Doctor overdose?

This is an 'overshare' post, but deals with something I have become increasingly frustrated and confused by: the line between medical care as a need and medical care as a business. I'd love if anyone with a similar experience or knowledge of sifting through the health care system could provide their advice!

While I was around 28 weeks pregnant, my OB recommended I see a geneticist. I was a bit confused about why – DORV is not linked to any genetic cause, 28 weeks is too late for an abortion if I wanted one, and the test they can run for informational purposes, an amniocentesis, carries the small but still possible risk of harming or killing the fetus. Nonetheless, even after making it clear I was not interested in the amniocentesis, my doc insisted it would be a good idea, and I naively believed that doctors know best. Instead, I showed up to the geneticist office and wasted my morning and my copay on a doctor who knew zilch about DORV and had nothing to recommend beyond the one test she had known in advance I refused. I was thoroughly annoyed and said so to my OB, who then admitted the referral is a standard practice to cover their backs, so I can’t later claim I didn’t get the option. In other words, this is the business end of medicine: “selling” services and tests. My next, high-risk, OB added to the cycle by redoing the same blood work the first OB had done, insisting she wanted her own office to check, and hitting me with a $300 bill for tests that weren’t medically necessary.

Now, I’m wondering if I’m being squeezed again. James sees 2 doctors regularly every few weeks, his cardiologist and his pediatrician. At his last appointments, we were encouraged to set up visits with a Nutritionist as well. Well, I called today to set that up and was told I must see a gastrointestinal doctor in the same department before the Nutritionist. That's 2 visits, 2 specialist copays, and... for what?

James isn't gaining much weight, and the NICU did assign him a feeding specialist during his initial hospital stay when he was born. However, his pediatrician has him on a special high-calorie diet already - as juiced up as she thinks he can handle - and his weight gain issues aren't critical. She tells me she's already spoken to the nutritionist, and the nutritionist agrees that his diet is pretty much at the max. So, 2 new consultations only serve to cover the bases, as no one expects that a change will be in order.

I feel like this is deja-vu; I sense my geneticist-induced rage appearing all over again. Do I feel guilted into consulting new doctors because “what if” they come up with a new idea; I should try anything for my kid’s health? Or do I assume this is ‘covering their bases’ too, and I refrain from jumping through hoops until/unless there is reason to think there is a problem they can fix?

Ughhhhh. We have had top-o’-the-line care, and we appreciate our proximity to such a reputable hospital and medical team. However, I am sick of our health care system as it is organized. You can only see whomever your insurance likes, even if it’s not the closest or best for you; you must pay up front copays for consultations even when the doctor has nothing to offer you; medical care is sold as a commodity with better care going to those with deeper pockets.

It’s a dysfunctional “store”: higher costs for quality care suggest you get what you pay for, yet up-front costs for doctors who then provide no service says you’re gonna pay anyways. You're charged just to walk through the door.