This is a conversation that I have, over and over again, with clients of mine. It’s easy for us to forget that our doctors work for us, right? Historically speaking, the viewpoint was that “doctor is God” and that everything your doctor says is right and correct. Well I’m here to tell you that isn’t true anymore.
Was it ever true? No, but there was a time when information wasn’t as easily accessible as it is today, and your doctor was your only access point to health-related information. Today, you can find anything you want on the internet. That doesn’t make everything you read true, but if you dig and use the right resources, you can find what you need.
Back to your doctor working for you; Yeah, it might feel like your insurance is flippin’ the bill for your doctor’s services, but how do you get your insurance? In most cases, you go to work, put in your time, and your employer pays you for your service, in part, with your insurance. If you’re paying out of pocket for your insurance, then you are even more directly flippin’ the bill.
At the end of the day, your doctor works for you. This means that you call the shots.
You, as the patient or the client, MUST advocate for yourself. That is your responsibility.
I have this conversation most frequently revolving around labs. Have you ever had a suspected thyroid issue and all your provider would order was TSH? You’re symptomatic with depression, weight gain, constipation and your hair is falling out, but your TSH looks “normal”, so when you asked for fT3 and fT4, your provider said it wasn’t necessary. I hear this story every single day. Asking for further thyroid workup in this case is warranted, and your doctor works for you.
A few more examples that I hear on the daily:
“I Feel exhausted and think I might be anemic”. Provider responds that RBCs look great and it’s not necessary to check iron studies?
“We checked my Vitamin D a few months back, but I’ve been taking 5,000 iu everyday since, can we check it again?” Provider responds that it hasn’t been a year since you last ran it, so you’ll have to wait.
I hear it all, and nothing really shocks me anymore. My response is always, “Your doctor works for you.”
Oftentimes, your provider won’t run extra labs because they know insurance won’t cover the extras and you’re going to be stuck with the bill. Insurance dictates the sequence of events in which medical care happens, to a fault. It’s important to tell your provider that even if insurance doesn’t cover the cost, you are happy to pay the bill, because you would like the additional information.
When doctors order labs, they have to code them with a medical diagnosis code (ICD-10 codes) for insurance coverage. A doctor can almost always find a way to ethically and truthful code labs.
At the end of the day, if you’re willing to open your wallet and pay, and the labs you request are logical and warranted, there should be no reason for your provider to decline your request.
If they decline, it’s time to find a new doctor.