Re: Does a Uro. do kidney biopsy exams

Pete wrote:
Jason Johnson wrote:
In article <e58d69028ne@xxxxxxxxxxxxxxxxxx>, "Pete" <pete@xxxxxxxxxx>
wrote:

Jason Johnson wrote:
As a result of having red blood cells in my urine, my doctor
referred me to a urologist. I have edema and some other
symptoms of kidney disease. It's my "guess" that the blood
in the urine is the result of a kidney disease.
Is it possible for a uro. to do a kidney biopsy to rule
in or out kidney disease as a cause for the blood in the
urine? I already know that the uro. will conduct various
tests and exams to rule in or out the various causes of
blood in the urine.

I should note that I asked my doctor to refer me to
a kidney specialist but he refused to do so because
of the rules of my insur. company.

Jason
Jason...please tell us what the rules were that prohibited your
primary care physician from referring you to a nephrologist. I am
interested. Sounds like more HMO bull*** to me :-) .

It's HMO bull***. The rules state that my doctor needs a medical
reason
to refer me to a kidney specialist. I have edema but it's not a
serious case of edema. There are several causes of edema. Perhaps if
kidney
disease was the only cause of edema, my doctor could refer me to a
kidney specialist. Almost every item on my kidney function blood
tests and urine tests are within normal limits mainly because I am
now a vegetarian. Therefore, the insur. company would hassle him if
he referred me to a kidney specialist. I don't know what sort of
punishement they use on doctors to keep them from referring patients.
I know that I have kidney problems since I read a book that was
written by a kidney specialist. I have many of the symptoms that he
mentioned in his book.
In another newsgroup, some of the posters tried to convince me that I
don't have a kidney disease. They may be correct but how could I know
for sure unless I have the proper tests such as a kidney biopsy? I
hate HMOs. Jason

Jason...That's why I stay with my Blue Cross (every open season), even though the doc's are dropping it because they don't pay enough. I don't need a referral, but certain specialists may require one anyway.

I would think that your doctor would be able to short circuit the bull*** (especially if you were close to him). In other words ("he needs a medical reason") should be general enough just for him to go ahead with the referral, unless he has no doubt whatsoever that you do not have a kidney ailment (and he has no way knowing that categorically - I do not believe).

This is total bull*** IMO, if you have a strong concern about your kidneys. Are you able to switch to a non HMO provider, or are you locked in with what you have.

Having said all that, you do have to be cautious about self diagnosing yourself, and "playing doctor" (as was discussed in the sci.med ng). However, if you are truly concerned about your edema (which you have the right to be), I think your doctor should refer you to a nephrologist, if you request him to.

Pete



Being quite familiar with the structure of HMOs it may well be that it will be the URO that has to do the referral to a nephrologist. And that may be only after additional approval by someone (an administrative doctor?) in the HMO. The reason they can maintain their big staff and provide medical service at cost less than other insurance is sort of obvious.
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