Crohn's Disease Forum » General IBD Discussion » Doctor will not write me a prescription for remicade unless I get a colonoscopy


01-18-2019, 10:09 AM   #1
Poppysocks
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Doctor will not write me a prescription for remicade unless I get a colonoscopy

I've had Crohns since I was 8. I've been on Remicade the past 15 years. It has been the best drug for me. I get a very high dose every month and it keeps me stable. Because of insurance issues, I haven't been able to get one the past 2 and a half months, and I also had to switch doctors because my old doctor stopped taking my insurance. Upon visiting this new doctor, he tells me that he will prescribe me 1 Remicade, however, he will not write anymore unless I get a colonoscopy immediately. And if I don't let him do a colonoscopy after I get my Remicade, to "find a different doctor".

If I feel fine, I don't feel sick, and I just want my usual medication, is it normal for doctors to demand these colonoscopies be done? I understand the need for checking up on things down there, but if I don't want one done, and I feel fine, why must I be coerced into getting one done? I feel as if this is extortion on the doctors part. If I do not let him do his colonoscopy (his primary way to make money), then he will not prescribe me the medicine that keeps me alive.
01-18-2019, 10:58 AM   #2
Scipio
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I really don't know, but I might guess that since you are a new patient he wants to get a baseline reading of the condition of your gut as he first prescribes this powerful medication.

He is apparently targeting achieving and/or maintaining mucosal healing of the gut rather than just control of your symptoms. If so this is a good thing. The actual appearance of the bowel and the pathological examination of the tissue specimens collected during the colonoscopy are much more reliable indicators of the true state of your disease and the effectiveness of the medicine than are your symptoms.
01-18-2019, 11:13 AM   #3
awoenker12
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When was the last time you've had a colonoscopy? Some doctors want colonoscopies every so often just to make sure things such as mucosal healing and inflammation, as stated by Scipio, are all in good condition.

My doctor typically wants me to get one done once every 5-6 years since I have been able to maintain remission for a while now.
01-18-2019, 11:28 AM   #4
Bufford
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Colonoscopies are a form of maintenance so that the doctor can see what is going on inside. I take getting scoped regularly as a good thing. Every time I met a new doctor GI it was always standard to get scoped first, its one of the best means for a doctor to get to know your condition. I would agree to getting a scope done, its good to keep an eye on whats going on inside.
01-18-2019, 12:24 PM   #5
Poppysocks
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Colonoscopies are a form of maintenance so that the doctor can see what is going on inside. I take getting scoped regularly as a good thing. Every time I met a new doctor GI it was always standard to get scoped first, its one of the best means for a doctor to get to know your condition. I would agree to getting a scope done, its good to keep an eye on whats going on inside.
Yes. I understand it is good to see what is on the inside. But you think it is okay for a doctor to deny you the medication you've been on your entire life if you don't want to get one done? Are you okay with that?
01-18-2019, 12:54 PM   #6
crohns35
 
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I've had Crohns since I was 8. I've been on Remicade the past 15 years. It has been the best drug for me. I get a very high dose every month and it keeps me stable. Because of insurance issues, I haven't been able to get one the past 2 and a half months, and I also had to switch doctors because my old doctor stopped taking my insurance. Upon visiting this new doctor, he tells me that he will prescribe me 1 Remicade, however, he will not write anymore unless I get a colonoscopy immediately. And if I don't let him do a colonoscopy after I get my Remicade, to "find a different doctor".



If I feel fine, I don't feel sick, and I just want my usual medication, is it normal for doctors to demand these colonoscopies be done? I understand the need for checking up on things down there, but if I don't want one done, and I feel fine, why must I be coerced into getting one done? I feel as if this is extortion on the doctors part. If I do not let him do his colonoscopy (his primary way to make money), then he will not prescribe me the medicine that keeps me alive.
The doctor has to do his own diagnoses of you to write prescriptions for you. It's the right thing to do and also it has to be done for his business insurance. What if the first Dr misdiagnosed you?

I am an electrician and I get a call to replace a receptacle that is bad according to a previous electrician. If I take the previous guys opinion and change the receptacle without looking at anything else and the house burns down because it was a breaker bad and not the receptacle I would be in big trouble.

Everyone has to cover their butts these days.
Why not let him look and see what's going on maybe he will help you more than the other guy?

01-19-2019, 11:15 AM   #7
Bufford
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Yes. I understand it is good to see what is on the inside. But you think it is okay for a doctor to deny you the medication you've been on your entire life if you don't want to get one done? Are you okay with that?

I would welcome a colonoscopy from a new doctor for it will give him/her a better understanding of my condition. The more information a doctor has, the better understanding the doctor has of my health issues.



I am scoped frequently about every 2nd year, its a maintenance precaution to catch cancer early and to find any other changes going on inside. Getting a scope give me more confidence as a patient; knowing what is going on and being in good hands of a professional.
01-20-2019, 10:19 PM   #8
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Does the new doctor have copies of all your records? If not, make sure you have them transferred from your previous doctor. If so, either have the colonoscopy done or try to get more information on why they want to do it before giving you medication.


I have to say, I don't care for the "find a different doctor" comment. If they don't want to treat you, find someone who does.
01-29-2019, 07:06 PM   #9
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My doctor wants to scope me every year. I have been in remission for the past 12 months. I am actually going next month for my yearly scope.

I would welcome the doctor doing another scope. All doctors want to do their own diagnostic for their own benefit.
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02-01-2019, 11:10 AM   #10
Trysha
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Annual upper endoscopy and colonoscopy due to disease both ends.
I certainly donít look forward to it but it is necessary to monitor for any changes.
Sometimes the drugs used in crohnís may cause internal changes....whilst not frequent
it does necessitate check ups with scopes.
It was insensitive and unhelpful of the doc to make the statement of find another doctor if you donít have the scope.
It is my opinion that he should have carefully explained the need to monitor.
03-01-2019, 01:50 AM   #11
tots
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Most Drs would stop refills if you are not being seen and monitored regularly. Even if you feel well, you may still be having issues. I ended up having my CD spread from mu small intestine to my large intestine. had not idea until I started bleeding. A few yrs later, had a GI bleed in the new area and ended up with a blood transfusion this past summer.


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