vent about doctors (mostly JAWM and/or be gentle)

[umsami]

:grouphug:

 

Second the NP recommendation... wholeheartedly.   I've also found (in general) family practice or internist DOs can be more holistic in approach and better listeners than MDs.  A lot depends on the practice, though. 

 

Remember, that in a lot of cases, doctors are just employees....and they have very little say in their schedule, number of patients they see, etc.  There can be enormous pressure to see 40-60 patients/day, etc.  (Most people don't realize that....and I never really understood the pressure until watching DH.)) 

[creekland]

Can you call the doctor? Sometimes a oh-so-sweet but carefully worded, concerned conversation can move mountains. Include some red-flag vocabulary--when the tone is sweet but the content is such as to hint at malpractice and death, doors may open. 

 

I don't understand why she cannot see a cardiologist if she has had a stent. Isn't follow-up care with the doctor who did the procedure normal? (Not disbelieving you, just unfamiliar.)

 

I'm not understanding it all either.  I just talked with her about two hours ago and learned of this latest "stuff."  It occurred last Friday.  She's waiting until tomorrow to call again and this time plans to have the person doing her cardiac rehab also call.  He supposedly tried calling Friday but had to leave a message and never heard back.

 

I've been less than impressed with the doctor she sees, but she's far more rural than we are (lives 8 1/2 hours away) and has very limited options.

 

She's supposed to update me tomorrow with what she finds out.  

 

I'll admit to wondering what's going on...

[Bluegoat]

I agree with you completely and it's why I've opted to ditch doctors entirely rather than "keep plugging."  (Ditch doctors completely for the main part of whatever is wrong with me now.  If I were to break a bone, of course I'd head to one rather than dragging along a body part for the rest of my life.   :lol: )

 

Doctors - even if you see them regularly (what is that, once per year?) do not know a person.  They can't ask others about a person (Hippa and all).  They have to make their best guesses based upon their experience (education or practice).  Most issues will be basic.  I think the vast majority of doctors will do just fine with those (that broken bone bit, but there are other issues similar too).  

 

But once one has exhausted that which doctors (and google) deem normal, then one has to look outside of that box to see what is causing things. (When the voodoo doll theory seems to fit the best...)  This is where I've hit stone walls (twice).  The last one told me "I'm sorry modern medicine has let you down."  My reply?  "It's not modern medicine that has let me down (yet).  (paraphrasing this rest to leave out details)  It's the fact that folks are unwilling to delve deeper into the problem to continue checking it out even when there are others who have had issues that are similar."

 

I've no real reason to think any particular third doctor would be different.  They would have to (ought to) start with the basics (again) and when those are eliminated (again), then hopefully be willing to delve deeper (this is what I doubt would happen).  Due to the time Sparkly mentions for appts, etc, the last one took me a year and health share is paying out a few thousand dollars for nothing different than what I got the first time (tests or answers) - even with progression on symptoms.

 

I think either doctor (GP) I saw would be perfectly fine for all that is common.  I don't think other doctors have the time or past experience to be willing to look for more obscure things either.  It's easier to assume I'm a hypochondriac because what I'm getting "doesn't happen."  And it's easier to prescribe meds to treat symptoms than to look for a cause.  Then there's probably that power struggle part about "whatever you see on google is bunk" - even if it comes from credible medical sources.

 

I refuse the meds due to the potential side effects - causing problems I don't yet have or want.

 

I feel I'm pretty darn healthy except for what is wrong.

 

What is wrong doesn't actually stop me from doing anything - aside from maybe scuba diving (haven't tried that one yet, but sooner or later I will).  I'm not changing my life. (Nerves give pain, but so far haven't affected actual muscle use.)

 

If I'm correct with my guess that the cause is vascular (and yes, that's an "if" without tests), then credible sites tell me there's roughly a 10% annual chance my body will fix itself (from one of the main potential causes).  I'm hoping that one works out. Definite win-win. If not, there's also a 10% annual chance it will knock me out (being blood vessels and all - esp in the head).  I'm ok with that one too - and my family is aware of that possibility IF this is it.

 

If neither of those happen (80% chance annually), then it will all boil down to how much anything progresses and how much I can live with.  That's still a game in progress, so no answers, but my family knows that if better days quit happening... such is life.  They understand.  For now I get through bad ones knowing they are temporary.  I might actually be getting more used to them too.  That would be helpful.

 

When/if middle son gets contacts that can skip over the "unbelievable" aspect of all of it, then there might be hope for that being a solution.  That is the only medical string I'm potentially hoping for at this point.  The rest I've worked through (mentally) and am set with.

 

I don't really think I'm alone in my thought process among those who get to draw the "lucky"  :cursing: straws for the unusual things.  From what I've read online, many go through a lot of  :banghead:  and questioning their own sanity.  Some are (obviously) more persistent than I am and will try doctor after doctor after doctor.  That's where I (and probably others) differ.  I have no desire to do that.  Que sera, sera is more appealing now that I've hit that wall and reason out the alternatives with the system we live under.

 

Sparkly should keep trying (for now) IMO.  I didn't quit early.  I just caution folks against expecting TV style "all answers are out there and will be found due to a dedicated dr" thinking because the absolute worst time (mentally) I've dealt with is when I had to come to the realization that our Ideal World and Real World differ tremendously with that once one gets outside the norm box - even with the desire to keep checking out credible options - even when $$ is not a factor.  I quite honestly almost didn't survive that moment in time.  I think it's better if folks are prepared that this might be the case and are thankful if it's not rather than being blindsided by the WTH? moments that can toss someone into depression when thinking rationally isn't quite there.

 

 

 

 

https://cspinet.org/nutrition-action-healthletter

 

The trouble with this approach I think is that eventually, you may just need a doctor, and at that point it will be too late to begin to build a relationship with one.

 

I do think there is a way to overcome the problem of the doctor not knowing you, which is to spend time getting to know your doctor.  When I was about 20, I went to see my doctor about depression.  I was lucky - he was able to have a good sense of me.  He'd delivered me and taken care of me all my life, he also saw my mom, and three of my grandparents.  He was able to ask if I minded if he talked to my mum about me.

 

I think that is the beauty of the family medicine model.  It doesn't mean you will always agree or get a perfect doctor, but you will have someone who has a sense of who you are.

[creekland]

The trouble with this approach I think is that eventually, you may just need a doctor, and at that point it will be too late to begin to build a relationship with one.

 

I do think there is a way to overcome the problem of the doctor not knowing you, which is to spend time getting to know your doctor.  When I was about 20, I went to see my doctor about depression.  I was lucky - he was able to have a good sense of me.  He'd delivered me and taken care of me all my life, he also saw my mom, and three of my grandparents.  He was able to ask if I minded if he talked to my mum about me.

 

I think that is the beauty of the family medicine model.  It doesn't mean you will always agree or get a perfect doctor, but you will have someone who has a sense of who you are.

 

Or I see if I'm still around when middle son finishes med school (or gets far enough in to give me decent contacts) and network through him if I want to at that time.  ;)

 

For pretty much anything I'd actually head to the doctor for at this point, it'll be obvious enough that almost anyone ought to be able to handle it (like that broken bone I mentioned).  

 

I liken the situation to Algebra teachers.  Most can help (correctly) with basic problems.  If you get out of their expertise, most problems can still be handled by someone they send you to see (a Calc teacher or similar).  But sometimes there really are tough problems that most can't answer.  The common advice at that time is to "skip it, it's really not needed" (or take meds suppressing symptoms and don't worry about it).  I don't want to skip it.  I want answers, esp since there is a major "area" not yet checked out that google tells me is a top cause of what I'm getting if a couple of other things are ruled out (as they are). 

 

I just don't have the patience or desire to plug through doctor after doctor until I get one who is willing to listen and think outside the box of what they've seen (via google or otherwise).  I've been spoiled in my life.  I'm not used to having to "bow down" or "bring hubby along" or having anyone question what I'm saying openly telling me I can't be experiencing things like that.  I'd rather take my dolls and go home than play in that situation, and I'm not so "in love" with life itself to balance the scale the other way.  Life (to me) has a major "quality of life" component to it.  Both physical and mental (demeaning) factors come into play.

 

Now in my mom's situation... she might be seeing an Alg teacher who doesn't belong teaching.  They're out there.  I like to think they're uncommon, but honestly?  I don't know.

 

I've been thinking about her situation overnight and I think Harriet Vane is correct.  I don't think she needs another referral even if she thinks she does.  It's the same "incident."  I plan to call her later today to discuss it further (but I'm also hoping the person handling her cardiac rehab can get her on the right track for another appt soon).

[SparklyUnicorn]

Vent away.  I've been dealing with this lately, too.

 

 

 

I have a rectocele that impedes bowel movements.  My gyno's advice was to take a ton of laxatives so I could have a bowel movement.  I told him they make me very sick and I'm in the bathroom all day, for days on end when I take them. 

 

His remark?

 

"Well, you just stay home, right?"

 

what an a-hole

 

 

[SparklyUnicorn]

Having just talked with my mom again tonight (chest pains --> "muscle" --> failed stress test --> 99% blocked artery --> stent), she's still having chest pain, her doctor is still saying it's a pulled muscle, she's lightheaded (possibly from the meds) and she gets out of breath walking from her living room down a small hall to her kitchen.  She wants a revisit to the cardiologist to double check that all is well with the stent, but her GP doctor won't approve it.  Without it being approved, she can't go.  She's even wary of the ER because (she told me) if she goes and they don't admit her, she has to pay a bit toward the cost.

 

I don't get the "pros" of our system in this country at all.

 

I don't either.  It's overpriced and not very good.  You have to jump up and down and be a PITA to get attention (I've seen this first hand working in a nursing home).

 

What gets me is the talk about screenings.  There are even organizations that will pay for certain screenings if one is too poor to afford them.  As if screenings are a treatment of some sort.  So if they discover you have cancer, and you are too poor to afford the screening, then what?  What are you supposed to do?  Is it beneficial that you know what's going to kill you ahead of time? 

 

And some of the examples here show that they do the screenings, but ignore the information gathered from them.  Elevated levels?  Ignore until it's severely out of whack.  What's the point of doing the screenings then? 

[SparklyUnicorn]

Or I see if I'm still around when middle son finishes med school (or gets far enough in to give me decent contacts) and network through him if I want to at that time.   ;)

 

For pretty much anything I'd actually head to the doctor for at this point, it'll be obvious enough that almost anyone ought to be able to handle it (like that broken bone I mentioned).  

 

I liken the situation to Algebra teachers.  Most can help (correctly) with basic problems.  If you get out of their expertise, most problems can still be handled by someone they send you to see (a Calc teacher or similar).  But sometimes there really are tough problems that most can't answer.  The common advice at that time is to "skip it, it's really not needed" (or take meds suppressing symptoms and don't worry about it).  I don't want to skip it.  I want answers, esp since there is a major "area" not yet checked out that google tells me is a top cause of what I'm getting if a couple of other things are ruled out (as they are). 

 

I just don't have the patience or desire to plug through doctor after doctor until I get one who is willing to listen and think outside the box of what they've seen (via google or otherwise).  I've been spoiled in my life.  I'm not used to having to "bow down" or "bring hubby along" or having anyone question what I'm saying openly telling me I can't be experiencing things like that.  I'd rather take my dolls and go home than play in that situation, and I'm not so "in love" with life itself to balance the scale the other way.  Life (to me) has a major "quality of life" component to it.  Both physical and mental (demeaning) factors come into play.

 

Now in my mom's situation... she might be seeing an Alg teacher who doesn't belong teaching.  They're out there.  I like to think they're uncommon, but honestly?  I don't know.

 

I've been thinking about her situation overnight and I think Harriet Vane is correct.  I don't think she needs another referral even if she thinks she does.  It's the same "incident."  I plan to call her later today to discuss it further (but I'm also hoping the person handling her cardiac rehab can get her on the right track for another appt soon).

 

Yes, it is a lot like that.  GPs mostly handle the very basic stuff which in many cases doesn't warrant a visit at all.  If you have something more serious you need a specialist.  And they are a hit or miss as well (not to mention it takes 100,000 years to get an appointment with one).

 

The kids' ped says every year after the physical we hardly go there.  Well yes because besides occasional colds they aren't sick.  Should I rush them in for colds?  Or make stuff up?  It's bad enough the physicals are a total rip off.  Except for the vaccines they don't really do much else.  They don't do blood work of any kind. They have never done a urinalysis on either of mine.  They tap on their knee, have them read an eye chart in a dimly lit hallway, and lecture me about how they should wear helmets and seat belts.  All to the tune of $800.  I would just die if I had to actually pay that amount, but I do not know where they get off charging that. 

 

 

[creekland]

What's the point of doing the screenings then? 

 

I agree with you about free screenings for those who can't afford them.  They're pointless unless there are also programs to assist with treatment if needed.

 

But screenings in general?  We live in an area with "open to the public" screenings for 30+ typical blood tests.  Hubby and I do them 2-3 times per year as they only cost $35 for that basic run and an additional $12 and/or $15 for thyroid and Ha1C, both of which I add due to my history.

 

I get the results.  I can adjust anything (diet, supplements, etc) as needed.  There are usually a few things that are slightly outside of normal (Na tends borderline low, bilirubin tends a little bit high, etc).  Those have stayed pretty consistent (we keep spreadsheets showing trends), so we're not super worried about "close, but not perfect."  If things were to stray from our normal, then we'd see what we wanted to do.

 

With the screenings in general, they send results to your GP if you have one (in their network) and say that they will have one contact you IF anything major shows up and you don't have one.  I still don't know how one would pay for it, but I think the knowledge in general (of the results) gives one options - even for self care (to the extent that can be done).

 

The price sure beats what I paid when I had to get thyroid testing done separately.  I get the whole panel for less than that one test.

[creekland]

It's bad enough the physicals are a total rip off.  Except for the vaccines they don't really do much else.  They don't do blood work of any kind. They have never done a urinalysis on either of mine.  They tap on their knee, have them read an eye chart in a dimly lit hallway, and lecture me about how they should wear helmets and seat belts.  All to the tune of $800.  I would just die if I had to actually pay that amount, but I do not know where they get off charging that. 

 

:svengo: We don't pay anywhere near that.  A regular appt costs us in the $80 - $120 range locally (up to $256 elsewhere).  Is it the vaccines adding up to so much where you are?

[SparklyUnicorn]

I agree with you about free screenings for those who can't afford them.  They're pointless unless there are also programs to assist with treatment if needed.

 

But screenings in general?  We live in an area with "open to the public" screenings for 30+ typical blood tests.  Hubby and I do them 2-3 times per year as they only cost $35 for that basic run and an additional $12 and/or $15 for thyroid and Ha1C, both of which I add due to my history.

 

I get the results.  I can adjust anything (diet, supplements, etc) as needed.  There are usually a few things that are slightly outside of normal (Na tends borderline low, bilirubin tends a little bit high, etc).  Those have stayed pretty consistent (we keep spreadsheets showing trends), so we're not super worried about "close, but not perfect."  If things were to stray from our normal, then we'd see what we wanted to do.

 

With the screenings in general, they send results to your GP if you have one (in their network) and say that they will have one contact you IF anything major shows up and you don't have one.  I still don't know how one would pay for it, but I think the knowledge in general (of the results) gives one options - even for self care (to the extent that can be done).

 

The price sure beats what I paid when I had to get thyroid testing done separately.  I get the whole panel for less than that one test.

 

See that is fine with me, but you know what a lot of doctors do.  They have you make an appointment for routine.  You go there and do nearly nothing and then you are sent to a lab.  So you go do the lab stuff.  Then you have to make another appointment to go over results.  So we are talking $60 in copays.  I know, it's only $60, but this could be reduced to $40 if done in one visit rather than this 2 visit nonsense.  To me it's a money grab on their part.  My husband encountered something one step worse.  At the follow up visit he was told his blood work was normal/perfectly fine.  Which, what is there to go over in the first place?  But whatever.  So then they told him to schedule another appointment.  For what?  Oh to just, you know, follow up.  So....one needs a follow up after a perfectly normal/fine follow up?  He got a new doctor.  The new doctor does not do that.  But what is up with that bull?!

[SparklyUnicorn]

:svengo: We don't pay anywhere near that.  A regular appt costs us in the $80 - $120 range locally (up to $256 elsewhere).  Is it the vaccines adding up to so much where you are?

 

Some vaccines are notoriously expensive.  The HPV one is very very expensive.  That was costs me $60 in copays because of the three visits.  Sure beats having to pay full price, but yeah.

I still think that price is a complete rip off.  And interestingly the insurance does pay close to that amount per the contract.  So the doctor isn't even really excessively billing.  I just don't know what is costing so much. 

[Bluegoat]

Or I see if I'm still around when middle son finishes med school (or gets far enough in to give me decent contacts) and network through him if I want to at that time.   ;)

 

For pretty much anything I'd actually head to the doctor for at this point, it'll be obvious enough that almost anyone ought to be able to handle it (like that broken bone I mentioned).  

 

I liken the situation to Algebra teachers.  Most can help (correctly) with basic problems.  If you get out of their expertise, most problems can still be handled by someone they send you to see (a Calc teacher or similar).  But sometimes there really are tough problems that most can't answer.  The common advice at that time is to "skip it, it's really not needed" (or take meds suppressing symptoms and don't worry about it).  I don't want to skip it.  I want answers, esp since there is a major "area" not yet checked out that google tells me is a top cause of what I'm getting if a couple of other things are ruled out (as they are). 

 

I just don't have the patience or desire to plug through doctor after doctor until I get one who is willing to listen and think outside the box of what they've seen (via google or otherwise).  I've been spoiled in my life.  I'm not used to having to "bow down" or "bring hubby along" or having anyone question what I'm saying openly telling me I can't be experiencing things like that.  I'd rather take my dolls and go home than play in that situation, and I'm not so "in love" with life itself to balance the scale the other way.  Life (to me) has a major "quality of life" component to it.  Both physical and mental (demeaning) factors come into play.

 

Now in my mom's situation... she might be seeing an Alg teacher who doesn't belong teaching.  They're out there.  I like to think they're uncommon, but honestly?  I don't know.

 

I've been thinking about her situation overnight and I think Harriet Vane is correct.  I don't think she needs another referral even if she thinks she does.  It's the same "incident."  I plan to call her later today to discuss it further (but I'm also hoping the person handling her cardiac rehab can get her on the right track for another appt soon).

 

I don't know - it can take years to develop a good relationship with your doctor, so I don't see that it makes sense to put it off.  In five years when you find something has gone wrong, like cancer, it's too late.

 

A GP, in a proper GP/family medicine model, continue to follow you in a situation like that, even when you are under the care of specialists.  The GP is the person who can help when the specialist is a jerk, or can't explain things well, or who can help you deal with making care choices where you need to define your health goals against a system that is trying to push you in a different direction.  The GP is the person who should be able to see how the care of all of your specialists fits together and helps you when they don'.t

 

GPs can do a lot more than many people think, in many cases. Sometimes people just assume they can't, or they assume people don't want that.

[creekland]

I don't know - it can take years to develop a good relationship with your doctor, so I don't see that it makes sense to put it off.  In five years when you find something has gone wrong, like cancer, it's too late.

 

A GP, in a proper GP/family medicine model, continue to follow you in a situation like that, even when you are under the care of specialists.  The GP is the person who can help when the specialist is a jerk, or can't explain things well, or who can help you deal with making care choices where you need to define your health goals against a system that is trying to push you in a different direction.  The GP is the person who should be able to see how the care of all of your specialists fits together and helps you when they don'.t

 

GPs can do a lot more than many people think, in many cases. Sometimes people just assume they can't, or they assume people don't want that.

 

That is the way the ideal world is supposed to work, I think.  The real world doesn't always work that way though - esp when one gets into the really weird things.  That's been my point.

 

And considering I spent a bit of the morning convincing myself that life is still worth living after being rather strongly reminded of some things I can no longer do while dealing with a not-so-great day to start with (that quality vs quantity of life thing again), I have to say, getting cancer doesn't worry me a bit.  I'd be fine with it coming and doing its thing.  I'd see no need to head to a doctor about that.  

 

This is for me, personally, of course.  I'll support anyone else with their decisions for themselves too.  I've gone back to work to help out a co-worker who is going through chemo - today (and for many months).

 

But to sum it up, the real world can differ considerably from the ideal world.  If one expects the ideal world to happen and it doesn't, that's a big mental challenge.  One quote in my sig deals with that.  'Tis best to realize life can differ and be open to Plan Bs when needed.

[OnMyOwn]

The trouble with this approach I think is that eventually, you may just need a doctor, and at that point it will be too late to begin to build a relationship with one.

 

I do think there is a way to overcome the problem of the doctor not knowing you, which is to spend time getting to know your doctor. When I was about 20, I went to see my doctor about depression. I was lucky - he was able to have a good sense of me. He'd delivered me and taken care of me all my life, he also saw my mom, and three of my grandparents. He was able to ask if I minded if he talked to my mum about me.

 

I think that is the beauty of the family medicine model. It doesn't mean you will always agree or get a perfect doctor, but you will have someone who has a sense of who you are.

Yes, but it seems that if you really need one, you'll likely end up with a specialist you've never met before. The whole medical field is being broken down into smaller and smaller pieces, almost like what happened in the manufacturing industry. My mom had to go to get a port placed for her chemo a few months ago and saw no less than 8 medical people within a 5 hour time period because they all had one little task to do. Now that she's really sick, her regular gp really has very little, if anything, to do with her treatment. Edited November 7, 2016 by OnMyOwn

[SparklyUnicorn]

I don't know - it can take years to develop a good relationship with your doctor, so I don't see that it makes sense to put it off.  In five years when you find something has gone wrong, like cancer, it's too late.

 

A GP, in a proper GP/family medicine model, continue to follow you in a situation like that, even when you are under the care of specialists.  The GP is the person who can help when the specialist is a jerk, or can't explain things well, or who can help you deal with making care choices where you need to define your health goals against a system that is trying to push you in a different direction.  The GP is the person who should be able to see how the care of all of your specialists fits together and helps you when they don'.t

 

GPs can do a lot more than many people think, in many cases. Sometimes people just assume they can't, or they assume people don't want that.

 

If you manage to find a decent GP. 

[SparklyUnicorn]

Yes, but it seems that if you really need one, you'll likely end up with a specialist you've never met before. The whole medical field is being broken down into smaller and smaller pieces, almost like what happened in the manufacturing industry. My mom had to go to get a port placed for her chemo a few months ago and saw no less than 8 medical people within a 5 hour time period because they all had one little task to do. Now that she's really sick, her regular gp really has very little, if anything, to do with her treatment.

 

Yeah they feel like the clearinghouse for medical care. You go there so they can tell you which specialist to see (if you don't know which one).  What stuff do they treat themselves?  Other than routine stuff, what do they do?  I don't go to the doctor's office for colds or UTIs or anything like that.  If I really need something for a UTI, I often go to a walk in clinic because I don't want to wait for an appointment (and my copay is the same either way). 

 

I'm technically being forced to go for routine at the moment, but otherwise I wouldn't even go there because I don't understand the point.  As it is, I did go there for a problem and was essentially ignored.  Which is what my entire complaint is about.  I'm doing what people are telling me is SO DIRE that I do, but it only reinforces my reasoning for not bothering.

[SparklyUnicorn]

To add in terms of the doctor following a person and being the overseer...um well no.  My dad has some complicated medical problems.  Due to taking lithium for years his kidneys are failing.  So he goes to a specialist for that.  Long and complicated story later...his regular GP and the specialist prescribed drugs that essentially work against each other.  My dad is fairly on top of things so he was able to say..whoa wait a minute before taking these things for too long.  The specialist should be the one prescribing the stuff for that problem IMO because he knows the most about it . I don't know what the GP was thinking.  That's been sorted out, but only because my dad said whoa wait a minute here.  So much for coordinating.  If my dad weren't so on top of it, who knows where we would be.  He is on the verge of needing dialysis and it is the drug that is keeping him from having to do that. The drug given was negating the effects of that drug.  And my dad has been going to both these doctors for years and years.  So there is no excuse that he is new, or they don't know his case.  They know.

 

 

 

 

[Lawana]

To add in terms of the doctor following a person and being the overseer...um well no. My dad has some complicated medical problems. Due to taking lithium for years his kidneys are failing. So he goes to a specialist for that. Long and complicated story later...his regular GP and the specialist prescribed drugs that essentially work against each other. My dad is fairly on top of things so he was able to say..whoa wait a minute before taking these things for too long. The specialist should be the one prescribing the stuff for that problem IMO because he knows the most about it . I don't know what the GP was thinking. That's been sorted out, but only because my dad said whoa wait a minute here. So much for coordinating. If my dad weren't so on top of it, who knows where we would be. He is on the verge of needing dialysis and it is the drug that is keeping him from having to do that. The drug given was negating the effects of that drug. And my dad has been going to both these doctors for years and years. So there is no excuse that he is new, or they don't know his case. They know.

I think it is becoming more and more of a problem, this lack of coordination. My mother is facing the same kind of issues with her PCP. When she moved to my town 5 years ago, we set about choosing a doc for her. It came down to 2 choices: the only MD in town who advertises a geriatric specially or a concierge practice Doctor. She went with the "geriatric" doc who rushes her through appointments, chops her up and ships her off to specialists, refuses to go over her long med list

for interactions or unneeded meds. When she was hospitalized for a serious illness, her PCP had no involvement at all, because the only medical center in town uses the hospitalist model. It is beyond frustrating and leaves her feeling unheard, and simultaneously under- and over-treated.

[SparklyUnicorn]

I think it is becoming more and more of a problem, this lack of coordination. My mother is facing the same kind of issues with her PCP. When she moved to my town 5 years ago, we set about choosing a doc for her. It came down to 2 choices: the only MD in town who advertises a geriatric specially or a concierge practice Doctor. She went with the "geriatric" doc who rushes her through appointments, chops her up and ships her off to specialists, refuses to go over her long med list

for interactions or unneeded meds. When she was hospitalized for a serious illness, her PCP had no involvement at all, because the only medical center in town uses the hospitalist model. It is beyond frustrating and leaves her feeling unheard, and simultaneously under- and over-treated.

 

Yeah they have you fill out those papers and tell them what you take, but then half the time it seems they don't bother to look at it. 

 

Why ask if you aren't going to use the information?

[Lawana]

Yeah they have you fill out those papers and tell them what you take, but then half the time it seems they don't bother to look at it.

 

Why ask if you aren't going to use the information?

And side effects. They just try to give you another Rx to "treat" the problem.

[SparklyUnicorn]

I once had a doctor flip out on me with my kid.  This was an eye doctor.  They asked me on the form if there were any eye issues to mention.  So I put down in detail that he has a dermoid on one of his eyes and I said it has been checked out several times and was deemed of no concern.  Obviously nobody looked at the forms.  He literally almost screamed at me asking if I saw this thing on his eye and OMG it could be cancer, don't I know that?  How can I not have this checked out?!  Holy crap dude.  He was born with it and yes I know all about it and yes I've had it checked out several times.  AND I WROTE THAT ON YOUR FORMS!!!!

 

I never went back there.  What an idiot.

 

 

[Lawana]

That is terrible. And another shared pet peeve lol. After carefully and thoughtfully filling out the history, no one actually reads it.

[SparklyUnicorn]

And side effects. They just try to give you another Rx to "treat" the problem.

 

Sometimes that might be the only solution, but yeah...

 

I told the doctor about the fact I have been taking Prevacid a long time.  So she lectured me that I'm not supposed to take it long term.  Yes lady, I am very well aware of that, but it works and when I've tried to go off of it that was an absolute disaster.  It was not possible.  They say not to go off of it cold turkey, but there is no reasonable way to cut down without making it a complicated project.  At least not with the OTC stuff.  BUT I said I would like to either get off of it or make sure it's not causing me issues that I could be addressing (like mineral deficiencies).  Know what she is doing about that?  Nothing.  Not a damn thing.  I went there with that problem and she did nothing and said nothing about how to deal with it.

 

I told her I have odd wacky symptoms that seem to point to a mineral deficiency.  I think she assumes I have diabetes.  That's somewhat fair because the symptoms are similar.  HOWEVER, I'm pretty damn sure that's not likely because for one thing I've been on a low carb diet for years and years.  So it does not seem likely.  But she wasn't interested in my details.  Apparently the details of my health and habits aren't related to my health. 

 

Maybe I'll need a psychotherapist after this. 

[creekland]

I told her I have odd wacky symptoms that seem to point to a mineral deficiency.  I think she assumes I have diabetes.  That's somewhat fair because the symptoms are similar.  HOWEVER, I'm pretty damn sure that's not likely because for one thing I've been on a low carb diet for years and years.  So it does not seem likely.  But she wasn't interested in my details.  Apparently the details of my health and habits aren't related to my health.  

 

It's worth testing for diabetes.  I have a friend who is as thin as a rail and eats incredibly healthy (diabetes-wise), yet she has Type II Adult Onset diabetes.  None of us can figure out how she managed to get that.  It'd be very similar to Cupid missing with an arrow.  Apparently, it doesn't only affect the stereotypical lifestyle.

 

With the known issues I've had (carpal tunnel, asthma, pregnancies, radiation, etc) I rarely get most of the "usual" symptoms.  My body likes to pick and choose its own - yet those have all happened.

 

I've become a great believer in testing over "best guesses" which is why I ended with the standoff on my worst issue.  The docs tested for the common causes (not it) and decided to use "best guess" on the next most common cause.  I'd prefer the results of the test(s) over "best guess."  It still boggles my mind that they'd rather use a best guess final answer TBH, esp since I so rarely get common symptoms.  (And that's where I suspect their "best guess" is "hypochondriac whose mind is making up problems."  This happens too, of course, but I'd rather that be the final conclusion after all medical options are eliminated via testing, not guesses.)

[SparklyUnicorn]

It's worth testing for diabetes.  I have a friend who is as thin as a rail and eats incredibly healthy (diabetes-wise), yet she has Type II Adult Onset diabetes.  None of us can figure out how she managed to get that.  It'd be very similar to Cupid missing with an arrow.  Apparently, it doesn't only affect the stereotypical lifestyle.

 

With the known issues I've had (carpal tunnel, asthma, pregnancies, radiation, etc) I rarely get most of the "usual" symptoms.  My body likes to pick and choose its own - yet those have all happened.

 

I've become a great believer in testing over "best guesses" which is why I ended with the standoff on my worst issue.  The docs tested for the common causes (not it) and decided to use "best guess" on the next most common cause.  I'd prefer the results of the test(s) over "best guess."  It still boggles my mind that they'd rather use a best guess final answer TBH, esp since I so rarely get common symptoms.  (And that's where I suspect their "best guess" is "hypochondriac whose mind is making up problems."  This happens too, of course, but I'd rather that be the final conclusion after all medical options are eliminated via testing, not guesses.)

 

Well the issues are more the vague ones.  Like muscles aches or tingling in extremities.  Not extreme thirst, using the bathroom all the time, weight loss, etc.  And I don't eat incredibly healthy in terms of what the ADA recommends.  I go much lower (carbs) than that.  I wonder if those amounts actually help anyone with diabetes.  They don't help my sister at all and they never helped my mother.  So I refuse to follow the advice. 

But sure they'll test for it.

[shawthorne44]

Hugs

 

It is easy to agree with you.   Doesn't everyone know someone whose health was permanently, severely harmed because doctor(s) didn't listen and whatever was it was went untreated for too long?   

[Bluegoat]

The tendency to move to specialists for everything is generally a bad one, IMO.  I'm glad we dont have that model where I live.  I rarely if ever see a specialist, I see my GP for pretty much anything regular, pelvic exams mainly for me, and all the kids check-ups and shots.  She followed my pregnancy though I had to also see a OB since it was a schedualed section, but she assisted during the surgery (and in fact I ended up with a different OB as the one I've met before could not be there in the end.)

 

If I need a same-day appointment, I might have to go to the duty clinic for the practice, but it will be one of the GPs from the same practice or another one they work with.

 

INterestingly, across the harbour where my mom lives, the model isn't as good, mainly because they have a university and teaching hospitals, and the GPs have tended to turn things over to the hospitals.

 

 

[SparklyUnicorn]

The tendency to move to specialists for everything is generally a bad one, IMO.  I'm glad we dont have that model where I live.  I rarely if ever see a specialist, I see my GP for pretty much anything regular, pelvic exams mainly for me, and all the kids check-ups and shots.  She followed my pregnancy though I had to also see a OB since it was a schedualed section, but she assisted during the surgery (and in fact I ended up with a different OB as the one I've met before could not be there in the end.)

 

If I need a same-day appointment, I might have to go to the duty clinic for the practice, but it will be one of the GPs from the same practice or another one they work with.

 

INterestingly, across the harbour where my mom lives, the model isn't as good, mainly because they have a university and teaching hospitals, and the GPs have tended to turn things over to the hospitals.

 

What's stupid here is the OB won't do a general physical.  They only do the pelvic exam.  I would love to just get that all done with in one shot rather than go to 2 doctors.  GPs can do the pelvic exam stuff, but they aren't generally set up for it like they are in an OB office so I would not want it done there.  That and I don't want that performed by a male doctor.  It's the one area where I am a bit strange and sexist.  Intellectually I know that, but that's my preference.  I don't necessarily want to be limited to a female GP because there aren't as many options.

[MysteryJen]

My biggest issue is that I have managed to find a family practice that I like three times, but each time an insurance change (not a job change) required me to find another doctor for all of us. Also, I have been super annoyed with arrogant cardiologists who forced me to have expensive tests, didn't tell me about results, ordered more tests and then just shrugged and said, well, borderline normal. Should be fine.  Okay...now I am out thousands and have nothing but my own experience to guide me.

 

We are with Kaiser now and I hate, hate them. It is like the Borg practicing medicine. The computer generates labs, the doctors read off the screen, and everything is squeezed into the appropriate boxes. And, yes, some screenings are free, but follow-ups certainly are not. If you ask about the cost of labs, you are plagued by robot phone calls assuring you that you can put labs on a payment plan. 

 

I know some people love Kaiser, but I think they are the worst medical care I have ever received.

[creekland]

The tendency to move to specialists for everything is generally a bad one, IMO.  I'm glad we dont have that model where I live.  I rarely if ever see a specialist.

 

I'm assuming this is because you haven't needed to see a specialist.  Our family medicine doctors all do what you said you've had too - except delivering babies.

 

But once something more specialist-worthy is needed, it's good to be able to see specialists - things like my youngest developing a less common form of epilepsy at age 16, and then having uncommon symptoms for it to where the ER doc said it "wasn't epilepsy" (and tested for illegal drugs) and our family doctor had no idea.  The specialist - using tests and checking with peer specialists - figured it out after one visit.

 

No one I knows runs to specialists for basic stuff either.  They might choose a family doctor or they might choose an urgent care place or clinic, but not a specialist.

[sunflowerlady]

Right there with you.  :glare:

 

In the last two weeks, I have spent about $500.00 on doctors and  prescriptions I am no better at all. I did see a different doctor after the first one. So, two doctors can't make me well. One prescription (a steroid) caused a mid cycle period from hell and made me even sicker. So, in addition to my original problem, I put 500.00 on my credit cards and now have my hormones all out of whack.

 

And I am sicker than ever. :cursing:

 

And they want me to come in for a follow up. More $$$$$. I could just flush the money down the toilet and get the same results. 

[Bluegoat]

I'm assuming this is because you haven't needed to see a specialist.  Our family medicine doctors all do what you said you've had too - except delivering babies.

 

But once something more specialist-worthy is needed, it's good to be able to see specialists - things like my youngest developing a less common form of epilepsy at age 16, and then having uncommon symptoms for it to where the ER doc said it "wasn't epilepsy" (and tested for illegal drugs) and our family doctor had no idea.  The specialist - using tests and checking with peer specialists - figured it out after one visit.

 

No one I knows runs to specialists for basic stuff either.  They might choose a family doctor or they might choose an urgent care place or clinic, but not a specialist.

 

If I needed to see a specialist, I could - generally I would have to be refered by my GP.  It's an important part of the model of care - if people just head off on their own, the idea of a doctor who is serving a function to coordinate care or look out for a patient he knows and so on isn't going to happen. 

 

I'm not sure why you say you would never see a GP for anything if all of the normal reasons to see one, where you are, are the same as here?  While plenty of healthy adults don't have need to go to the doctor very often if at all (especially men), there is always the possibility of needing one for something like stitching, weird rashes, wart removal, recurrent UTIs... just to name a few things that occur to me.   If these things aren't being done by specialists, and not by GPs, where would they get done?  Walk in clinics really have some pretty serious downsides for regular care.

[SparklyUnicorn]

If I needed to see a specialist, I could - generally I would have to be refered by my GP.  It's an important part of the model of care - if people just head off on their own, the idea of a doctor who is serving a function to coordinate care or look out for a patient he knows and so on isn't going to happen. 

 

I'm not sure why you say you would never see a GP for anything if all of the normal reasons to see one, where you are, are the same as here?  While plenty of healthy adults don't have need to go to the doctor very often if at all (especially men), there is always the possibility of needing one for something like stitching, weird rashes, wart removal, recurrent UTIs... just to name a few things that occur to me.   If these things aren't being done by specialists, and not by GPs, where would they get done?  Walk in clinics really have some pretty serious downsides for regular care.

 

Stiching...huh...trying to think if I'd go to a GP for that. 

 

A recurrent UTI...they'd send you to a specialist.  BTDT

 

Weird rashes...if it is super weird..again specialist (sister was just sent to a specialist for this). 

 

Warts...they sell OTC stuff for that.  It would be way cheaper.

What it comes down to for a lot of people here is they want to go directly to a specialist if they happen to know it's needed because it saves money.  I do a lot of what I do to save money.  The doctors make no effort to save me money. 

[Zinnia]

 The doctors make no effort to save me money. 

 

I have found this to be hugely true in many of the practices I've seen.  

 

I was a nurse midwife before I had kids.  Standard of care for our (largely self-pay at the time) clinic was one ultrasound.  We tried to time it after 20 weeks to see heart anatomy, but because we knew that one ultrasound was expensive enough, and our patients would have trouble paying for more than that.  We didn't do early ultrasounds for dating, trusting our exam skills, along with trusting that the patients knew their dates.  Sometimes we got it wrong, but the risk was small.

 

We didn't do estimated weight ultrasounds at the end, again trusting our exam skills, knowing that sometimes we would be off, but the risk benefit assessment, taking into account the cost, made it worthwhile.

 

In my 4th pregnancy?  I went to an OB because I knew I'd need a c-section.  He wanted to do a dating scan (declined), an anatomy scan before 20 weeks (declined to do it that early), then a size ultrasound at the end (I was having a scheduled c-section with a history of 11+ lb babies--absolutely nothing to be gained from this but curiousity; I declined).  Each time I declined, the office acted like it was such a BIG deal.  I knew my stuff, plus I'm cheap, and this was a high deductible/high out of pocket pregnancy, so each ultrasound was moneyo ut of my pocket.  I continued to decline.  They continued to act as if I was borderline neglectful.  Come on, you know?  Doctors, providers, and their office staff should be better informed of costs and what is really, really necessary and what can be skipped.  

[SparklyUnicorn]

I have found this to be hugely true in many of the practices I've seen.  

 

I was a nurse midwife before I had kids.  Standard of care for our (largely self-pay at the time) clinic was one ultrasound.  We tried to time it after 20 weeks to see heart anatomy, but because we knew that one ultrasound was expensive enough, and our patients would have trouble paying for more than that.  We didn't do early ultrasounds for dating, trusting our exam skills, along with trusting that the patients knew their dates.  Sometimes we got it wrong, but the risk was small.

 

We didn't do estimated weight ultrasounds at the end, again trusting our exam skills, knowing that sometimes we would be off, but the risk benefit assessment, taking into account the cost, made it worthwhile.

 

In my 4th pregnancy?  I went to an OB because I knew I'd need a c-section.  He wanted to do a dating scan (declined), an anatomy scan before 20 weeks (declined to do it that early), then a size ultrasound at the end (I was having a scheduled c-section with a history of 11+ lb babies--absolutely nothing to be gained from this but curiousity; I declined).  Each time I declined, the office acted like it was such a BIG deal.  I knew my stuff, plus I'm cheap, and this was a high deductible/high out of pocket pregnancy, so each ultrasound was moneyo ut of my pocket.  I continued to decline.  They continued to act as if I was borderline neglectful.  Come on, you know?  Doctors, providers, and their office staff should be better informed of costs and what is really, really necessary and what can be skipped.  

 

Oh yeah if I don't take every single piece of advice I'm borderline neglectful (at best).

[Bluegoat]

Stiching...huh...trying to think if I'd go to a GP for that. 

 

A recurrent UTI...they'd send you to a specialist.  BTDT

 

Weird rashes...if it is super weird..again specialist (sister was just sent to a specialist for this). 

 

Warts...they sell OTC stuff for that.  It would be way cheaper.

What it comes down to for a lot of people here is they want to go directly to a specialist if they happen to know it's needed because it saves money.  I do a lot of what I do to save money.  The doctors make no effort to save me money. 

 

They do straight-forward stiching here at GPs offices.  If it is something like a hand, they'll send you to the ER so a plastics guy can look at it.  UTIs - it could end up at a specialist, but a GP will usually try and figure it out with you first.  Stuff like rashes if it is a problem that can't get worked out, though most rashes just go away.  Vaccinations of course.  Wart removal is generally something done if OTC remedies don't work, or i's something in a funny spot.  IUD insertion, birt control stuff, management of any chronic but controlled things like diabetes or whatever.  Standard tests like bone scans will normally be ordered by a GP and discussed with her.

 

How the money aspect works is a big issue.  I suspect that when access to specialists is through the GP it actually saves the system money, but since in the US the payment is so weird, it comes out in a way that is probably less efficient.

[Bluegoat]

The number of tests they seem to want down there is really over the top!  We normally only have one u/s unless there is a special reason for others.  I didn't think they were even considered reliable for estimating weight.

[creekland]

If I needed to see a specialist, I could - generally I would have to be refered by my GP.  It's an important part of the model of care - if people just head off on their own, the idea of a doctor who is serving a function to coordinate care or look out for a patient he knows and so on isn't going to happen. 

 

I'm not sure why you say you would never see a GP for anything if all of the normal reasons to see one, where you are, are the same as here?  While plenty of healthy adults don't have need to go to the doctor very often if at all (especially men), there is always the possibility of needing one for something like stitching, weird rashes, wart removal, recurrent UTIs... just to name a few things that occur to me.   If these things aren't being done by specialists, and not by GPs, where would they get done?  Walk in clinics really have some pretty serious downsides for regular care.

 

Same here with needing referrals to see a specialist.  If we didn't, I'd have had the other possibility for my issues checked.  I would like to know if it is or isn't the cause and made that request/desire known.  

 

It's the GPs who have set up the roadblocks, great helpers that they are.  Their best guess (no tests) is that it isn't possible and when I forwarded a credible internet link showing it was (and often is), I was told to stay off the internet.  That, quite literally, was the straw that ended it all (for me).  The GPs final suggestion to me was to see another ENT - as if the first two somehow missed something coming to the same conclusion that there was no ENT issue.  Both Google and the Anatomy teacher at school led me to believe there was no ENT issue merely from the lack of those symptoms (before either ENT visit), but I did those due to the recommendations anyway.  I played along with their thoughts and when those came up empty I got chided for adding mine.

 

Sorry... your Ideal World with GPs in control just doesn't always work out the same in the Real World.  I'd have felt completely differently I suppose if they had been willing to let me have every possible option checked out even if we ended up with no answers, but they won't.  I despise our system giving them the final say so about such things.  It's not them enduring the issues.

 

All those other things you mentioned can be handled just fine by the Urgent Care clinics around us if needed.  We're among those who rarely need them.

 

Orthopedics, around here, also has walk in availability if one were to get a broken bone or something.  Sports folks at school know who is worthy of seeing and who isn't.

[SparklyUnicorn]

Same here with needing referrals to see a specialist.  If we didn't, I'd have had the other possibility for my issues checked.  I would like to know if it is or isn't the cause and made that request/desire known.  

 

It's the GPs who have set up the roadblocks, great helpers that they are.  Their best guess (no tests) is that it isn't possible and when I forwarded a credible internet link showing it was (and often is), I was told to stay off the internet.  That, quite literally, was the straw that ended it all (for me).  The GPs final suggestion to me was to see another ENT - as if the first two somehow missed something coming to the same conclusion that there was no ENT issue.  Both Google and the Anatomy teacher at school led me to believe there was no ENT issue merely from the lack of those symptoms (before either ENT visit), but I did those due to the recommendations anyway.  I played along with their thoughts and when those came up empty I got chided for adding mine.

 

Sorry... your Ideal World with GPs in control just doesn't always work out the same in the Real World.  I'd have felt completely differently I suppose if they had been willing to let me have every possible option checked out even if we ended up with no answers, but they won't.  I despise our system giving them the final say so about such things.  It's not them enduring the issues.

 

All those other things you mentioned can be handled just fine by the Urgent Care clinics around us if needed.  We're among those who rarely need them.

 

Orthopedics, around here, also has walk in availability if one were to get a broken bone or something.  Sports folks at school know who is worthy of seeing and who isn't.

 

I don't need a referral.  But years ago I had a plan that required it for everything.  It hindered my care.  I had severe back pain following the birth of my second kid.  I didn't even walk out of the hospital upright.  My OB wouldn't help me and my regular doc wouldn't help me.  They just kept prescribing pain pills when I'd go there visit after visit (which is stupid).  I made another appointment for one of the other doctors in the same practice (so not a specialist, but someone else I could talk to who I didn't need a referral too).  He gave me a referral to a PT place.  I was good as new in a month.  I kept complaining to my regular doctors for almost a year before getting anyone to listen to me. 

 

 

 

 

[SparklyUnicorn]

The number of tests they seem to want down there is really over the top!  We normally only have one u/s unless there is a special reason for others.  I didn't think they were even considered reliable for estimating weight.

 

Yes, this is certainly another aspect.  I am all for tests if they will be useful.  There are some tests I feel are generally useless.  An example is the stuff they do to check for reflux.  My opinion of course, but it wouldn't be easy to change my mind on that one.

[SparklyUnicorn]

I asked my husband yesterday what he thought about doctors in general.  This was via e-mail (we e-mail back and forth sometimes when he is at work and kinda chit chat).  So he wrote me a pretty detailed e-mail telling me about the experiences he has had.  I'd say about 1/2 of his experiences were ok to good and the other half between not good and downright terrible.  These were all the details of his experiences in Germany and his experiences here.  He has lived in Germany longer, but he has been here over 16 years.  So enough to have something to say.

 

So I dunno, maybe healthcare is a hit or miss most places where sometimes you find someone great and sometimes you don't.  I just feel like they see me coming and decide to be crap.  LOL  But probably not.

 

 

 

 

[Lawana]

I saw the GP model work well when I was growing up. My parents had the same family doctor for 2 decades. He knew them quite well.

 

Now, not so much. For me, I went about 20 years without a routine physical, seeing my OBGYN yearly and a handful of docs along the way for a specific issue or two. When I finally decided (in my mid 40s) to get in for a physical with the doctor that my dh was seeing, he told me to come back in 5 years for my next exam lol. Not exactly a relationship building experience.

 

I am an eminently forgettable person. Even my OB/GYN who saw me yearly for 18 years plus through 2 pregnancies and deliveries didn't ever remember me much. The patient load of doctors is staggering. When they see you for a few minutes once a year, interspersed with many hundreds of other patients, there simply is not the exposure time to develop any kind of meaningful relationship. Of course, if one is not healthy and is in much more often, that might be different. I wouldn't know.

[SparklyUnicorn]

I saw the GP model work well when I was growing up. My parents had the same family doctor for 2 decades. He knew them quite well.

 

Now, not so much. For me, I went about 20 years without a routine physical, seeing my OBGYN yearly and a handful of docs along the way for a specific issue or two. When I finally decided (in my mid 40s) to get in for a physical with the doctor that my dh was seeing, he told me to come back in 5 years for my next exam lol. Not exactly a relationship building experience.

 

I am an eminently forgettable person. Even my OB/GYN who saw me yearly for 18 years plus through 2 pregnancies and deliveries didn't ever remember me much. The patient load of doctors is staggering. When they see you for a few minutes once a year, interspersed with many hundreds of other patients, there simply is not the exposure time to develop any kind of meaningful relationship. Of course, if one is not healthy and is in much more often, that might be different. I wouldn't know.

 

Growing up my parents really got to know their doctors.  I had doctors I knew well.  I trusted them and didn't feel too nervous going there.  Long story short I was treated inappropriately by a doctor as a young child.  My mother switched finally, but I was still pretty young so I had all those years to build up a trust with another doctor who never mistreated me.  Then I had to move to another state.  That's where it fell apart.  I was terrified to even go to ANY doctor.  And I didn't go for gee like 11 years.  Now I'm trying to find someone and having to get over that fear has not been easy.  So I finally am making some progress, I think, but then now I'm just meeting crap doctors who don't listen to me. 

[Bluegoat]

Same here with needing referrals to see a specialist.  If we didn't, I'd have had the other possibility for my issues checked.  I would like to know if it is or isn't the cause and made that request/desire known.  

 

It's the GPs who have set up the roadblocks, great helpers that they are.  Their best guess (no tests) is that it isn't possible and when I forwarded a credible internet link showing it was (and often is), I was told to stay off the internet.  That, quite literally, was the straw that ended it all (for me).  The GPs final suggestion to me was to see another ENT - as if the first two somehow missed something coming to the same conclusion that there was no ENT issue.  Both Google and the Anatomy teacher at school led me to believe there was no ENT issue merely from the lack of those symptoms (before either ENT visit), but I did those due to the recommendations anyway.  I played along with their thoughts and when those came up empty I got chided for adding mine.

 

Sorry... your Ideal World with GPs in control just doesn't always work out the same in the Real World.  I'd have felt completely differently I suppose if they had been willing to let me have every possible option checked out even if we ended up with no answers, but they won't.  I despise our system giving them the final say so about such things.  It's not them enduring the issues.

 

All those other things you mentioned can be handled just fine by the Urgent Care clinics around us if needed.  We're among those who rarely need them.

 

Orthopedics, around here, also has walk in availability if one were to get a broken bone or something.  Sports folks at school know who is worthy of seeing and who isn't.

 

Every place as a model of care, and from everything I've seen the family doctor model is more sucessful that most of the other options I've seen - in the Real World, as you say. So far I've never heard of any model that is perfect in the Real World, so I don't know that it is a realistic goal. Of course not every doctor will be great.  The consumer model certainly doesn't seem to have much going for it.

 

I've never heard of any medical person who thinks the walk-in model is a good one.  Urgent care for as a sort of extension of a family practice or an ER is one thing, but for things that the GP would otherwise be used for, I've heard and read nothing but complaints that is expensive, drains the system, and gives inferior care.

[SparklyUnicorn]

Every place as a model of care, and from everything I've seen the family doctor model is more sucessful that most of the other options I've seen - in the Real World, as you say. So far I've never heard of any model that is perfect in the Real World, so I don't know that it is a realistic goal. Of course not every doctor will be great.  The consumer model certainly doesn't seem to have much going for it.

 

I've never heard of any medical person who thinks the walk-in model is a good one.  Urgent care for as a sort of extension of a family practice or an ER is one thing, but for things that the GP would otherwise be used for, I've heard and read nothing but complaints that is expensive, drains the system, and gives inferior care.

 

Then another issue around here, not enough doctors.  There are tons of doctors in my area relatively speaking, but anytime I make an appointment I wait for weeks.  Even for a problem.  Sometimes the only place I can go to be seen sooner is a walk in clinic.  Then when you finally get there to the regular doc, they rush you out.

[Ausmumof3]

Yes, it is a lot like that. GPs mostly handle the very basic stuff which in many cases doesn't warrant a visit at all. If you have something more serious you need a specialist. And they are a hit or miss as well (not to mention it takes 100,000 years to get an appointment with one).

 

The kids' ped says every year after the physical we hardly go there. Well yes because besides occasional colds they aren't sick. Should I rush them in for colds? Or make stuff up? It's bad enough the physicals are a total rip off. Except for the vaccines they don't really do much else. They don't do blood work of any kind. They have never done a urinalysis on either of mine. They tap on their knee, have them read an eye chart in a dimly lit hallway, and lecture me about how they should wear helmets and seat belts. All to the tune of $800. I would just die if I had to actually pay that amount, but I do not know where they get off charging that.

 

 

What!??? Here the same visit costs $100 all of which is refundable by Medicare. Although we do vaccines separately so I'm not sure how much they are worth!

[creekland]

Every place as a model of care, and from everything I've seen the family doctor model is more sucessful that most of the other options I've seen - in the Real World, as you say.

 

I'm happy for you.  As I've said many times, I think pretty much any doctor is fine for the basic stuff (though my mom's situation has me wondering about that belief TBH - she has a Family Doctor she's seen for years - the same one who told her to go home and take painkillers for a few days when she went to see him about left side chest pain as it was probably a pulled muscle.  That pulled muscle ended up being an artery that was 99% blocked).  It's when one gets to the short end of the bell curve that many of us can have issues.

 

There are more than enough stories wandering around, but feel free to think we're all batty.  That's the general consensus after all.  If you reach this stage at any time in your (or a loved one's life), I think you'll understand.  If not, probably not.

 

As much as I'd like all disbelievers to reach that end to see what I'm talking about, esp doctors wielding power (sort of a karma), I don't actually wish it on anyone.

[Bluegoat]

Then another issue around here, not enough doctors.  There are tons of doctors in my area relatively speaking, but anytime I make an appointment I wait for weeks.  Even for a problem.  Sometimes the only place I can go to be seen sooner is a walk in clinic.  Then when you finally get there to the regular doc, they rush you out.

 

Yes, this is a common problem in many places. 

 

The walk-in clinics pop up to take care of that problem, but they also make it worse, because that clinic and those doctors are now not taking regular patients. 

 

They also prey on greed a little - they are a money-maker for doctors and easy work with predictable hours.  THough I would think it would be terribly boring.

[shawthorne44]

I've had excellent care from doc-in-the-box.  Including one that diagnosed my about-to-burst appendix even though I didn't have the primary symptom and I'd forgotten to mention the antibiotics I was just finishing.  I've also sat in the hospital room of a good friend and listened to her mother rave about the great doc-in-the-box doctor that diagnosed some weird problem.   My experience is that they were like GP's except they listened when you talked about your problem.  Maybe because everyone that comes to them has a problem so they get into that habit.  

 

I also like the specialist model.  When I had problems with my feet I went to a foot doctor.  For female things, I see my OBGYN.  I have a skin disease so I see a skin doctor for that.   It is hard enough to find a skin doctor familiar with the latest treatment for my skin disease, forget about finding a GP that even recognizes it.  I have relationships with all three of those docs.  

 

One thing funny, one year we needed a physical to get the cheaper medical deductions.  I asked my OBGYN who she'd recommend for a physical.  She thought and said she'd do it.  So, the paperwork was on their normal OBGYN exam paperwork.  The admin at work flipped and said, "I can't show (HR guy) this" because it had several drawings of female things.  

[creekland]

I've had excellent care from doc-in-the-box.  Including one that diagnosed my about-to-burst appendix even though I didn't have the primary symptom and I'd forgotten to mention the antibiotics I was just finishing.  I've also sat in the hospital room of a good friend and listened to her mother rave about the great doc-in-the-box doctor that diagnosed some weird problem.   My experience is that they were like GP's except they listened when you talked about your problem.  Maybe because everyone that comes to them has a problem so they get into that habit.  

 

I also like the specialist model.  When I had problems with my feet I went to a foot doctor.  For female things, I see my OBGYN.  I have a skin disease so I see a skin doctor for that.   It is hard enough to find a skin doctor familiar with the latest treatment for my skin disease, forget about finding a GP that even recognizes it.  I have relationships with all three of those docs.  

 

One thing funny, one year we needed a physical to get the cheaper medical deductions.  I asked my OBGYN who she'd recommend for a physical.  She thought and said she'd do it.  So, the paperwork was on their normal OBGYN exam paperwork.  The admin at work flipped and said, "I can't show (HR guy) this" because it had several drawings of female things.  

 

I haven't had problems either, but then again, we don't go very often.  I certainly haven't seen where either of the GPs I've tried have been better medically.  Personality wise I liked one a bit, but personality doesn't help medically.