What to do if you can’t find a primary for clearance?

Question

Hi so I currently have a primary but he is old school an don’t believe in surgery at all I felt like he was judging me for my decision to remove extra skin of the abdomin an muscle repair he kept referring it to a weight lost surgery even tho I told him my main focus was to remove the extra skin as that was my biggest down fall about myself an I felt very self conscious about that area what do I do?

Tommaso Addona, MD · Answer

Thank you for your question.
I recommend talking to your plastic surgeon about your difficulties in acquiring medical clearance. They can most likely refer you to someone who can assist you.

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding what to do if you can't find your primary care doctor's surgery. Unfortunately, your primary care doctor will not clear you for surgery. There can be a multitude of reasons. However, here in Los Angeles and Beverly Hills, your plastic surgeon can refer you to a private independent medical internist or a cardiologist for clearance. These private doctors confidentially see you, examine you and review your labs. If you were healthy for surgery, they would clear you for surgery. We all want you to have safe surgery. A coordinating team approach is essential. Therefore consult with your first surgeon and a team of private Internet and cardiologists to work for medical clearance. Thank you for your question regarding how to get medical support from your primary doctor.

Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon, President of the American Society of Bariatric Plastic Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery, and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)

Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon, President of the American Society of Bariatric Plastic Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery, and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)

Jonathan Heistein, MD · Answer

It’s best to communicate this to your plastic surgeon.  I’m sure your plastic surgeon can call your primary care doctor to ask for this letter of clearance. If not, then he/she may know of another primary doctor that could do this for you. Best of luck!

Mansher Singh, MD, FACS · Answer

Some Urgent care facilities also do clearance. Additionally, if you are young and healthy without any medical issues - discuss with your Plastic surgeon. He/She might be able to do the case with just lab work.

Ronald J. Edelson, MD · Answer

If you need clearance ask your plastic surgeon to refer you to someone. Most surgeons have doctors that do medical clearance for them. Also it depends on what your medical issues are. You don’t mention if you have anything specific like heart problems. In my practice you would not need medical clearance if you are healthy

Daniel Barrett, MD · Answer

Dear Powerful3175,
every plastic surgeon has his own preoperative protocol which he recommends to his patients. I would suggest you to discuss this with your plastic surgeon.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Jason Hess, MD · Answer

I would contact the plastic surgeon and ask for advice.  Usually plastic surgeons office can refer our direct patients to a provider for clearance as needed.  Some primary care providers are very against plastic surgery.  Other primary care providers have plastic surgery themselves.  Best of luck in your journey.

Connie Hiers, MD, FACS · Answer

If your surgeon requests a medical clearance, then you will need to go to another doctor who will do this.

Camille Cash, MD · Answer

Your surgeon should be able to give you a referral for a primary doctor you can see for medical clearance.  Another option is to contact your insurance carrier for primary care physicians in your area who are accepting new patients.

Mats Hagstrom, MD (license on probation) · Answer

Plastic surgeons will sometimes specify if they want medical clearance for specific reasons or buy a specific type of doctor.If it’s simply medical clearance from your primary care doctor then any internist or family practice doctor can give you medical clearance.
If you’re not happy with your primary care doctor then maybe it’s time to pick a new one. No one should be felt judged by any doctor let alone for having a medical procedure. My advisor in medical school many years ago top me a valuable lesson when he said “judges judge and doctors heal”
Best,
Mats Hagstrom MD