Doctor questions

[W2R]

Khan, I am so glad to hear that you are going for a checkup! Here are my suggestions, which are not from a viewpoint of expertise but are from somebody who sincerely cares about you and your health. Which, I do.

When you see the doctor, be sure he understands that you have not seen a doctor in 20 years. That way he will hopefully understand that he cannot just rush you through. In fact, you also might want to alert his office of this because they might want to schedule a possibly longer appointment for you.

Bring a written list of any questions or symptoms you may have had. Then go through your list with him.

If you are like me, you will freeze up and forget to ask something important unless you have it on paper in front of you. That is why I suggest you bring the list.

You have mentioned some serious hereditary conditions in your family history, that you may have. Ask if you can be checked for those conditions.

Congratulations for taking this big step!

 

[braumeister]

When you're scheduled for blood tests (lab work), you should certainly fast at least from midnight before your blood draw. Some tests will give inaccurate readings otherwise. Also, at your age you should also consider the pneumonia vaccine in addition to the shingles one.

I would say the most important thing to keep in mind is twofold:

A. Make a list of questions and take it with you to the appointment so you can remember to ask them all.

B. Bring a notepad so you can jot down the answers you get.

 

[Amethyst]

The article suggests the physical may include a female gynecological exam (breast check, Pap smear). I have never gotten those from a GP. Always have to make a separate appointment to see an OB-GYN.

Amethyst

There you go Khan.

Annual Physical Exams: What to Expect

I disagree with the idea of starting with lab tests. The most important part of the investigation is the history. If there are issues you would like your doctor to focus on, make a list.

Best of luck!

 

[sengsational]

People are talking about lipid panels. That will just be an excuse for the doc to put you on a statin, which will probably make you hurt and enrich some big pharma. What you want is a carotid IMT test. There are no x rays, and you can learn if your last 20 years of lifestyle are catching up with you or not.
Intima-media thickness - Wikipedia, the free encyclopedia

Full disclosure, DW was a diagnostic sonographer.

 

[ls99]

The article suggests the physical may include a female gynecological exam (breast check, Pap smear). I have never gotten those from a GP. Always have to make a separate appointment to see an OB-GYN.

Amethyst

IMHO there is a very good reason for OBGYN specialty. Had a SIL who trusted her GP for GYN exams. He kept telling her for months she had ovarian cyst.

She died a year later from ovarian cancer.

Just a word to the wise.

 

[obgyn65]

You are joking, right ? She has not seen a provider in 20 years and you want to replace a lipid panel testing for baseline with ordering carotid Imt / us at her first visit ? I need another beer.

That will just be an excuse for the doc to put you on a statin, which will probably make you hurt and enrich some big pharma. What you want is a carotid IMT test. .

 

[obgyn65]

Kahn - you are getting some good advice from some of us here. Some other posts are not standard of care. Please feel free to PM me if you need any additional information. Take care.

 

[Meadbh]

You are joking, right ?

+1

That would be malpractice!

 

[obgyn65]

Yes indeed.

+1

That would be malpractice!

 

[W2R]

I have switched docs over the years for many reasons, often result of several hundred mile moves across state lines.

None have ordered anything until after the first look see.

+1

 

[sengsational]

You are joking, right ? She has not seen a provider in 20 years and you want to replace a lipid panel testing for baseline with ordering carotid Imt / us at her first visit ? I need another beer.

Heh, no, not replace a $12 test,hehe. Just give some ammo if the test comes back in the realm of maybe I can put this person on a drug for the rest of her life.

 

[imoldernu]

http://assets.harvardvanguard.org/app_assets/adulthealthhistoryformfemale_20120620t160550_en_04926eb4-1140-490a-a395-ee65dcc7eb6e.pdf
Framework for discussion.

 

[savory]

In addition to all the other advice, I would call your insurance company to see what they cover BEFORE the appointment and if there are any labs less expensive. Our physicals were 100% covered until this year. They charged us $35 to transport our specimens to the lab. Amazing to me. You may not have much choice about the tests but if you know the tests that are covered, the Doc maybe able to work with you, reducing your costs. At minimum, make sure the doc codes everything right? so you don't have long conversations with your insurance company.

 

[Khan]

Khan, I am so glad to hear that you are going for a checkup! Here are my suggestions, which are not from a viewpoint of expertise but are from somebody who sincerely cares about you and your health. Which, I do.

When you see the doctor, be sure he understands that you have not seen a doctor in 20 years. That way he will hopefully understand that he cannot just rush you through. In fact, you also might want to alert his office of this because they might want to schedule a possibly longer appointment for you.

Bring a written list of any questions or symptoms you may have had. Then go through your list with him.

If you are like me, you will freeze up and forget to ask something important unless you have it on paper in front of you. That is why I suggest you bring the list.

You have mentioned some serious hereditary conditions in your family history, that you may have. Ask if you can be checked for those conditions.

Congratulations for taking this big step!

Thanks, I am working on all of that.

 

[Khan]

As a retired federal employee I have excellent insurance.

 

[W2R]

Thanks, I am working on all of that.

Great! Sounds like you are all set.

As a retired federal employee I have excellent insurance.

Bring your insurance card with you to the appointment, if you have it. They'll probably want to the information off of it, so that they can file the claim for you.

 

[ER Eddie]

Make sure to request a prostate exam.

 

[REWahoo]

Make sure to request a prostate exam.

 

[obgyn65]

What you are suggesting is not standard of care.

Heh, no, not replace a $12 test,hehe. Just give some ammo if the test comes back in the realm of maybe I can put this person on a drug for the rest of her life.

 

[travelover]

Not to hijack, but an observation.

I've had a physical every year for the last 30 years. In the past, the doc would have you strip down to nothing but a gown, and check your whole body for moles, check your feet, look into every orifice including a prostate check, thunk your abdomen, check for hernias (cough!).

During this last exam, I was fully clothed, spent most of the time answering questions and practically had to beg for a cholesterol test. (Was good last year, no need to repeat yearly). I don't know if this was policy change or the fact the the doc I got was a recent grad., but I'm starting to wonder what an good physical should entail.

Back to Khan.

 

[Stanley]

Don't fear modern medicine. It is a great tool and we benefit mightily from it. But, also, do not fear questioning modern medicine. Doctors today are rushed and pressured from all sides. As human beings they will make mistakes at times, and at other times take the easier way out. You must manage your own care to the best of your ability. A doctor is a professional you hire to do to a job. Nothing more.

 

[JakeBrake]

Back in the day when I was retired but before I was on Medicare, my doc bemoaned the fact that my insurance, United Healthcare, did not tell the doctor what tests and exams could be performed on a routine annual physical that would be 100% covered by insurance. What doc wanted was a list from UHC for the exams/tests that could be performed and would be reimbursed 100% as part of a routine annual physical, that is, with no diagnosis or symptom stated.

Disclaimer: My UHC insurance was provided through my Megacorp, which is self-insured. UHC handled the paperwork and Megacorp made the rules and paid the bills. It's different now that I'm on Medicare. UHC/Megacorp lets Medicare decide what to pay.

 

[Mulligan]

Not to hijack, but an observation.

I've had a physical every year for the last 30 years. In the past, the doc would have you strip down to nothing but a gown, and check your whole body for moles, check your feet, look into every orifice including a prostate check, thunk your abdomen, check for hernias (cough!).

During this last exam, I was fully clothed, spent most of the time answering questions and practically had to beg for a cholesterol test. (Was good last year, no need to repeat yearly). I don't know if this was policy change or the fact the the doc I got was a recent grad., but I'm starting to wonder what an good physical should entail.

Back to Khan.

That has been my recent experiences, and that is why I haven't gone in over 3 years. I now just get my BP and cholesterol checked on my own for free at health fairs when they pop up. When I turn 50 I may go and see if a doctor can convince me to get my prostate and/or colon checked.

 

[Buckeye]

Be careful. If you mention an "ailment" during your first visit the visit probably will not be coded as a 100% covered "wellness" visit. The office visit and the tests now become related to whatever ailment you complained about. If you want this visit to be covered 100% under "wellness benefit," my suggestion is to save any complaints for the second visit. During the second visit, the doc will have all the results ordered during your covered "wellness" visit and can order any additional as required to address your specific complaint.

If this is your first visit to this doctor, the doc's office may code the visit as a "new patient exam" which may not be covered 100%. Maybe your insurance is good enough that you won't end up paying much even if the visit is not coded as a "wellness" visit but I don't want you to be surprised when you discover that the office call and the tests are not covered 100% under your "wellness" benefit.

My doctor moved away and I wanted to go in for a covered "wellness" exam with another doctor. I called and talked to the billing weenies at the doctor's office and they said they would not code the first visit as a "wellness" visit that is 100% covered even though I have no complaints and I am coming to see the doctor for a "wellness" check. Looks like I'll have to first pay about $100 for a "new patient visit" ("Hi, I'm a new patient. Can I go now?" and then return for a 100% covered "wellness" visit that includes blood tests. I have a high deductible policy so I pay the first $6,000 in charges.

My annual "wellness" check and associated tests are covered 100% without meeting my deductible but I am at the mercy of the doc's office and how they code the visit. I have to be sure how the visit will be coded before I step in the door or I could be surprised by the bill.

Asking for pain meds on the first visit might caused a raised eyebrow. I'm not sure I'd go there.

 

[obgyn65]

Just go, get it done, and keep healthy. There. I have been both on the provider side and on the receiving end also, no need to make a big deal out of this.

When I turn 50 I may go and see if a doctor can convince me to get my prostate and/or colon checked.