Captain Blight

I don't go to doctors unless I'm bleeding, vomiting, or there's a limb at a funny angle. And not always even then. I gave myself the last 7 stitches i needed.

It's the language barrier. I don't speak duck.

Zoxe

In general, most doctors don't inspire a lot of confidence. I don't want to answer the same 6 questions every time I come in -- read my chart before you walk in the room. Then at least you can pretend to remember me, even though I was just in your office the month prior for the same complaint.

If I say something hurts, I want to know WHY it hurts. Immediately offering heavy pain meds makes me think you don't care and aren't willing to help me figure it out.

Don't contradict yourself on back to back visits. It just shows that you're making it up as you go.


So as far as the original question ... for my part, I show up for my annual physical and get my bloodwork done. I take a lot of what I hear with a grain of salt, and I look for consistent advice over multiple visits. My old doc moved out of network and I tried a half dozen doctors over the course of 3-4 years. None were worth a repeat visit (one even argued with information I was giving her, despite it being written in my chart).

Last year I thought I might have a hernia. We'd moved a few months prior so I decided to try a newly established med center closer to the new house. After some research on their web page, with a younger guy who was "Internal Medicine" and not "family doc." Night and day difference -- don't know if it was the specialization or just his demeanor. I finally found someone who inspires confidence ... hopefully he doesn't move on me.

So my advice: Shop around. Take notes. But don't try to "tough it out" because it's inconvenient or embarrassing to visit the doctor.

jagraham

Count me as one of those who has a relationship with my primary care doctor -- we're on a first-name basis, and I've seen him 4 times so far this year alone. Usually if I adopt a wait and see attitude things go wrong -- horribly wrong. I've been seeing my neurologist once a month since October to work out some medication and hardware problems, too, so it's been a crazy winter for me. Having made three unscheduled appearances in ICU is 3 times too many, and under Mike's watch we're at zero in ten years.

zjrog

For primary care, I have a PA I really like. She is very good, spends extra time answering even the most boring questions. She knows my name, she remembers what we've talked about, and always has an answer, even if its, "I don't know, lets look at that"... She also knows I don't come in unless something isn't right. So she takes everything seriously. I bet she'd be happy with the pounds I've lost too...

poperszky

If it weren't for Doctors I would be dead or in a wheel chair. I have two artificial knees, let's see you try and walk off a knee that is bone on bone, doesn't work real well. With that said, my goal is to see my primary care Dr. once a year when I have a physical, some years I make it, some years I don't. Diet and exercise go a long way to staying healthy, but their are times when they don't go the whole way.

RedWhiteandRed

Doctors in general are very very good.

I see my doctor once a year for a checkup and then maybe 2 other times for specific maladies. We have a useful professional relationship. He has been very helpful in many aspects of my life.

My doctor also recommended and arranged for a nutrition clinic and an exercise test and support group.

My positive experience is based on a lifetime of interacting with the medical profession. Everyone should see a doctor at least once each year.

Not that it matters with respect to the above but I live in Canada.
I am also fortunate that my father's doctor makes house calls and has been seeing my father at home for about 15 years. This is very useful if you are infirm or shut-in.

There are certainly some doctors that are less attentive than others and some have odd bedside manner. My wife's throat surgeon is not much for idle chat but his communication is professional and his surgical skills are amazing - no scar to speak of.

Everyone should have a solid relationship with a physician. Makes no sense not to.

Neil_B

My experience since I began weight loss:

I saw a new doctor in 2006, four months into my weight loss. He never noted scoliosis in my charts, so when I put my back out in 2007 and went in for a referral, he was surprised I had it. Keep in mind my curve is noticeable enough that strangers sometimes come up to me about it.

I was sent for physical therapy. The therapists advised me I needed to sit bolt upright in the saddle, which is a horrible position for my back. Once I tore up their recommendations and let my shop fit me for the bike properly, I went from 4 miles to 100 over six months.

My new doctor seems to be an improvement, but only a small one. I saw my new PCP yesterday about my knee problems, the problems that have kept me from exercising for close to two months. He looked at me and went into the standard doctor speech about climbing stairs and walking around in the grocery store. I interrupted him and explained that I ride centuries and hike up mountains. "The stakes are a little higher than climbing stairs" I said.

I'm not sure if he entirely believes my recounting of mountains and centuries, because he didn't give me a referral to an ortho. Instead I have a couple of weeks on Mobic and a follow up when that doesn't work. That follow up could be a referral to an ortho. He favors switching me to Synvic treatment, although that didn't work well the last time I had it. While my new doc isn't opposed to my getting new knees, he doesn't think I should rush into it, even though he agrees I'll wind up with metal joints eventually.

steve0257

So much depends on the doctor and the patient's expectations. Usually when I see my doctor it for something I'm not sure about and I'm quite content for him to take a quick look and tell me what it is and that it is nothing to be concerned about. I've had some acquaintances act shocked that I didn't insist the doctor run tests for whatever it was I saw him about. The most recent example is last fall I had some skin growths I wasn't sure about. The doc took one look and said I had barnacles and they weren't anything to be concerned about.

mthayer

I do not have a primary care physican, or health insurance. I am not in a position that I will go to the doctor unless something keeps getting worse, or I can not tolerate the pain any longer. I am not really convinced that the doctors really mean what they say. The last couple or times, the doctors would scould me for high blood pressure that I have had for 12 years that has not been treated. They say you need to be on pills, but do not prescribe them, and they state the effects of it. Do I really need the pills or not? If I did they why have they not prescribed them?
I do prefer to see PAs of a MD. They seem to provide better services and are more customer friendly. The PA I saw for my Department Of Transportation Physical, required to drive commercially in Texas, worked with me and made sure I passed it. Took checking the blood pressure a few extra times, but he was patient and understood the situation I was in. No pass = no driving, no driving = no job. No job means no place to live (house is part of my salary).

Agave

Remember when a 2" laceration got you 12 stitches not 60?

Remember when you broke your collar bone they put you in a figure 8 and a sling and told you "6 weeks". Now it's plates/screws and "6 weeks".

lubers

I don't have a primary, I see our nurse practitioner at work, shes young and very good looking plus it only cost us ten bucks to see her.Had way too many bad experiences with doctors when I was young, cut my hand in half one year then had my older sister push a swing under my chin and bit my tongue in almost in half, cut my knee open while playing football in a empty lot. Our old doctor didn't believe in freezing anything just sew you back up and your on your way. I need a knee replacement soon but was trying to put that off another three years until I am almost ready to retire. Going in for oral surgery tomorrow, second time this year boy it sucks getting old.

ecovelo

Like any profession, there are good ones and not so good ones. I am very fortunate to be blessed with an excellent GP. We have quite a bit in common - she's an avid hiker and at least a casual cyclist. She is very knowledgeable about the latest in nutrition and exercise, and like me, is very "anti - meds", so it is easy to explore many options in my lifestyle before using any "traditional Western therapies" (ie; drugs, etc.)

I typically see her yearly... for all the things a mid 40's, overweight, stressed out, woman who (up till recently) has chronically abused her body through sports/competition, for nearly 30yrs, should see her doctor for.

I really like my podiatrist as well. He is an avid cyclist, and like my GP, understands that my definition of quality of life means being able to ride and hike - the longer the better - and not just being well enough to work.

Now...my experience with an orthopedist in 09' was very different. I injured a knee and was in excruciating pain whenever I lifted my heel off the floor. He suspected a meniscus but insisted it should not be as painful as my reaction when he did certain manipulations at my knee joint. I told him many times... that I get that the pain in my knee might be meniscus, but WHAT??? is causing this incredible pain in the back of my knee whenever I lift it off the ground??? He didn't know. He kept saying he was surprised at the amount of pain and clearly did not believe me when I said I had a high pain tolerance (anyone out there have trouble with this?). Got the MRI, mild meniscus tear (didn't want surgery especially by him), but nothing to explain the more intense pain in back. Turns out I tore my popliteal muscle - diagnosed 4 weeks later by a PT and later by a massage therapist (with no hinting). Yeah. THAT would explain it!

My best friend has had similar problems: specialists seem to see or be concerned with the exact area of their specialty and be blind to everything else. Back Doc wants to put steroids in her spine - when she finally (2yrs later) sees Doc about her hip, he wants to ignore the back. My orthopod sees only joints - so torn muscle does not concern him. And again with my friend - Doctors not believing she has a high pain tolerance. 3 yrs after first seeing medical professionals about BACK AND HIP pain, she finally got an MRI of her hip. She has torn ligaments and a torn labrum, to go along with her disc pinching on a nerve in the back. And she's been told by several Docs that the pain "can't be that bad", because she is working and gardening and hiking, etc. - before they saw the MRI, of course!

Doctors are human and can make mistakes - and patients of course are extremely varied in their symptoms, descriptions and tolerances - and that would make some diagnoses difficult. HOWEVER, we are living in such an advanced age in technology, that it is criminal that people can not get proper care. Pharmaceuticals and insurance rule our healthcare system.... and until that changes, "...ya never know what your gonna get." o.k.... better not get started on that.....

I do realize how lucky I am to not only have health coverage, but also to have some flexibility within it.

timmythology

I can agree that their are good and bad, but with Dr. we also have the middle. Which is worse than being bad! In march of 2010 I was diagnosed with Asthma, which is a what ever. The problem I had was it took me questioning my Dr, and his treatments, to get to this point. At the time he was going to prescribe another regimen of antibiotics to treat another round of bronchitis. I simply asked him, how many times have you prescribed these to me in the last two years? His response was six times in 24-months. I just asked, could it be something else? He tried me on advair, and I have not had any need for more antibiotics since.

You see, this Dr. just did his job, he just forgot that his job was not working at 7-11, and a persons health was in the balance.

This was the first time I made a choice not to micro manage the Dr, and that was my mistake.

Ingeneral the problem I have with the health care industry is it slave mentality to the the diagnostic information. If your over wieght, than that is the cause, even if a persons diagnostic information says other wise.

Seve

Be not afraid of good health: some are born healthy, some achieve good health and some have good health thrust upon them. ( Apologies to WS )

You are not alone it seems.

""Men generally wait until they have a problem before they see the doctor."" ... "Men are babies," he says. "We're terrified by bad news, so rather than having to deal with bad news, we don't go." https://www.healthzone.ca/health/article/651839

aenlaasu

I'm an Athena, but I'll put in.

I go to doctors for certain things. When my back hurts so bad I can barely walk from one end of the apartment to the other is one. Severe pain in a shoulder which turned out to be tendonitus. Both things were hindering my daily functions. Of course, my knees have times where the least little flex brings tears to my eyes. Makes sitting down or stairs a challenge, but I don't go for that. I know exactly what I'll be told. 'Lose weight'. Um, yeah. 'Thanks and how do I do that other than starving myself when I can't exercise?' is my usual response to that statement. I guess the doctors don't like me any more than I like them.

Of course, as I respond to this, I'm having a raging debate with myself. Do I go for the pain in my lower calf which is exactly like the pain I had with a blood clot or wait a few days and hope it's a pulled muscle. Choices, choices.

snowman40

I had one doctor who had primarily senior citizens, and illegals/non-English speaking (the files were all like 2 inches thick, wood paneling in the waiting room and an old school type lounge atmosphere). Boy did that suck - I challenged his diagnosis's and he despised that, later I found out he was on a points system (more points = bigger bonus from insurance companies). My temp is below average and susceptible to the temperature around me (my body acts like a heat sync at times....), so I had a 99 degree fever one day and they wrote down flu. Later that visit, he looked at my swollen, red and infected ingrown toenail (the reason I was there) and diagnosed me with gout. I pointed out that it was secreting puss and couldn't be gout, but he insisted. He told me to get an x-ray, so I did (to humor him....he was amazed that the x-ray didn't reveal any signs of gout). X-ray tech that took the photo looked at it and said, that's an infection, not gout. My last visit with him almost ended in a verbal confrontation, he wanted me to do something else but since I knew it wouldn't help my problem, I was calling him out on it.

I don't think he likes it when someone questioned him, but most of his patients were older and of questionable immigration status - groups of people that would listen and do everything he said to do.

Current doctor is great. He does bits and pieces of physicals each visit because I only go when I have something that doesn't feel right new pain, new type of pain or pain is just different than before), hasn't gotten better, might have caught something from my kids (my oldest had walking pneumonia recently....I went in just in case). Since I'm also in the IT field, I give him several possible diagnosis's and I've only been off the mark once - he seems to like that, makes his job easier. I go more now then when I was a kid growing up. Then, I'd have to have something broken or contagious looking to go see a doctor.

B.Alive

My definition of a good doctor is one that listens, understands, thinks, then diagnosis. Having a great personality is awesome, but secondary to listening and understanding. I'm a people person, a talker, and a doctor that fits my definition and is friendly is like a Master Card commercial-- Priceless.

dgrenthum

WOW, I hope people see this on the second page. I am a SN my sis and uncle are MD's and best friend is a DPT. There are alot of issues with the medical system it is a fact but most doctors know what they are doing even if you dont understand it. Then sometimes they are ust trying to get paid. Alot of problems are at work here.

CYA cover your ass. When someone mentions something about pain or funny feeling anywhere that area and any system above or below it gets a full assessment. If there is a test even at a billion dollars that would give a better assessment it may be ordered. Why? becasue if it is missed and you die or have a stroke or heart attack because it wasnt caught there will be a lawsuit. You need to colaborate with the doc on what is an absolute neccessity or not. He may even right an order for an expensive test and then have you sign it as refused to cover their ass.

Reffered pain: Pain in other areas of the body then where the actually problem is. Ever heard of someone having left arm pain and it being a heart attack? What if the doc only looked at the left arm, and you died. There would be a lawsuit. Several other serious conditions present like this.

Asymptomatic area causing pain in another. After getting hit by a car I had AC joint pain and swelling PCP looked there and stopped, first ortho looked there and stopped DPT looked at the SC joint and felt the tightness and realized it was causing extramovement in the AC and causing the issue. So lots of people and lots of money to figure ti out, of course this one is on the Docs just not knowing what else it could be. But as others have mentioned some are good some are bad, others just havent seen the issue before and not aware how it presents.

Money: There are many times where simply asking an extra question on the exam or interview with a patient warrant being able to bill for another code. Insurace and medicare/medicaid does not pay out 100% on what a doctor bills. One way for doctors to get some of this money back is to do a lil extra that doesnt take alot of time even if it doesnt make sense. Not legal in the strictest sense but think of it this way. You tell someone it will be $100 to fix a wheel and they give you $15 for a deposit and say i they have bike insurance to take care of the rest. You have your billing specialist bill teh insurance co for the other $85. The insurance co sends back and check for $50 and says we are not going to pay for anymore. Instead of asking the customer for the rest the doc just grins and bears it. Charging an extra $15 for nipples on the rims to the insurance co helps make up some of that difference. With that being said tell the doc you do not have insurance, they should change things up and not add in those little extras.

As for doctors not being able to explain things in plain english there are plenty of thing I could not dumb down to effectively explain. It is impossible to talk about the bowmans capsules, nephrons, and the loop of henle and how they work inside the kidneys to and what is going wrong to someone that has not taken A&P and understand diffusion and the like. Not being a dick but I try to explain things as simply as i can but by doing so alot of times the meaning is lost. Cant do much about it. Took me 3 years to learn it and it is hard to explain in our 30mins together. I have also seen alot of people go to webMD and self diganosis and it is good for someone to come to the table with ideas. The issue is when that person comes in and you tell them it is not that because of "name your lab test" but they insist that it still is becuase they have all the symptoms. I encourage everyone ot learn as much as possible on the internet but keep an open mind that it could be other things.

As for herbal stuff, if you have a doc make sure he knows that you are taking it. Lots of herbs will do the same thing as your thousand dollar drugs will do (same active ingredient) If you are taking the herbal and taking the MD stuff you could over medicate and crash. With that being said alot of your herbal medications can vary in the amount of active ingrediant from lot to lot. So results may or may not be consistent, just depends on how much room for error there is for that type of drug. They get away with this because "they are not intended to treat or cure any disease" and therefor not regulated like the ones that fall under the FDA.

I could write a book but i will stop at there. Find a doc who will listen to you and you will listen too. If you have an issues that last over a week or two make sure you go see them.

snowman40

I only go to WebMD to help diagnosis pain, because that will help me figure out what I did to hurt it (because I usually don't know what I did). If it is joint pain (most of my problems) I don't bother, but I do mention it at my next appointment; my PCP gets it, he has another Marine (about 50-60) and me and him have the same joint pain complaints...he found it fascinating that we complained about the same things and have the same limitations and mindsets about it (knees hurt when running, so neither of us run). Looking up symptoms on WebMD is worse than playing Russian Roulette...you get all kinds of stuff that isn't the problem.

magohn

And how does outlining how insurance fraud takes place put the doctor in a positive light? You do realize that bilking the insurance hits only one person - the insuree by way of higher premiums.

Also, my wife, who is on basic health insurance, asked if she was fit enough to start cycling - a simple "yes" from the doctor cost us hundreds of dollars out of pocket as the cycling question was not part of the regular check-up. Tha'ts some profession ...makes Bernie Maddof almost look honest.

JohnA42

Any MD who can't diagnose gout in your big toe from 10 meters needs to go back to med school. And, for the record, an X-ray isn't going to tell him what he needs to know. You need to do blood work and check for uric acid levels, though even that can be inconclusive. As a patient, you only need to have gout diagnosed once; you'll never mistake it for anything.

ecovelo

[QUOTE]A patient's understanding has very little to do with misdiagnosing, IMHO.

AGREED!

Not necessarily. I know of at least 6 examples in the last 2 yrs, of "specialists" who narrowed their focus only to their area of specialty and completely ignored other areas contributing to the problems/symptoms reported. Perhaps these experiences are the minority on a National level, but it is clear that in these cases, their focus was extremely compartmentalized, and the idea of looking at the systems of the body and how they interrelate and impact one another, was completely neglected.

In my experience, (17 yrs in healthcare), COST drives whether or not certain tests may be ordered. For common, life-threatening episodes or diseases, sure.... the demand in this country for QUICK AND EASY diagnostic tests has brought the cost of these types of tests down - those needed to assess heart, lung, and brain health IMMEDIATELY, especially. But taking the step up from an X-RAY to an MRI, for example, often means many months (if not a year or two) of repeat visits, and painstaking alternative, CHEAPER methods of treatment with no results, before an MRI can be ordered/paid for.

Collaboration is rarely an option. As you mentioned.... symptoms match diagnostic codes which then determine what tests to order. Results from diagnostic tests then fall into another algorithm to determine the next step. This is true whether it is Medicare/Medicaid, employer provided or private coverage - or a combination.


Yes! This is all part of the game that is "healthcare in the United States". And some people are better/more experienced at playing, than others!

No need give an A&P lesson to the patient to explain the function of the kidney and why the patient is presenting with particular symptoms. Again, understanding the medical terminology has nothing to do with misdiagnoses. I think there were a number of posters who were clearly getting the point across that some doctors were either missing something in regard to their symptoms, not understanding their presentation before the illness or injury, or in some cases completely missing a portion or all of a diagnosis.

It definitely takes a "team" of medical professionals in many cases - that's why we (in the medical profession) are here. I have a number of friends who are MDs and I hear the same complaint over and over again - especially from the older ones - that their professional judgement - or at least what steps they can take for treatment given their judgement - is/are often dictated by people who are not medical professionals (Insurance and sometimes Hospital Admin.)

There is an incredible amount of information and new technologies being discovered and practiced every day - a great deal for MDs and all healthcare professionals to keep up with this ever growing body of information. For the most part, I believe that most Docs want to "do no harm" and want to help people get well - I believe that it is their (and other healthcare workers) intention. It is difficult to ignore however, the persistent and pernicious drive for profit, that is inherent in our healthcare system.

dgrenthum

Wasnt tring to make doc's look good. My whole shpill was about the system and what to look out for, not that docotors are "good" I was making you aware that it happens so that if necessary you can pull in the reigns and say hey lets focus on the issue and not all this other crap (that they maybe trying to get paid on). However i also tried to let peole know that sometimes those other questions are asked because they make sense even though they may not to you (see reffered pain). Again its about understanding the system to work through it, it sux and its broken and that was one of my first original lines.

As for the question your wife asked that cost hundreds of dollars, thats a health insurance issue. They decided not to cover it because the insurance doesnt cover consults like that. Not the doctors fault, she asked a question and he provided his medical opinon and he billed for it. Doctors cant expect to know every nook and cranny of the million insurance policies out there. Funny thing is every health program or diet out there says to consult your doctor before starting a program. They know 99% wont becasue of cost but they practice CYA (cover your ass).

THe system is not as bad as madoff but yeah its bad. Anytime you tie someones hands saying they cant bill for something or can only charge so much and its in a 1000 pg manuscript. You best believe people are going to find a way around it or to manipulate it. Sure the first few times they may think they are getting paid what they are owed but then it becomes common place to do it all the time and well its a slippery slope. Its only not as bad as madoff cause you do get something out of it.

Wogster

I am not a doctor, but with nearly 50 years as a patient, I feel I can comment.

Sometimes misdiagnosis is due to the patient not telling the whole story, because the patient *knows* they don't want it to be a certain thing.
I think sometimes this is due to the culture of medicine, you go to your doctor with chest pains, they send you to a cardiac specialist, the cardiac specialist runs a few heart tests and if it's not the heart, the culture of medicine doesn't allow that specialist to tell the patient it's not the heart and that they should return to their MD to go another direction.
It's easier here in Canada where government health insurance pays for many of the tests, but it doesn't pay for all tests, which means a doctor is likely to order a test that insurance pays for, rather then one it doesn't. However there is still the culture of medicine that gets in the way, and some doctors keep right up with technology, some don't.

The billing issue is interesting here. A doctor is paid about $10 for an office visit, so it's common to go to the doctors office, they order a bunch of tests, then you go back to the doctors office when the results are in, because it's another office visit they can bill to the government insurance. Good for the doctor, but not for the patient who may need to take time off work for the visit, time that either comes out of a small number if personal days or unpaid time. Still, it's better then in the US where not only do you lose pay, you need to pay the doctor and it's a heck of a lot more then $10.

dgrenthum

@ecovelo

I aggree with much of what you are saying and my reply was a mishmash of replying to many posts that were made so perhaps taken a little further then intended if you were not the one it was directed at. Thanks for the level headed reply.

As for the specialist comment, I agree with you specialist are a little different ball game, especially if they have been doing it for awhile. If you go to ortho and your chest hurts they make sternum rather than heart. They do look at problems from the perspective of the systems they specialize in and always seem to relate everything back to them. I find too many people nowadays like to go to a specialist first cause they "know what the problem is" as opposed to a primary care phyisician who might give some alternatives.

about the cost driving tests. I havent seen the issue to the degree you imply. Typically there is a set list of test before going to MRI or something as expensive but it also depends on the severity problem and the insurance involved. So i sort of agree, However, In my experience it is second to CYA. If you have to go before a licensing board about failure to perform and why something wasnt done, it cost too much, probably wont save the license.

about collabaration: This was directed at thsoe complaining about cost. 20 years ago you basically did what the doctor told you to do for an issue. Now you can have more input and there is always a different doctor to see if you dont like the answer you are getting. I suppose what i was trying ot get across is if test are benig ordered you dont have an understanding, ask. Perhaps there are other alternatives or i see fairly often where (especially in the case of blood) extra labs are ordered that may be insignificant but since you are there and you are having blood drawn, they add them. It will paint a more complete picture to your health status but not be relevant to your current complaint, just saying talk to them and work together decide what you need vs be nice to have. You are right though there are plenty of docs that dont want to be collaborative and if you dont want to do the test that they want, they in a nice maner say take-a hike.

as for your last little bit, perhaps where I fail, is being able to explain thing in laymans terms. It seems i can say the kidneys are not filter XYZ because of ABC but usually i get a blank stare. Or i get a why and then i go deeper and more blank stares. I will have to look into that.

I definitely agree with the industry not being driven by medical professionals. I woudl surmize most hospitals are owned by business people not medical professionals.

Nice last paragraph.....