nm

[cute fuzzy bunny]

I didnt get asked or have the option. He said "yeah, pretty much...lets take some x-rays" and left the room. I was 18 or 19. I didnt realize I was being taken for a ride.

I'm sorry, is this going to turn from the doofy doctor who did unnecessary tests on me when I had walked in with satisfactory care already applied to my having done something wrong?

So if I walked in and said my toe hurt, and he ordered a head MRI and I didnt stop him, thats a-ok?

[Rich_by_the_Bay]

Quote:

Originally Posted by wab Now you know why doctors seek ER.

[shiny]

I have the same complaint about some vets. One vet did lots of expensive tests to find out why my dog was vomiting and made me feel like a bad dog parent for questioning the expense. He never did offer any good reason - told me to come back in 90 days to do the tests again. Now I just feed her 4-5 small meals per day and she is mostly ok. We have a new vet.

I understand the doctor's perspective, but it is frustrating to not get answers after paying for it.

[youbet]

Quote:

Originally Posted by Cute Fuzzy Bunny So if I walked in and said my toe hurt, and he ordered a head MRI and I didnt stop him, thats a-ok?

Well....... *you said your toe hurt. But you also presented yourself to him and he did get a look....... *And he ordered a head MRI. *If he had ordered a digital postrate test, then I would have wondered. *

[cute fuzzy bunny]

Might have just been looking for my head.

Rough equivalent in my area of expertise: a guy calls and tells me his computer is acting up and I look at it and he clearly needs to reload windows. He's ready to do that. I suggest he pay me $200 for a diagnostic, the result of which doesnt affect the material original diagnosis and I was aware of that when I made my evaluation. Guy isnt going to be happy with me. He's not going to pay me.

[Martha]

Quote:

Originally Posted by Cute Fuzzy Bunny I didnt get asked or have the option. He said "yeah, pretty much...lets take some x-rays" and left the room. I was 18 or 19. I didnt realize I was being taken for a ride. I'm sorry, is this going to turn from the doofy doctor who did unnecessary tests on me when I had walked in with satisfactory care already applied to my having done something wrong? So if I walked in and said my toe hurt, and he ordered a head MRI and I didnt stop him, thats a-ok?

Just curious, as you seem so assertive. But 18 years old isn't forty something.

Last summer I had my hand smashed when a big container of sand fell on it. My doctor said "crushing" injuries rarely result in broker bones, so she wouldn't bother to X-ray unless I wanted it. I didn't.

[larry]

Quote:

Originally Posted by youbet If he had ordered a digital postrate test, then I would have wondered.

...and that would probably have been the last time you ever went to that dentist again. yuk, yuk, yuk

[Billy]

Thanks for bringing the subject back to - uh - something I could follow without blushing... I was afraid someone was going to start talking about dual emergency airbags next. *

Certainly the $428 should have come with an itemized invoice, and in lay terms, please. If not in lay terms, then the codes should be listed. Then the codes need to be explained. No explanation, no payment.

Still, I think that it's fortunate no organs were taken out, or suggested to be taken out. That's positive. *You might want to look at the effects of stress on your body, or lifestyle choices on your body. Couldn't hurt.

Akaisha
Author, The Adventurer's Guide to Early Retirement

[maddythebeagle]

Going to a dr. with "nonspecific symptoms" will almost always end in tests and 400 bucks sounds pretty cheap to me. :P I am not a dr. or play one on tv, but was diagnosed with a relatively rare problem and spent several years bouncing around from diagnosis, treatment and follow-up. Sometimes you need to just keep narrowing down and be your own advocate. We are talking about people and not cars right * *

[cute fuzzy bunny]

Quote:

Originally Posted by Martha Just curious, as you seem so assertive. But 18 years old isn't forty something.

Yeah, thats generally not a problem, but at that stage I was at the "doctor speaks, I listen and nod" stage.

I still figured that even with just a busted toe that there was going to be some sort of cast or other remedy involved than just taping it.

And hell, my tape job and the quality of the tape I used was better. :

[Billy]

Maddy the Turbo Beagle

Quote:

I am not a dr. or play one on tv, but was diagnosed with a relatively rare problem and spent several years bouncing around from diagnosis, treatment and follow-up. Sometimes you need to just keep narrowing down and be your own advocate.

I have certainly had similar experiences. I consider myself to be an 'active patient.' I ask questions, I want to know why I'm supposed to take a particular test or med, and what is to be gained from it.

I can't tell you how many doctors are shocked at my approach...* However, I must say I do it in a non-confrontational manner, and I try to do my homework beforehand or by follow ups.

Akaisha
Author, The Adventurer's Guide to Early Retirement

[shiny]

Quote:

Originally Posted by Billy I can't tell you how many doctors are shocked at my approach... However, I must say I do it in a non-confrontational manner, and I try to do my homework beforehand or by follow ups.

I once had the nurse tell me to stop reading so much!

[2B]

Quote:

Originally Posted by Cute Fuzzy Bunny I think you should go back there and demand that your fuel injection nozzles be power flushed at 2500PSI and your entire exhaust system removed, sanded, acid washed and replaced with quarter inch bolts, nuts and lockwashers. Stat!

[Rich_by_the_Bay]

Quote:

Originally Posted by Billy Maddy the Turbo Beagle I have certainly had similar experiences. I consider myself to be an 'active patient.' I ask questions, I want to know why I'm supposed to take a particular test or med, and what is to be gained from it. I can't tell you how many doctors are shocked at my approach... However, I must say I do it in a non-confrontational manner, and I try to do my homework beforehand or by follow ups.

I think I would enjoy having you as a patient. I feel best when my patients play an active role in their medical decision-making. Having mostly practiced in academic locations, I have many such patients who are faculty members, other docs, etc. They are well informed, and respond to facts and thoughtful decision guidance rather than "orders."

[Billy]

Shiny:

Quote:

I once had the nurse tell me to stop reading so much!

I don't doubt that a bit. *8) And I realize fully that I am not a doctor, -- it's not my area of training. However, I'm also not a blind follower. I take notes on side effects I may be getting, and I research symptoms and diagnoses. And I don't give up my internal organs freely!

2B

Quote:

I asked one of my girlfriends to do that and I was lucky to walk away with my life. *However, she didn't have a problem with flushing my injection nozzles.

* * *

Rich:

Quote:

I think I would enjoy having you as a patient. I feel best when my patients play an active role in their medical decision-making. Having mostly practiced in academic locations, I have many such patients who are faculty members, other docs, etc. They are well informed, and respond to facts and thoughtful decision guidance rather than "orders."

Hey, thanks! I very much appreciate what you said.*

Akaisha
Author, The Adventurer's Guide to Early Retirement

[razztazz]

Quote:

I am not a dr. or play one on tv, but was diagnosed with a relatively rare problem and spent several years bouncing around from diagnosis, treatment and follow-up. Sometimes you need to just keep narrowing down and be your own advocate.

Thius is what we're paying for. I get really annoyed when i pay big bucks and the "experts" seem incapable of or indifferent to just looking it UP!. If I can do it should be automatic for them but no dice.

Quote:

I consider myself to be an 'active patient.' I ask questions, I want to know why I'm supposed to take a particular test or med, and what is to be gained from it.

THis usually gets not so furtive groans, eye-rolling,open displays of contempt and naked appeals to their own "authority". Even data from the pill manufacturer doesn't mean anything to them.

[Rich_by_the_Bay]

Quote:

Originally Posted by razztazz THis usually gets not so furtive groans, eye-rolling,open displays of contempt and naked appeals to their own "authority". Even data from the pill manufacturer doesn't mean anything to them.

Razz,

Not to dismiss the other points you made, the data from "pill manufacturers" is not the gold standard for medications. They often include every side-effect reported in "post-marketing" surveilllance to protect themselves legally ("we disclosed that" "told you so"). So, if someone in the study has a headache, that is listed in the side-effect list, even if it was just a tension headache. Whatsmore, many symptoms are nonspecific and when they occur while a patient is taking a drug, they need to be assessed carefully and not just assumed they are drug-related.

Regarding benefit, distortion is also common. Example: risk of heart attack over the next 10 years is 8% on no meds, and 6% on meds, they will report a "25%" reduction in heart attacks (2%/8%). Technically defensible, but the patient really needs to know that in absolute terms it is a 2% reduction, with a 1% serious side-effect occurrence. You may still take the drug but it's a whole different scenario.

These are just a few examples. The doctor should use objective, independent research evidence (readily available) to help the patient make the right decision. Drug companies have done some great things, but generally speaking -- at the marketing and sales level -- they are not your friend.

Hope this is of interest.

[razztazz]

Thanx R_I_T but I'm not talking about the light weight stuff.
I cannot get into detail here or I'l crash the server. A previous girfriend was a doctor and my siustyer works for a pharaceutical co. I knwo what I'm talking about.
I'm talking about life altering stuff clearly listed by the producer and cleary flipped off by the MD.

Also, They never seem interested in identifying real problems, or causes, focusing on appropriate treatment and informed descisons and all that. They inisist on giving out as much medication as possible, give as little relevent information about my condition as they can get away with (hence the atitude when I ask questions) They diagnose via telepathy. It's like eveytime you go to the bank they start twisting your nuts about getting a new credit card or opening some new kind of mutual fund account. Well, a trip to the dr's is like that only with medications... and new diseasses I dont have but they insist, in spite of the test data, that I DO have... and a complete disregard for medical problems I do have but they are not interested in treating because there apparanetly are no drugs for it. Or it's "here take this drug... get lost"

[wabmester]

Rich, I'm curious what you think about concierge medicine.* * Seems like it might be the perfect avenue for a doc like yourself who wants to wind down, and I'm sure it benefits patients who are looking for something other than assembly-line medical care.

[Rich_by_the_Bay]

Quote:

Originally Posted by wab Rich, I'm curious what you think about concierge medicine.* * Seems like it might be the perfect avenue for a doc like yourself who wants to wind down, and I'm sure it benefits patients who are looking for something other than assembly-line medical care.

I understand the motivation behind it both financially and pace-of-practice. I do not criticize my colleagues who choose this route. For patients it is a more pleasant experience (and more expensive). BTW, from what I have seen, it is not always the most highly respected or most medically astute doctors who are doing this, although some fit the bill. Caveat emptor.


Personally and professionally, it goes against everything I stand for, and undermines many of the reasons why I chose the profession. I am not naive but truly feel I should provide the exact same level of service for all patients regardless of ability to pay; our health care system doesn't make this easy, I admit, but I have always managed to have a mix of rich, poor, sophisticated and ignorant, paying and nonpaying patients.
Guess which ones have provided the greatest satisfaction? Hint: it's not the society crowd.

What we really need to do is fix the system to that everyone could enjoy the type of access and accessibility that a concierge practice proposes to provide. Most of us would gladly forego the fancy artwork, designer waiting rooms, free Starbucks in the waiting room.

Re: a nice semi-retirement job, I think about "locum tenens" where you fill in a month here and there for various practices around the country. Travel, hotel, malpractice paid, good money, DW can accompany if she wants, no nights or weekens, only take assignments when you feel like it. Cripe - I'd better knock this off before I up and quit today .