Would You Change Your Doctor If He Didn't Grant Your Request?

I might go somewhere else to get the test. But, a few years ago, I moved twice in 6 months and had a 1 year old. I was SUPER tired. I told my doctor about it and she really recommended that I start taking a B vitamin. I took it for about 6 months and then really started feeling like myself again. He might be on to something with the B12.

Good luck,
L.

I have fired doctors who wouldn't listen to me. I know my body, and I know what's normal for it. If something isn't normal, I know it's not normal, even if the numbers say it is.

Yeah, I would be miffed. I would probably need a more specific answer than that. I want numbers of what a normal range vs. me vs. 'there's a problem' are.

It might not be him, it might be that your insurance won't cover a test that is considered (to the insurance company) unnecessary.

If I were in this situation (I love my PCP btw...he's totally awesome) I would probe further and ask him to educate me about the tests and why he feels I don't need it. He does a great job at taking the time to talk/educate me on various things and I leave his office fully understanding why he did what he did.

Don't change doctors yet (if you like him) but perhaps go for a second opinion and request the same tests and see what a completely different party has to say.

"What's it to him? It's my money!" Well, that prespective is only half the issue... Now a days, doctors have to be aware of what the health insurance will pay for. They also have to be aware of the number of patients who don't pay their medical and lab bills on time, if at all. And that is actually a large percentage. A responsible doctor will not order you up hundreds of dollars worth of lab tests. Only after he's ruled out the common causes will he order up the more uncommon, specialized tests--the healthcare coverage will cover that more readily (if that process is followed) and in turn, it helps keep the office costs lower for the rest of the patient community (because it lowers the chance that patients won't pay their bill).

I wouldn't change doctors just because of this instance. I don't necessarily want my doctor to agree 100% of the time with me. Instead I'd rather that my doctor was concerned with my situation and showed intent to help resolve it.

My doctor told me I didn't need a bone density scan when I asked for one. (This was years ago.) I knew that I fit the profile for Osteoporosis and I wanted the scan. If he hadn't been a friend of my husband's I don't think he would have ordered it......He told me I was not a candidate for thinning bones because I was premenopausal....well I had been on steroids as a child, I'm petite, and I am white...three of the four dangers for osteoporosis.

I had my scan and I was diagnosed with Osteoporosis. My doctor was not only embarrassed but apologized. He was close to tears. I have since reversed the Osteoporosis back to Osteopenia with an absorbable Calcium supplement and weight baring exercises. If I hadn't know, I probably wouldn't have put in the effort to get well.

I guess my answer is yes...change doctors until you get what you want. YOU are paying for it and it's your life. Doctor's are not used to being challenged. They should be willing to work not only for you but with you.

There are doctors willing to listen. You just have to look real hard!

M.

Doctors know things we are not privy to and are not able to google on the internet. Imagine being a doctor and having patients all day coming in and telling you how to do your job because they have self-diagnosed on webmd or some other website. We did not go to school for years and years studying the human body and related medicine. If we could and were able to self diagnose, we wouldn't need doctors. I am always careful not to self diagnose and to keep an open mind when listening to the doc.

Having said that, it is important that he consider your ideas, because, after all, nobody knows you better than you. Most doctors have an unreasonably large patient load and can't possibly consider all aspects or factors related to a condition in one two-minute conversation.

Did you ask him if it were possible that an iron panel would pick up something that was missed on the other blood test? I am reluctant to conclude that you should switch doctors over this, but I am also a firm believer that you need to be completely comfortable with your healthcare professionals. If you feel he didn't consider your request, you should talk to him or his nurse about it. Maybe they can tell you the why.

M.R. is exactly right about some testing not considered "medically necessary" by the insurance. If you had a full round of bloodwork done two months ago and it all came back in normal range, it may not be approved. I'm not sure about your insurance situation but a rational discussion with the doctor would be helpfully be able to explain his rationalization to you. I'm not sure about TX, but in CA doctors can actually lose money on you as a patient by ordering more tests and procedures. Once again, depends on your type of coverage so it may not be "all your money". Good luck!

Might upset me at first, but then I'd realize how silly I sounded demanding a test that had already been performed.
I would eventually realize I wanted some help in not feeling exhausted and then tell my doctor that I am at my wits end and just want some energy back. Does he have any additional recommendations or tests to further support a diagnosis. Then spend my $$ on those tests instead.
Doctors are not there to bend to our will and do what we want. They are here to manage our care based on their YEARS of education and hours upon hours of CEU annualy, not an internet search or "woe de jour" - LOL!
Stick with this doctor, they are being an advocate for your health and are being honest with you even if you don't like the answer. sounds like a keeper.

No, I would not change Doctors and would not be upset. I would ask for further explanation if I didn't understand his reasoning. The Doctor's job is not to give you every test under the sun you think up, you are paying for their professional opinion and knowledge. If he has already tested your iron and it was fine what were you hoping to find out from an iron panel that you think he doesn't know from the tests he has already done? If yes, then ask him about that specifically and ask to be educated further where there is a particular concern. If he gave you the test and then your insurance refused to pay for it and it costs a lot would you blame him then too?

I did a quick google search on the subject. If you do some research you could get even more information. Here is a link:
http://www.anapsid.org/cnd/diffdx/irondisease.html
That one explains both anemia and overload and I think shares some of your viewpoint, and encourages a $15 test for transferrin, which could pick up excess iron.
HOWEVER, there are generally other indicators, and your doctor probably has a good reason to not want to order unnecessary tests. Like the other poster said, ask him why not. If he won't explain himself, then yes, find another doctor, one who will explain his rationale for you.
Let him go through the basic tests first, and then ask for the nonstandard stuff if the easy answers aren't the right ones. Iron overload is pretty rare, especially in women of childbearing age, and the risk is higher as you get older.
I'm always exhausted, and it's because my kids are crappy sleepers so I haven't had a single 8 hours in a row of sleep in over 4 years. Not once. Not once of even two 4-hour stretches. And I'm only now working very hard to exercise and drink enough water and eat as healthily as possible.
From your handle, M., I'm guessing that's a big reason for your fatigue. What mom of 3 isn't always tired? I've only got 2 and I haven't been well rested in four years, like I said.
But if you are getting enough good quality sleep, drinking enough water, eating correctly, exercising, and your blood work and hormones all come back normal, then you can try looking for the rare stuff and your insurance is more likely to pay you back for it.

For me it would depend on what my relationship with my doctor was like. Is it usually adversarial? Was he able to give a reasonable explanation as to why it was not necessary to check the iron panel again? Is he taking your complaints seriously as to being tired all the time? Does he usually take the time to discuss your concerns with you and does he usually give reasonable explanations? After you answer all of those you will know whether it is time to find a new doctor.

Did you know that if you have ever had mono which is caused by the Epstein Barr virus? I believe it lies dormant within your body and can reactivate at any time. Did they check for that?

Are you taking any new medications which could be causing the fatigue?

I wish you all the best.

Unless you've done something drastic in the last two months, then the test results would still be valid. Why don't you just request a copy of the report and do some research on your own? You do have a right to your medical records. Every blood test that I have ever had shows the results, what is considered normal range, and an interpretation (low, normal, high, etc).

If you otherwise like this doctor, I don't think this is a reason to change. If he otherwise is receptive and a good provider, then stick with him.

I think if your iron test came back ok, I would accept that for now - he obviously thought of iron as a possible cause and included it in the testing.

I think it's wise he's testing your B-12 as the lack of B vitamins can cause fatigue.

There are SO many factors that come into play when you're talking about fatigue. The biggest -besides hormonal issues - is diet. A diet of processed foods that have preservatives and artificial ingredients do not fuel the body and are not used efficiently for energy. I'm sure you have already evaluated your sleeping habits, but don't neglect this important component as well.

I'm not generally a fan of drs or the medical model that is in place now. I prefer a more holistic approach to healthcare and I question drs when it seems they are not making a decision based on convention rather than a specific person's circumstance. I think I would ask for a second opinion or do my own research on this before pressing the issue. Depending on how the test is performed (I'm not familiar w/it), it may be in your best interest to forgo it, ex: if it is invasive, requires meds, or uses radiation.

I generally trust doctors, but I would be annoyed too.

My niece was anemic but the doctors thought she was fine (the rest of the family, and daycare, noticed and we were very worried about her health. Very pale, dark circles under her eyes, no energy. We told her parents they needed to INSIST that her iron was checked even though the doctor didn't want to. Sure enough, she was severely anemic. :/ Doctors make mistakes too I guess. I would get a different doctor, or when your other results come back I would DEMAND her does the additional blood work.

I you are paying cash for whatever you want, no insurance, sure change doctors and get the test, you are the consumer.
If you aren't and insurance is picking up the tab, your doctor is doing the right thing- if its not indicated, there is no reason for your insurance, and the pool of people covering the premiums, to have to cover the expense.

If your doctor is just blowing you off, I would switch doctors, however I can understand him not wanting to repeat a test that you just recently took. There are many reasons for fatigue: depression, The Epstein-Barr virus, Lyme disease, a parasitic infection, an autoimmune disorder, stress, overwork, cancer, allergies, etc, etc. Is your doctor looking further into your condition? If so, keep him. He would be doing you a disservice if he just kept looking in one direction - towards iron when it has already come back as normal - THAT would upset me.

As I understand your question...you had blood work done that showed your iron was in the normal range but wanted to spend money on tests to show you that your iron was still in the normal range?

I don't understand your question I guess. If you already had it tested why do it again?

Yes, it would upset me...I was admitted unexpectedly to the hospital last year. The admitting doctor discharged me 1 day later. I insisted something was wrong, that I was still very ill, that he was making a mistake, and he basically sneered and walked out. I ended up back in the emergency room one day later, and this time the hospital kept me for 1 month. It was very serious. Doctors are fools if they ignore the patient. You feel what is happening to your body...that is a better tool than any test they've designed yet. A doctor who doesn't listen to and communicate with his patients has forgotten that he treats people, not symptoms. I see no reason why you couldn't have it even if it was an insurance billing issue; it could be agreed that the test charge wouldn't be billed to insurance, but rather to you directly. I would call the office, ask to speak with the Doctor or Physician's Assistant and request this clearly. If the Doctor says no without an excellent explanation, then absolutely switch!

I would ask him again to do it. Or call another doctor that will do it. If he, is not willing to do what you ask then maybe find another doctor. these doctors order tests sometimes that seem irrelevant but can't put aside their ego to do what you ask. And if the insurance won't pay he should say it upfront that way the decision is on you.
Good Luck and feel better.

Ask him to check your Vitamin D level, too. When I went to see a new doctor (!) I told her about how I was tired all the time. She included a Vitamin D level in my bloodwork and found mine was a 12. The optimal minimal level is 30-something. When I remember to take the mega-dose prescription she gave me, I feel so much better!

Sometimes seeing a new doctor is a really good thing, because they have new ideas & insights your previous doctors haven't thought of. I've been telling doctors for over ten years I'm tired all the time and she's the first one who thought to check my Vitamin D. In your case, I think the initial bloodwork you had done would have shown him whether your iron was too high. That's a pretty straightforward thing. You probably don't need an iron panel to recheck it. A better "test" for your doctor would be whether he is willing to continue trying to find the cause of your fatigue. Check with him about the Vitamin D & any other causes of fatigue you've heard about and see how willing he is to check into them. If he's checking your B12, it sounds like he's willing to try. He may tell you something you're heard about is crazy, but he should be able to explain why, and nicely.

Good luck : )

If you dont feel your dr is listening to you then yes change dr's. They do not always know everything and sometimes they just dont want to deal. Years ago I was having problems with my shoulder and left arm, my dr had me go through some test that showed everything was fine yet I was still in pain and having spasms. I decided to get a second opionin and found out that the pain was actually coming from my neck.
Second story you can read about in my blog where a dr was wrong. http://valerielint.blogspot.com/

Yes it would upset me. I would express my concerns with him during my next visit.Let him know that as a patient, you have a right to request test or anyting else regarding your health, if you feel it is necessary. If he refuses at that time, then you should seek further medical attention else where. Good luck. Hope you feel better

Yes, I would. you are an informed consumer, you have done your research, you have requested a simple blood test... if you had demanded some outrageous elective procedure...but a blood test!? Find a doctor who will take your concerns seriously.
Good luck.

"He told me there was no need for an iron panel since my iron came back fine." You are demanding a retest and he is saying lets try another avenue. . . it's probably not your iron.

Yes, I would seriously consider changing doctors.

No, I certainly wouldn't change based on this scenario unless you yourself are a doctor and are disagreeing based on actual knowledge and not something you read or heard somewhere. I would have a reasoned discussion regarding his assessment of your situation but that's just me. Sounds like it bugged you simply because he wouldn't do your bidding. It would be unethical and illegal for any health practitioner to simply do anything their patients asked of them. That said, I'm sure you can find a quack out there who will perform all sorts of unnecessary tests and will even prescribe you drugs if you want them. Sure hope it is your money and NOT health insurance that pays for it and jacks everyone's premiums up.

Tough call. I would be happy with a doctor who is determined to get to the bottom of my issue and doesn't prescribe unnecessary tests--which he obviously believes he has ruled out the iron issue--so now what's the plan? And after he checks the B12?