My primary care doctor wants

[jas]

Me to go see a surgeon. This is the story. I went to him the other day to get the results from an x-ray done on my lower back. The results are that I have mild arthritis in my lower back. Any way he asked so have you had your mammogram done yet this year? (He is not the doctor that sends me, that would be my gyno doc) I said "Yes." "Just last Friday to be exact." I used to work there and my old boss did the mammo. She saw something that I guess she thought the radiologist would want to have extra views done. So instead of leaving and going home and waiting for the letter to say I needed to come in for additional views she said since I know you I will have the doctor look at them right now and if he wants more you can get it done right now.

He did want more views and an ultrasound. It came out that it is a cyst and he wants me to come back in 6mo to check on it. He said it was not cancerous and he didn't think it would turn into it.

So back to my primary doc asking about the mammo. He gets up and calls the place I had the mammo done and get the report sent over to him. He reads it and says that it says to come back in 6 mo for a follow up. All he has is the written report no films to look at. He goes well I want to send you to a surgeon. He may want to do a biopsy.

Don't get me wrong, if there is something there I would go no problem. The radiologist has all my films from the last 4-5 I have had done. The last three being digital. He can see it all and thinks it is okay to come back in 6 months.

My primary doc made an appt for me with this surgeon for this Wed. I doubt he will have my films. I will have to pay a 35.00 co-pay and then probably another 35.00 when he gets the films. I know I can call and see if they are being sent over. I just don't know why my doc is rushing me over there. Does he not trust this radiologist report? He isn't going off of seeing the films himself.

Any thoughts?

Thanks

[mauimagic]

Did you ask your primary doctor those questions? Was there any discussion? Seems sort of strange to me - does your Primary doctor have any background in this area. I'd probably want to talk to this dude again and have an in depth discussion as to his reasoning before persuing anything....IMHO. Please let us know what happens.

[dcompton]

I would not go. The radiologist has the films, your history, and doubtless more experience in this area than your primary care doctor. He is probably just being extremely cautious.

I'm with MM. I would want more discussion with him as to why, without even seeing the films, he is so anxious to rush you off to a biopsy. I once got caught in the playing cautious trap. I had a mammogram years ago, the radiologist saw something that was "almost certainly nothing." But wanted an ultrasound done. Did that. Still almost certainly nothing. But then wanted a needle biopsy. It was where it could not be reached. But not to worry. Still almost certainly nothing. But let's do a surgical biopsy anyway. Ok. After that the surgeon admitted that what he removed turned out not be to be right thing when a mammogram showed the still almost certainly nothing was still there. So they sent me for a different biopsy procedure, computer guided (so why didn't they do that first?). Result. It was nothing.

I saw this through because I was concerned the insurance, in the event it later did turn out to be "something" would say I had refused treatment in a timely manner and be difficult. But I wouldn't do it again. Oh, and the insurance did not cover any of the three or four mammograms after the initial one because they became "diagnostic," not "routine." How does that make sense?

I would move very slowly on this.

[jas]

Thanks. I do need to talk to him again as to why the rush job. You are right the insurance probably won't pay for all the extra mammos They are 100.00 a pop for self pay. And they are radiation after all.

My primary doc is real quick to send you off to someone else. He is not paying all the co-pays.

Like I said before if I didn't trust the radiologist with reading my films or if he had even in the slightest said I think we should look into this further I would in a second for sure. Or even if he was concerned and said come back in three months I would. He has to cover his back too. Another thing my old boss would have said something also about further testing.

[ladytoysdream]

$$$$$$

One of my doctors ( ENT specialist ) wanted to do surgery this spring. I asked to see another specialist for his opinion. Second doctor made some changes to my sleep machine settings, and said he did not advise surgery as my chances for success would be only 40 %
My conclusion was that the doctor was looking for some income.

I think the economy the way it is, is affecting doctors, etc.

Ask for another opinion if you feel the need of one, and / or just cancel this new appt that you don't think you need.

[Contrary Housewife]

I would wait 6 months and see what happens. The radiologist looked at the films, your primary did not.

[Momto5RN]

just something to keep in a mind a radiologist really knows nothing of your personal hx or your family hx just goes by that pix alone and possibly a previous one for comparison.

i would speak to your primary and see what his concerns are and ask why .

many woman have been told something was nothing only to be told it was something 3 months later - so if they want to do a BX to make sure- i wouldnt mess around with that because of a co-pay and wanting to save money . Prevenative medicine is alot cheaper than treating something .

the basic rule of thumb anymore is better safe then sorry when it comes to woman and breast cancer .

[jas]

just something to keep in a mind a radiologist really knows nothing of your personal hx or your family hx just goes by that pix alone and possibly a previous one for comparison.

i would speak to your primary and see what his concerns are and ask why .

many woman have been told something was nothing only to be told it was something 3 months later - so if they want to do a BX to make sure- i wouldnt mess around with that because of a co-pay and wanting to save money . Prevenative medicine is alot cheaper than treating something .

the basic rule of thumb anymore is better safe then sorry when it comes to woman and breast cancer .

No previous history personal or family. My primary didn't even ask about any previous history personal or otherwise about breast cancer. The radiologist has all of my previous films to compare them too and I know they do compare them. I used to work there. They don't even want to do someones if they don't have previous films if they know some exist or they will wait on them to be sent. Unless of course it is a baseline.

Like I said if someone who has seen the film and thought they saw something that maybe the radiologist didn't see or didn't agree. I would go no problem co-pay or not. I just don't want to be run through the ringer and have test after test just to be bringing in money for the doctors.

I fully understand how serious breast cancer or any cancer for that matter is. And you should not mess around with it.

[thefrug]

what are we? twins?! I'm just now this past week having the same discussion with my doctor who I trust completely. BUT, you didn't mention any sort of pain. Thats where we're different. I have pain to where my seat belt and when I'm carrying something makes my nipple and part of the areola hurt. My doctor also found a painful spot when she did a palpation. I go for the mammo and ultra sound next week. Then I see the surgeon in sept. My doctor told she doesn't play around when it comes to women's breasts.
Where I'm at, you don't have the garuntee(sp?) of having the same person reading your mammo every time.
I hope it all works out for you. Good Luck.

[jas]

what are we? twins?! I'm just now this past week having the same discussion with my doctor who I trust completely. BUT, you didn't mention any sort of pain. Thats where we're different. I have pain to where my seat belt and when I'm carrying something makes my nipple and part of the areola hurt. My doctor also found a painful spot when she did a palpation. I go for the mammo and ultra sound next week. Then I see the surgeon in sept. My doctor told she doesn't play around when it comes to women's breasts.
Where I'm at, you don't have the garuntee(sp?) of having the same person reading your mammo every time.
I hope it all works out for you. Good Luck.

Nope no pain, no lump. I had the ultrasound done the same day. That was only because I used to work there otherwise I would have had to wait till I got a letter in the mail and had to come back.

I hope everythings goes well for you also.

[HandyMom]

A pain in my thigh which my regular doc misinterpreted as pain in my pelvic area resulted in my having several ultrasounds, blood tests and an unnecessary surgery last year. Near $3,000 in co-pays later -- it was "nothing" but a benign cyst on my ovary that more than likely would have shrunk away had we left it alone for a couple months. A scalpal-crazy gyn didn't want me to wait it out to see if it would shrink on it's own even though blood tests showed it was not cancer. The gyn also tried talking me into having a complete hysterectomy for no other reason than to possibly prevent cancer although no family history of it either. Gyn said, "I can get you in this Friday for a complete hysterectomy - I do them every Fri." I ended up getting a second opinion and a different surgeon that specialized in oncology. It ended up costing me a few thousand dollars in co-pays and 10 weeks recovery time off my feet basically. Now I keep my mouth shut when I see my regular doctor and tell him I am feeling just fine.

Proceed with caution if you can't really afford to go in debt with medical bills over tests and exploratory surgery.

AND... I still have the numbness and pain in my one thigh.

[HandyMom]

[QUOTE=thefrugWhere I'm at, you don't have the garuntee(sp?) of having the same person reading your mammo every time.[/QUOTE]

I did have the same person read an ultrasound and the second time around my uterus was measured as a different size and everything. Guess they didn't keep track or notice they read the same thing a month earlier. I thought it was ridiculous. I'd love to know how accurate their "readings" really are but who can afford to keep having another test/reading done at $300 a pop each time?

[Momto5RN]

if your primary knows nothing about your past medical hx of family hx what kind of office is he/ she running ??

that info should be taken when you first go to them the first time -usually there is a multi page form about PMH family hx etc that one has to fill out - and stays in your file as long as you are under their care heck even to see an eye dr at even walmart anymore you have to fill out a medical hx.

That said dr just may be hypersensative at " covering " himself then .
especially now now a days in this sue happy world.

i would speak to him though -try to find out his thinking
and get the actual type written report copy of the mammogram and US results for your own files for future reference.

[frugalfranny]

I would not go. The radiologist has the films, your history, and doubtless more experience in this area than your primary care doctor. He is probably just being extremely cautious.

I would move very slowly on this.

Yep........I agree.

I also would call or email (if your Dr. does that- mine does) some questions........preferably call. Make a LIST.........so you don't forget anything and ask them all.........make sure he/she answers them. He sure does seem in a hurry. But like another poster said.........your primary knows your history, not the radiologist.....but still......

My Dr. sends me off to someone else for about ANYTHING other than flu/shots/RX or basics.

[jas]

if your primary knows nothing about your past medical hx of family hx what kind of office is he/ she running ??

that info should be taken when you first go to them the first time -usually there is a multi page form about PMH family hx etc that one has to fill out - and stays in your file as long as you are under their care heck even to see an eye dr at even walmart anymore you have to fill out a medical hx.

That said dr just may be hypersensative at " covering " himself then .
especially now now a days in this sue happy world.

i would speak to him though -try to find out his thinking
and get the actual type written report copy of the mammogram and US results for your own files for future reference.

In all fairness I am sure that about 15 years ago when I started going there I filled out the standard family history and personal history paper. My family history is high BP/heart stuff and skin cancer. (hard to avoid living in flordia) During that 10 min appointment he did not look all the way back to that sheet and didn't ask me verbally what my family history was. Now if in his family there is breast cancer and he is just super aware because of that he didn't say.

This doctor is the one that I use to monitor my BP meds and not much else. I have other doctors for other things. Urologist for my kidney stones, Gyno for female issues, which she is the one that sent me for the mammo in the first place. I have an appoitment in a few weeks for yearly exam and she would be telling me from the mammo report the results and her reccommendation. (If any) And then a cardiologist seen only rarely I have MVP.

Don't you think It would be reasonable to at least wait to see the doctor who sent me for the mammo in the first place before I go off in all directions because of my primary doc asked a general question have you had your annual mammogram yet? My gyn has more of my female info in my files there than this doctor does. And to tell the truth if there was a problem I would much rather deal with her than him. I realize that if there was a problem there would be many more docs involved in that speciality than a primary doc.