He went through a list of things. "When was your last colonoscopy?" Art couldn't remember. The doctor told him he might need to get one. "It's 3-5 years if they found a polyp and 5-10 years if you haven't had a problem. Good luck trying to find a doctor to do a colonoscopy since you're on Medicare," he warned us.
"Would you like a prostrate test, checking your PSA? I wouldn't recommend it. It's very controversial and much more often than not lead to unnecessary further testing and treatments. You don't really need a cholesterol check since you run."
"How about a skin check?" he asked.
"Could he see a dermatologist?" I asked. "Art runs in the sun and he's got a lot of dark spots on his skin. Moles?"
"On Medicare, I doubt it. The medical profession in the U.S. is not perfect. Doctors don't want to take Medicare patients."
"Maybe Art should go to Kaiser then," I asked. I figured my mother belongs to the Kaiser HMO and her doctor really seems to care for her, is personable, and refers her to all kinds of specialists when she needs to see one without a problem.
The doctor was affronted. I didn't think he would care. "Maybe I shouldn't schedule so many blood tests for you then, since you might go to Kaiser like your wife says."
The bottom line was that he felt Art didn't need to see a doctor so often because he doesn't smoke, isn't overweight, and eats healthy foods. He felt that seeing a doctor too often just causes unnecessary testing and sometimes leads to unnecessary treatment. He did the skin check for Art and did not find abnormalities, just age spots. Art will go for some blood tests tomorrow and a follow up next week. His last words were that "Clean living is what keeps you healthy."
I left the office not very thrilled, with a matching scowl to the doctor. I like my doctors to care. I like my doctors to be warm and smile occasionally. I also like my doctors to be smart. Well this doctor hit one out of three.
On the way home, Art said, "You know what? I like this doctor. He doesn't want to see me often. He's against unnecessary testing and he's smart."
I guess as far as Art is concerned, the good doctor hit three out of three.
I'm going to see my nurse practitioner, Kathy at Tripler in a couple of weeks. I love Kathy. She always hits 10 out of 10 for me.
Well, it's a good thing that Art is too healthy to need a doctor.
ReplyDeleteSo many things in your post shock me. Obviously I don't understand how Medicare works.
Art should subscribe to HMSA 65-C, the insurance plan that accompanies Medicare. Most doctors will accept it.
ReplyDeleteThank God David still works and has me on his health plan. We belong to HMSA-HMO, which is excellent.
Happy to hear Art's check up was a good one. He's a good role model to the rest of us. I wish I had my in-law's doctor, she is a lady who is near retirement age though, and I know they're going to miss her when she does retire. I wish she lived near me as they are always singing her praises.
ReplyDeleteKay, that's kind of funny...different doctors appeal to different people. So it seems Art's fine where he is.
ReplyDeletetoo funny, my husband is like yours except he doesn't go to the doctor at all...
ReplyDeleteI am on Medicare and belong to a clinic that takes Medicare patients. I had to wait for a couple of months on a waiting list before I was processed into the clinic, but I love my new doctor, who cares (important to me, too, Kay!).
ReplyDeleteHe doesn't sound like a doctor I would like much, but the important thing is that Art likes him (and he has you for backup to make sure he gets what he needs).
ReplyDeleteI'm with Art on this, I avoid doctors unless I'm ill and don't care for too many routine tests unless there's a good reason for them. My current doctor said that there's not much point me having a cholesterol test since I can't take the medication. I don't much care for taking any other medications either. I prefer to eat and drink healthily and hope for the best.
ReplyDeleteI think he should get on Kaiser. Art may be healthy now, and he fits the "good health" models we are all supposed to follow, but he still needs a comprehensive workup at his age. Even if he would rather avoid it.
ReplyDeleteOh Boy Kay --
ReplyDeleteI think docs should be more personable, (only about 10% genuinely are,)but they're processing too many patients. The "why are you here?" is a bit abrupt, and my wonderful internist or his Nurse Practitioners will ask, "What brings you here today?" Much more pleasant.
It's usually the women who get family members to docs. Men delay and don't like to go. They treat it more like a business interaction too, which may be why Art likes the doc he saw. Some docs get flustered with wives attending non-critical appointments. Having a list of questions is good, too.
He IS of the newer breed of doc which THINKS before ordering unnecessary tests, which WAS borne out of HMOs trying to spend as little as possible per patient.
Most women don't like that type.
Compare the options since he's got Medicare too. I know the military benefits vary from vet to vet, and can intermesh with Medicare in a jillion ways. How that intermeshes will be different at another location. Having a secondary "back-up" option would be nice if there were any future serious events, but I think Art is healthily "outrunning" the bad possiblities. DrumMajor
Goodness, you are the second blog where I have heard that doctors no longer want mecicare patients or will no longer accept medicare assignment which means we are responsibile for what medicare writes off. Thanks, think I need to make a phone call.
ReplyDeleteThat is too funny that Art liked that doc. Like you, I need a bit more.
Arkansas Patti -- I've been hearing of many doc offices, "no longer accepting Medicare patients," for about 8 years. I can't remember what lack of reimbursement law occurred to cause that trend. Bummer. DrumMajor
ReplyDeleteWait. We have COCKROACHES???!!
ReplyDeletewalt (catching up)
I loved the Doctors at Kaiser. They cared and they were smart!
ReplyDeleteWhat I kept thinking as I read about Art's doctor is that he doesn't seem to believe in preventative medicine.
Kay, what's the doctor's name? I want to go to him... He sounds like 10 out of 10 for me!
ReplyDeleteRe: yesterday's post, don't forget about the $8 cereal, too.
Arnold
Do you and your husband accompany one another to doctor appointments?
ReplyDeleteI'm with you, Kay. I know he's trying to save money, but you want him to be thorough. Glad Art is so healthy.
ReplyDeleteDid I miss yesterday's post?
ReplyDeleteFunny you should mention your different attitudes toward doctors.
Our doctor has different attitudes toward patients.
He sees Dick (who is healthy) far more often than he sees me, with my umpteen certified illness and my disability pension. He never says "Come back in six weeks" to me but Dick is forever being sent for blood tests, and going in to have them reviewed.
Very strange, there and here.
— K
Kay, Alberta, Canada
An Unfittie's Guide to Adventurous Travel
Shane would like Art's doctor too. He seems to be straight to the point. I like a doctor with more personality. I love our children's dentist. She is very energetic and out going with the kids. Shane could take her or leave her.
ReplyDeleteThe selection of doctors is a very personal choice. Thankfully, I have several who care for me. All of them are caring and supportive. I ask for the blood tests that I think are necessary. I have thyroid problems, so I want to stay on top of things.
ReplyDeleteWe have a supplemental that pays what Medicare does not. I know many do not, so I am grateful to have that.
My doctor told me last week that if they see Medicare patients and have not gone to totally computerized records, they will penalized by Medicare. She is willing to pay the difference rather than switch the way she does her record keeping. Others are just not seeing Medicare patients.
dkzody: We accompany each other sometimes, especially when we want to make sure somebody else is hearing the same thing. I might also ask questions that Art might not want to. Art comes with me if I'm seeing a specialist so he can hear exactly what's being said and ask questions I might not think of because I'm preoccupied.
ReplyDeleteArt used to go to Kathy at Tripler before he got on to Medicare. She was very unhappy that he ended up on his own because Tricare told him he'd have to go with somebody else if he continued on at Tripler. She still asks about him which I really appreciate. Art likes to see Kathy with me sometimes so he can make sure I don't lie (stretch the truth) to her about how often I exercise.
Arnold: What kind of cereal are you eating anyway? You sure it's not the Costco 100 pound bag?
ReplyDeleteI'll be happy to give you the name of the doctor... but really... I think you'd want somebody with better bedside manners.
then they're called quacks.
ReplyDeleteKay - This blog topic is a hoot.
ReplyDeleteOkay: I've learned that 100 pound bags of cereal cost $8, (sounds like a bargain,) but storing such a bag may attract cockroaches in Hawaii.
If more docs knew that patients considered them genuine quacks for having poor bedside manners, more new docs might learn some social graces.
I consider a doc a quack when he has a bad communication stance AND doesn't know what he's doing with the direction of diagnosis, care, and irregardless of insurance approach or rules, orders painful unnecessary tests. When other competent docs on the case see this type of care, they cringe and don't want to be associated with them. SOME docs made low grades in med school, and just squeaked though. If they survive residency, we nurses can tell they didn't do well in school/residency.
In a civilian hospital, I've had docs take 3-4 hours to return calls to the hospital, and 3-4 days to return a call to the patient. Again, from a civilian hospital, I've called docs about patients, and the doc said, "oh, I didn't look at the labs this morning when I was there at the hospital."
I estimate about 10% of docs do what they should.
Sounds like Tripler has specific docs, and maybe other nice NPs, to handle the Medicare-only type of patients. It takes a long time for docs to align their practice to what the darn insurance plan requires or limits. It's hard to be a good doc these days. Some order, or don't order labs, based on the insurance's approach: prevention or spend as little as possible to fix a worsening aliment.
The VA patients get different primary docs alot. When hospitalized, they get different docs weekly because of the teaching rotations.
Stay healthy! It's scary out there!
Disclaimer/Credibility: My Dad was a doc in the '60s-'80s. He said, "today's nurses are yesterday's doctors." I didn't know what he meant until I graduated from nursing school. Behind the counter, when the doc is writing orders, and we know how much they did/didn't talk to the patient, or ask the nurses about their patients, do we learn what kind of doc they really are. DrumMajor
I'm with Art on this one, on the whole: the doctor told it to him straight, and didn't see the need for unnecessary tests.
ReplyDeleteThe only thing I didn't like was that he dismissed the skin check.
If you are worried, Kay, take photos and measurements of various moles around his body once a month, and compare them. You'll soon see if there are changes.
Well, I'm glad Art liked him. I didn't.
ReplyDeleteI think it's time to find another doctor. One who at least has some social skills along with knowledge.
ReplyDeleteTook me years to get The Hubby to actually go to a regular doc and not a minor emergency clinic most of the time. Now he has a physical every year! Makes me feel better for sure.
ReplyDelete