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Old 02-24-2009, 10:38 PM   #41
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Khan--I don't know anything about your carrier, but some plans DO NOT require you to have a primary physician. You can simply choose a specialist and make an appointment.
IMHO that's often a bad strategy. Subspecialists may have a "buck stops here" approach (they have to in some cases) and tend to be more aggressive in chasing down every remote possibility with every available tool. While that is sometimes necessary, the primary doctor can often do some filtering, try some simpler things, and help you know what's safe and what's not.

In addition, it is not always easy for a layman to even know which subspecialist is most appropriate. Would you go to a neurologist for a pain above your eyes? Or maybe an ENT doc for sinus trouble. Maybe an opthalmologist. Abdominal pain might be urinary, gastrointestinal, stress, infectious, etc. And frankly cardiologists hate, for example, patients who refer themselves for chest pain which is obviously muscular, or otherwise noncardiac.

I prefer (both as a physician and when I need to be a patient) to have a primary internist I trust, and let him help me make those decisions.

And who will oversee preventive stuff, probably the most important of all. Subspecialists don't even stock immunizations, etc. and they are less knowledgeable in almost every discipline outside their field than is a sharp primary care doctor.

Too bad there is such a shortage of primary care.
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Old 02-25-2009, 07:30 AM   #42
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...I prefer (both as a physician and when I need to be a patient) to have a primary internist I trust, and let him help me make those decisions.
And who will oversee preventive stuff, probably the most important of all. Subspecialists don't even stock immunizations, etc. and they are less knowledgeable in almost every discipline outside their field than is a sharp primary care doctor.
Too bad there is such a shortage of primary care.
I totally agree. I rely on my primary doctor to be the conductor of the orchestra. Going to a primary doctor ensures continuity of records from any specialist referrals, lab and screening test work. I get one stop shopping for my medical history, vs having records all over the place. Most importantly, having a primary makes it possible to develop an ongoing trusted realtionship with a single doctor. This is key.
I entertain my doctor with my checklists. When I go for wellness checks 2x per year, I hand him a yellow sticky with things (improvements and potential problems) I know about my body and mind. On that list I put items we need to address. He places them right in my folder. It saves us both time and allows us to discuss items in detail vs spending time with the drawn-out Q&A method or him having to hurriedly scan my folder.
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Old 02-25-2009, 08:09 AM   #43
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Some links courtesy of the Mayo Clinic
Healthy Living Information - MayoClinic.com

Age and Gender interactive tool for health screening
Health screening guidelines - MayoClinic.com

Symptoms checklist
10 symptoms not to ignore - MayoClinic.com

Compiling family medical tree
Medical history: How to compile your medical family tree - MayoClinic.com

Men's health
Men's Health Center - MayoClinic.com
Prevention for men
Mayo Clinic medical information and tools for healthy living - MayoClinic.com
Top 10
http://www.mayoclinic.com/health/mens-health/MC00013

Women's health
Women's Health Center - MayoClinic.com
Prevention for women (copy and paste this link - i had to spread it across 2 lines to overrule an emoticon)
http://www.mayoclinic.com/health/womens-health/
Wo00102
Top 10
Women's health: Preventing your top 10 threats - MayoClinic.com
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Old 02-25-2009, 09:02 AM   #44
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So how do I find someone to perform this exam?

And how do I find someone to drive me to and fro?
I had the advantage of having the office where they do the test only three blocks away. I walked down there. They asked if I had made arrangements for a ride back. I said yes. I walked home. No problems.

One possibility is taking a taxi.
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Old 02-25-2009, 09:34 AM   #45
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"IT" being my newest rite of passage into "oldfartdom" (right, Martha?)
Darn, this is an serious and important thread. I thought "IT" was something entirely different.......
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Old 02-27-2009, 06:06 AM   #46
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If it says I'm in perfect health then that'll be really bad news cause then we'll be back to square one and the constant pain will continue unabated.
It seems like you're having some trouble. What kind of pain do you have, cramps, gas, etc.?

I just had my second colonoscopy, the DR didn't even talk to me after, too busy and the nurse told me to follow up, that I had a polyp removed, and gave me a hemmorhoid prescription. I still have cramps, gas and discomfort. Having them for several years. Weird.

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Old 03-01-2009, 12:11 AM   #47
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IMHO that's often a bad strategy. Subspecialists may have a "buck stops here" approach (they have to in some cases) and tend to be more aggressive in chasing down every remote possibility with every available tool. While that is sometimes necessary, the primary doctor can often do some filtering, try some simpler things, and help you know what's safe and what's not.

In addition, it is not always easy for a layman to even know which subspecialist is most appropriate. Would you go to a neurologist for a pain above your eyes? Or maybe an ENT doc for sinus trouble. Maybe an opthalmologist. Abdominal pain might be urinary, gastrointestinal, stress, infectious, etc. And frankly cardiologists hate, for example, patients who refer themselves for chest pain which is obviously muscular, or otherwise noncardiac.

I prefer (both as a physician and when I need to be a patient) to have a primary internist I trust, and let him help me make those decisions.

And who will oversee preventive stuff, probably the most important of all. Subspecialists don't even stock immunizations, etc. and they are less knowledgeable in almost every discipline outside their field than is a sharp primary care doctor.

Too bad there is such a shortage of primary care.
In this case, I was referring to the single procedure of having the colonoscopy. Why bother with a primary care physician if your goal is to see a gastro and have the procedure?
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Old 03-10-2009, 09:15 PM   #48
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So, I live alone and have no spouse or friend that I would impose on to drive me there and then pick me up hours later and babysit me at home. Someone has to be present all day until 10:30 at night? I'd have to hire someone. Hire a taxi, hire a care provider. What the heck? No wonder people put off these preventative tests.
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Old 03-11-2009, 05:29 PM   #49
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So, I live alone and have no spouse or friend that I would impose on to drive me there and then pick me up hours later and babysit me at home. Someone has to be present all day until 10:30 at night? I'd have to hire someone. Hire a taxi, hire a care provider. What the heck? No wonder people put off these preventative tests.
My thoughts exactly.
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Old 03-21-2009, 07:53 PM   #50
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Here in Nova Scotia, they are launching a colorectal cancer screening program. If you are between 50 & 75, you are sent a test kit ( poop on a slide, sent to a lab ). I'm involved in the IT end of the program. It should be launching in the next couple of weeks. The idea is if you have a positive FIT test, you are booked for a scope exam.

I have a sister in law that survived colon cancer 8-10 years ago. Very good program IMO.
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Old 03-21-2009, 10:57 PM   #51
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If you are between 50 & 75, you are sent a test kit ( poop on a slide, sent to a lab ).
I sure hope that the slide/poop is sent to the lab, not the pooper.

Sounds even more harsh than "commit a crime, go to jail"...
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Old 03-22-2009, 06:52 AM   #52
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The slide goes to a lab . I think the slide is less 'intrusive' than the scope.
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Old 03-22-2009, 07:20 AM   #53
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So, I live alone and have no spouse or friend that I would impose on to drive me there and then pick me up hours later and babysit me at home. Someone has to be present all day until 10:30 at night? I'd have to hire someone. Hire a taxi, hire a care provider. What the heck? No wonder people put off these preventative tests.
The level of surveillance afterwards depends on how much "happy juice" you request. I asked to be completely out of it. Other posters have indicated the "juice" wore off within a few hours. YMMV.

Whether you decide to go for colorectal screening is a personal choice.

All I can say is I have total peace of mind knowing I did the screening and all is well. The diverticula are minor and most likely will cause me no problems. If they had been larger and/or inflamed, I just saved myself a whole lotta grief. All I need to do is take 1 dose of Metamucil every day, which I had already been doing for a few months prior to get more soluble fiber in my diet.
Best of all, I went and I'm off the hook for 5 years.

Update: I just got my bill. The total hospital bill was $2200. My copay was $75. So does make me a cheap date?
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