims/endodocs.htmlThis is a list I found of doctors around the country that specialize in endometriosis and excision surgery. The top one in Georgia has a bowel surgeon on standby in case work needs to be done when they are in there for the lap. Someone just mentioned this guy, Sinervo, on this site a week ago. They had a great experience with him after having bad experience with a local surgeon who was supposed to be the best. I am thinking of going to him as well. I have highly suspected adenomyosis (endo in my uterine wall) but dont want to lose my uterus, however I am having awful nerve symptoms in my legs (weakness and sensory changes) and bowel symptoms and guess i need someone to do a lap and take a look around.
    Anonymous 42789 Replies
    • February 7, 2007
    • 05:45 AM
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  • Endometriosis wont help just knowing what it is and you can treat it symtomatically. You need to go to endometriosis specialist. They treat it with Lupron and it will dry it up.The insurance standards have to have so many criteria; I bleed for nine months and we knew I had adenomosis and I wanted a hysterectormy butmy insurance company made me HAVE a laproscope before I could have a hysterectomy 10 days later. Stupid isn't it. The condition doesn't show up well on MRI's.I used to belong to the Endometrosis Society, they would have more info on doctors.Good LuckBJ
    Anonymous 42789 Replies
    • February 7, 2007
    • 07:51 AM
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  • that is a good idea, thank you :) one sister had the lap in wyoming, 1500 miles away!-great results, 4 years later and still no symptoms.the other sister was done locally- but the surgeon made a mistake on her ovary and emergency treatment and further surgery was needed.I dont know if it was related but she had 2 miscarriages after this. I definetly dont want that guy. I had to pay cash for a new doctor consult today, I was better prepared this time i think (thank you everyone). I brought a paper with all the symptoms, timing, pelvic mass concern, and family history of endo. He looked at me funny-and then referred me to a new ob/gyn who he said is experienced in laparoscopic surgery. they will call me tommorrow with an appointment date. I dont know if the new one will do the procedure or if insurance will cover it, but at least there is hope again.I am glad you did that! I wish you the best.
    Anonymous 42789 Replies
    • February 7, 2007
    • 00:31 PM
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  • I have been fighting so hard for these tests-and now i feel stupid and childish. The tests were ordered, and i am terrified. I am afraid of the pain ,risks,complications, who will care for my kids, etc. the endoscopy and flex sigmoidoscopy are to be done tommorrow morning. those make me feel panicky but mostly ok. (its the tubes in my throat and sedation,etc). but on thursday morning im am scheduled for a laparoscopy (with lasik ablation if endo) and a histeroscopy (with dialation and curretage if anything found). I wish he would have lied to me or sugar coated it some, he said that it would feel like someone stabbed me with a pencil for 2 or 3 days. i was close to tears from the pain of the pap smear. he said the cervex was raw looking. i dont understand why- he said prbably from child birth but my kids are 4 and 7, and no dr has mentioned this before. Im so scared of something going wrong like with my sister. my mom had a bad surgeon remove a tumor in the late 80s and now has facial paralysis, suffocating spells, and other life threatening effects. she goes blue and just falls over. im terrified. there is no one for my kids in that situation. i know it is very rare- but i have never had surgery or procedures done. I react badly to medications and dont heal well. I need courage and major sedation.
    kamsae 88 Replies
    • February 13, 2007
    • 03:43 AM
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  • oh yeah- very weird thing he said: "adenomyosis is only diagnosed with an autopsy or histerectomy, otherwise they can think it might be right, but not accurately". :confused: is this true?
    kamsae 88 Replies
    • February 13, 2007
    • 03:46 AM
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  • yikes, sorry for rambling, i wanted to include that my stepmother said she went to this same Dr. last year for bleeding, pain, and gas. she was mostly concerned with the unnatural flatulence. he told her to change her diet and lose weight, even though she insisted it was not related as shes done all of the diet changes (ibs,lactose,fiber,etc). She said she left there very unhappy. last week she was diagnosed with uterine cancer. i dont know if he can make the same mistakes with a visual exam like mine- but its pretty alarming. she is physically doing ok, but emotionally trashed right now. they are still unsure of how advanced it is or how far spread.
    kamsae 88 Replies
    • February 13, 2007
    • 03:53 AM
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  • endoscopy came back with one little growth in the esophogus- did a biopsy and will call back on it. Flex sigmoidoscopy was normal.GI says likely accurate in the endometriosis assumption. the laparoscopy and hesteroscopy was cancelled. They called and said the pap smear was abnormal. :(
    kamsae 88 Replies
    • February 13, 2007
    • 11:01 PM
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