One way is to tell them that’s what you want by phone, if no biopsy, no appointment.. this is easier in areas with a larger number of doctors.

Thanks for adding me. Will read. Going to ask doc for the biopsy. Not sure he will give me. Let’s see

Hi P2,
Welcome. I’ve added you to my team. A biopsy is a great first move, as many people go for years without having anything but an IMO diagnosis.
https://www.mypsoriasisteam.com/resources/is-a-...

I invite you to read my profile where I share what Ive learned while looking for answers doctors couldn’t provide me.