I’ve been taking HRT for several years. I originally went to a boutique hormone clinic but it was expensive. It cost more monthly than a three month supply of hormones. For a while I switched to a functional medicine nurse practitioner who I was seeing through telemedicine for my thyroid, but she couldn’t prescribe testosterone because she was in another state.
I started seeing a local gynecologist. She would recommend mammograms but I wouldn’t get them. She encouraged me to get thermography if I didn’t feel comfortable having a mammogram. The thing about me is that I don’t like going to doctors. I don’t like having tests. I like as little medical intervention as possible. I’d have none if I could but it isn’t feasible to live with miserable menopause symptoms. So everything was going fine with the Doctor suggesting breast cancer screening and me not getting it and her prescribing hormones anyway. Until she retired and a nurse practitioner replaced her. When I went to refill my estradiol cream and I was out of refills, things started going in a different direction. The nurse practitioner informed me, rather snappishly, that she DOES NOT prescribe HRT without a mammogram AND it MUST be a mammogram, it CANNOT be thermography. This was in a voicemail. She went on to say that she would be willing to do a short term (3 month) refill so I could take some time to think about what I wanted to do. I called the office and left a voicemail saying yes, please give me a short term refill, thank you. A different nurse called back demanding to know if I was getting a mammogram. I relayed the Nurse Practitioner’s message that the short term refill was so that I could take some time to think about what I want to do. The exact wording of the voicemail. She aggressively insisted that NO, Allison needs to know NOW if I’m getting a mammogram so she can know for how long to refill the prescription.
Here’s my question. Is this crazy or what? For one thing it has always been my understanding that a medical provider can suggest testing and provide the patient with all info including pros and cons of the test and possible negative consequences of not having the test, but they can’t demand, insist, or try to coerce the patient under threat of retaliation in the form of suddenly refusing to refill a prescription the patient has been taking long term. This situation seems outlandish to me. Unethical even. Whether or not to have testing is up to the patient and a matter of autonomy over one’s body and health.
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