Which specialist?

[abcde78212]

I am a 34-year-old black female. I have had three blood tests between June 2012 and November 2012 and all three tests indicate that I have iron deficiency anemia. My hemoglobin is normal, but my iron level is low. The last test showed a level of 43. My primary care doctor sent me a letter yesterday advising me to consult with a gastroenterologist to rule out any internal GI bleeding and with a gynecologist to rule out uterine fibroids. When I informed my doctor that I would consult my gynecologist first to rule out any gyno issues before I consulted with a gastroenterologist, he seemed unhappy with that decision. Although I have not reported any GI symptoms to him, he seemed to push the need for an endoscopy and colonoscopy. I had a colonoscopy in 2006, which was completely normal. In his letter, he twice told me to call his office to set up consultations with HIS gastroenterologist and gynecologist, even though I have my own. He also wants me to see him in six weeks even though he's recommending i go to specialists. I do not see the point. My question is whether it is ok for me to see the gyno first. I've already made the appointment and have no intention of ignoring the doctor's advice, but I just prefer to see the gyno first.

[abcde78212]

Thank you for your comment. You've been very helpful!

[Elaine Brown, MD]

Hi!
If you were my patient, I would advise you to come to see me first (the gynecologist) since menstruating women are far more likely to have anemia as a consequence of heavy periods than of occult(not noticeable) GI bleeding.
I would also advise you to consider seriously whether you want to continue to see this GP. I'm not sure (and suspect that you're not either) that his recommendations are solely based on medical and not financial considerations.
The doctor you should see is the one with whom you feel most comfortable and with whom you feel you can communicate best.  Enough said!
Good luck!
Dr B