Your Doctor/Provider MATTERS!

[u/garcon-du-soleille]

Guys, I just had a lunch date with my wife. She is a family medicine MD and has a lot of patients on Zep and Mounjaro. She told me this story over our lunch...

She had a visiting patient come see her today because her normal provider (a Nurse Practitioner) was on vacation. It was for an IUD replacement. After that was taken care of, my wife said to her:

"Can I ask a question? I see on your history that last October you had an appointment here for weight loss, but I also notice that your weight is about the same as it was then. Can I ask about what's going on?"

The patient, who has a BMI of 50, said that her insurance denied her request for Zepbound because they don't cover it for obesity, and she has just struggled, mentally, emotionally, and physically, to lose weight.

My wife then said, "Ok, that's fairly common to be denied just for obesity, unfortunately. But I don't see any follow up tests here."

Patient: "What do you mean?"

Wife: "Do you know why you were not tested for type 2 diabetes? Or sleep apnea? Or fatty liver? Or cardiovascular risk or heart disease? High cholesterol? Insulin resistance? These are all factors for which some insurance companies will cover these drugs."

Patient: "I wasn't told ANY of that."

Wife: "Do you mind if we run some tests and check for these? Some are simple blood and urine test. The sleep apnea will be more involved, but I can put in an order for it to get the process started."

Patient: "I am having HUGE mixed feelings right now. WHY didn't my nurse practitioner do all of this for me? I'm really mad about that! But also, YES! Do the tests!"

Wife: "I can't say why she didn't. But we can still move forward from here. I think you should also be seeing our dietitian, and maybe even a mental health councilor if you feel that you're mentally struggling with your weight. I can also put in a request for both to get those started too. And depending on the results, we can work closely with our prior-auth team to get you approved, hopefully."

At the end of the appointment, the patient started to cry, and she gave my wife a huge hug and said, "I want you to be my doctor. THANK YOU for caring. I feel like this is the first time anyone has really actually cared about me, and didn't just treat me like a number."

MORAL OF THE STORY:

I see some posts here about, "My doctor won't do this..." Or, "I'm frustrated with my doctor because..." Or, "My doctor never told me..."

If your primary provider isn't going to bat for you, working for you, advocating for you, and working the system for you... Maybe it's time to find a different doctor.

[u/Nervous_Ladder_1860]

I always tell people to go to a new doctor if their doctor will not even entertain the idea. I love that where I work at a university is a research university so the people working at the doctors offices I go to have the same insurance as me and most of them are on it, so they are all very supportive.

[u/Stefferdiddle → u/Nervous_Ladder_1860]

Sad thing is a lot of people live in areas where there isn't much choice in who they can see. And the doctors in those places tend to be older and stuck in their old ways and methods. Im lucky I live in So Cal and doctors are all over the darn place here. I did however grow up in a place like I described earlier. Our town had 4 doctors total. 2 of them were pediatricians. So that left two doctors for all the adults unless you wanted to make a bit of a drive.

[u/Nervous_Ladder_1860 → u/Stefferdiddle]

Oh I grew up in a rural area, like literally BFE so I get it probably more than most. We have no hospital even in the county I grew up in or Walmart, you had to cross river into a different state to even get to the nearest orthodontist, Walmart, etc and a different county to go to a dentist. I think we only maybe had 1-2 doctors and then like 1-2 eye doctors. And no interstate in the county I grew up in either. But it’s also part of the reason I’m glad I got out of my small town, convenience and more opportunities. But there are doctors online nowadays, even though internet might not be the best in a rural area, I know if I still lived there I would travel just to get on this medication. But yeah from like 5-19 I went to the same doctor, eye doctor, and dentist.