Found a lump - PPO - who to schedule appointment with?

HMB44

Hey all! I have had a small spot on my breast for a while. I totally thought it was a clogged pore or a pimple of some sort. It is getting a bit bigger and now tingles a little so I am going to get it checked out. My question is... I have a PPO insurance plan so I don't have to go to a primary care doctor for a referral. This is great because money is tight right now BUT I'm wondering who I would go to first. If I go get scans done, who would I meet with to read the scans? I hope this isn't a silly question but before I was on the PPO plan, I had medicaid so I haven't had to navigate these insurance scenarios before. I realize that going to see a primary doctor might be a good start and they could send me in the right direction, but then I imagine that scans and biopsies might be needed, then a visit to read the scans, and I am bit nervous about how much this is all going to cost.

Thank you for your thoughts!

Heather

mle42

Hi Heather,

When I found my lump I called up my gynecologist (who has been my primary dr) and she ordered the ultrasound and mammogram. At the appointment where those scans were done, the radiologist told me right then that they wanted me to come back for a biopsy. In your case, since it sounds like something may be going on with your skin, it might be a good idea to start with your primary care doctor, because maybe you need a mammogram, maybe you need a dermatologist, maybe it’s something that doctor can take care of themselves. Primary care doctor will be able to give you a better idea of what is needed, and IF scans are needed they would be able to get those ordered. Even with a PPO you typically wouldn’t be able to make an appointment for any scans without a doctor’s order. If scans are done and the radiologist doesn’t give you the results directly (either at that same appointment or sending the report online),they will send the report to your primary doctor who should just call you with the results (vs. requiring an in person appointment), and would refer you to another doctor if based on the results you need a specialist.

Good luck, and I hope it turns out to be something totally benign!

Emily

HMB44

Emily! Thank you so very much for your detailed and thoughtful reply. I really appreciate it. I thought it would be recommended to go the route of starting with a primary care doc, and to be honest, it has been a while and probably not a bad idea. Thanks again!

Sunshine99

Heather, I went to my PCP (both times) and they each ordered an ultrasound. I agree that your PCP is good place to start.

All the best,

Carol

MinusTwo

Heather. I went to my OB/Gyn doc and she ordered the testing. A doctor who deals with breasts regularly would likely know more than a family doctor.