Hey Pam, I must tell you after being a Case Manager in Nursing it is the insurance companies that insist on this prolonged way of bringing about a diagnosis. The doctors are basically dictated to by insurance companies. They don’t care if the poor woman is 93 years old. If you don’t get a biopsy after you had a sonogram and a pet scan and a CT, no way are you having surgery!
There is a huge thick binder with criteria that must be met before an insurance company will pay. It is called Interqual. I had a multitude of denials for payment with my patients that didn’t have the right blood test or the right x-ray before they did blah blah blah blah blah. Medical insurance companies run the show.