a new referral needed?

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Veteran Member

Date Joined Nov 2008
Total Posts : 1037
   Posted 8/2/2010 3:47 PM (GMT -6)   
I have been seeing the same PM Doc for 8 years or so....I was seeing a PCP that referred me to him way back then and have been going ever since...since then I have a new PCP... When my last appt. with the PM Dr. came up I was told that I needed a new referral...before they could see me. I was out of meds. and they told me this the day before my appt. I called my PCP to get the referral but he was out on vacation and they couldn't help me....ok, a few days I could handle....That was last week....this week I get a call from my PCP saying that he wants me to see another PM Dr. ...actually a Neurosurgeon...and I couldn't get in until August 25th.....That's way too far away...and my PCP never liked the fact that I was taking so many pain meds....and I think he's using this to change that.... My PM Dr. can't help me without the referral...not even with me being out of meds...What am I going to do? I can't go without my meds.....

Has anyone ever heard of this before?
Spinal Stenosis, DDD, DJD, HBP, Type 2 Diabetes

Methadone 120 mg. X daily
Oxycodone 30 mg. 5 X daily
Lisinopril HCTZ 10/12.5 2 X daily
Metformin ER 500 mg. X 2 @ bedtime
Novolin 50-0-50-50
Novolin R 0-50-0-0

That's all....but OMG!! isn't that enough?

Veteran Member

Date Joined Mar 2008
Total Posts : 3089
   Posted 8/2/2010 9:55 PM (GMT -6)   
Hi Me,

I've never heard of having to get a new referral before. Certainly many, if not most PM's require new patients to have referrals, but I've never heard of an established patient having to get a second referral -- especially not after so many years. But perhaps I'm not the best person to answer this question, as I don't see a PM. I did for about a year, but then I switched back to my PCP, as he was more than happy to take over my pain management & I wasn't thrilled with the PM doc's office.


Regular Member

Date Joined Jul 2008
Total Posts : 329
   Posted 8/2/2010 10:35 PM (GMT -6)   
Have you tried offering to pay cash? Usually a referrel is only an insurance thing so there really should be no reason for them to deny you if you do that. If they do, I would ask some more questions and find out a full reason as to why the sudden change.

Hysterectomy at 25 : Fell down stairs 3 days after4 laproscopic surgeries since 24

Cervical Stenosis between C 2 and C6 and two buldging disks located C2/3 and C4/5

Meds - Embeda 20mg 2x per day: Dilaudid 2-4 mg every 4-6hrs::Amrix 15mg 1x day: Pristiq 50mg 1x day


In the United States today, there is a pervasive tendency to treat children as adults, and adults as children. The options of children are thus steadily expanded, while those of adults are progressively constricted. The result is unruly children and childish adults. ~Thomas Szasz 

Forum Moderator

Date Joined Feb 2003
Total Posts : 16780
   Posted 8/3/2010 5:33 AM (GMT -6)   
As far as the referrals go, yes, I have had to get new ones before, seems like mine were good for one year then a new one was needed. I have also had limited referrals to drs. This was requested by the ins company.

You cannot go without medication that long. I would go not call, but go to my PCP's office and tell them that you need the referral so that you can continue with your current medication, you are on too much just to be stopped dead cold, that is wrong and something needs to done this could be very dangerous for you. What on earth is your PCP thinking here? I don't know how long they make you wait for an appt (PCP) but if its a long wait then I would show up and demand nicely someone help me. Even if you have to agree to see the surgeon I would do it in order to be complying with the dr. Your dr should not be doing this, its just wrong, If he wants you to see another dr then he needs to be a big enough person to tell you. This just floors me.

crohns disease dx 2002 & small bowel resection, still looking for remission whatever that is, chronic pain 22 yrs, added ulcerative colitis 6-05 to the mix, high blood pressure 28 yrs, aortic heart valve insuffiency, depression, osteoarthritis, osteoporosis lumbar spine, scoliosis lumbar spine, peripheral neuropathy hands & feet, COPD & on oxygen therapy, lupus & psoriasis and psoratic arthritis. Several other health issues just not enough room to list it all. Too many surgeries to list and too many medications to list. Currently on 17 different daily medications. Intrathecal pain pump implanted June 05.

Mrs. Dani
Veteran Member

Date Joined Jun 2009
Total Posts : 2787
   Posted 8/3/2010 10:07 AM (GMT -6)   


   Dear Rhonda,

     Good morning *warm hugg* Goodness, it sure is good to hear from you. I had hoped that no news was good news. I am so sorry to hear the turmoil between your current PM and new PCP. That has got to be frustraiting to no end!

     I do think that my current specialists need updated patient file and referral about once a year. But it isnt done the way your situation has been handled. I am just asked to come in earlier and go through the "new patient" questions. The referrals are all done or re-done in the back ground, so there isnt a hassle.

     Your situation has me worried for you to say the least! You are depenent on way to many meds for that kind of lapse in care. Can you call your current PCP and let him know about the time frame of leaving one office for another? Someone, some how, needs to be made aware of the lapse in your medication. I cannot see anyone allowing that kind of preventable damage to occur.

     I hope someone will be able to help you. I am sure you are frustraited and rather angry. I would be livid in your shoes. To top it all off you still have the worry over seeing a surgeon. Gosh, I am terribly sorry you have so much on your shoulders. Hang in there and Stay Strong!


TWO roads diverged in a yellow wood
And sorry I could not travel both
And be one traveler, long I stood
Chronic Pain Moderator

spinal soldier
Veteran Member

Date Joined Dec 2009
Total Posts : 687
   Posted 8/3/2010 3:12 PM (GMT -6)   
No doctor in his right mind will let you cold turkey from 120 of methadone. The oxy is bad enough but methadone W/D take a month or 2 of hell. On celebrity rehab with Dr. Drew Pinsky said the drummer from alice in chains I think, was in the worst biological state a person could be in detoxing from about 100-200 of metadone. He had a drug problem and no pain problem. Even a ER hell hole would help you in that situation I think? ha ha. I am praying for you.
L4,L5,S1 bilateral Laminectomies, Foraminotomies 2002
L4-S1 PLIF with instumentation 2008

current Rx: MScontin 30mgs 2x, dilaudid 8mgs 4x p.r.n., soma 3x, Arthotec 75mgs\200mcgs 2x, neurontin 300mg HS, vistaril 25mg 3x prn, wellbutrin 150mg 2x(ADHD),Adderall 20mgs 2x(ADHD)

Veteran Member

Date Joined Nov 2007
Total Posts : 6795
   Posted 8/3/2010 4:28 PM (GMT -6)   
Hi, Rhonda,
I agree with Straydog, you need to appear in your PCP's office and I would also go with a letter in hand, so that if no one can see you earlier, you put in reasonable language on paper all the meds you are currently taking, and reasonable fears you have over an abrupt withdrawal. You can say you will see the surgeon, but in the meantime you need to be able to stay with your PM. You can be willing to get an opinion from the surgeon, but in the meantime not to pull the rug out from under you with these meds.

I would also call you insurance company and see if the PM is not seeing you because of an insurance requirement for a new referral, or is the PM doing this because perhaps he and your PCP have talked. If it's an insurance issue, I would explain to your insurance company what is happening and see if they can allow you to keep seeing your PM under the old referral until you get the surgeon's consult. Ask to speak to a supervisor if you need to, and explain what meds you're on. If it's NOT an insurance issue, I would call your PM's office and ask the reason why he won't keep seeing you at least until you get the surgeon's opinion, and that if it's necessary for you to detox from these meds, you do so under his supervision. I would tell them you feel "abandoned" as a patient. That word will perk up their ears. That PM has been seeing you for 8 years - has this ever happened before? It could be, again, an insurance thing because you need a referral with the new doctor's name on it, but because this new PCP has a different view on the meds issue, that's no reason to withdraw the meds from you abruptly. In fact, I'd be looking for a new PCP if he's the problem.

Don't give up here. I realize it's going to take a lot of energy, but the way this is being handled is just plain wrong.

Good luck. Let us know what happens!


Veteran Member

Date Joined Aug 2008
Total Posts : 3193
   Posted 8/3/2010 6:32 PM (GMT -6)   

I agree w/ everyone here... nobody could just go off that amount of meds... I don't get what the deal is. Re: getting updated referrals - it seems others here have had to do this, but I've never heard of this except when going to a new doctor... not an existing doc needing an updated referral. That's never been my experience.

I, too, would go into the office and stay until you get this handled. I know it's a pain, but better that than being left in a dangerous situation, w/ no meds.

I'd be livid if I were you! I hate situations like this. Keep us updated, and good luck...
Main Health Issues: Dysautonomia/POTS; CFS/Fibro; Chronic Pain (back issues, migraines, carpal tunnel, among other things); Chronic Hypertension; Hypothyroidism and Hypoadrenalism; Mixed Sleep Apnea (on BiPap); Depression/Anxiety; Vitamin D Deficiency.

MAJOR surprise - Pregnant, w/ twin little girls (after six boys). Due Sept, 2010. Praying they are healthy. YES, you can have chronic pain AND have a successful pregnancy - not easy, but it can be done. :)

Retired Mom
Veteran Member

Date Joined Feb 2010
Total Posts : 1753
   Posted 8/4/2010 4:09 PM (GMT -6)   
This is a horrible situation and I'm so sorry that you are facing it.

Please go in without delay! I would almost wonder if this is against the oath for these Dr's to "cause no harm". Abruptly stopping your meds will most certainly cause harm.

Please see someone asap!
Retired Mom

deb in indiana
Regular Member

Date Joined Aug 2005
Total Posts : 387
   Posted 8/4/2010 11:21 PM (GMT -6)   
This same thing happened to me 6 years ago the doctor i was seeing said i can't help you any more to much going on with you'So when i called the new doctor i found i just told him i needed to see a doctor he said i had to have a referral and i said all i have is my self so i went to see him and he asked why the doctor quit me after 6 years and i said i have no idea he asked me who he was and if he could call him i said yes i have nothing to hide always did what he wanted injections,p/t i did it so its been fine i have been with this doctor for 4 years now Good luck and take care Deb
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