When you just don't feel well....

[GGT]

...or feel "right". How long do you wait to make an appointment with a doctor?

When you do make the appointment, are you clear or super vague? (Fever longer than a week, a rash that won't go away, or just "not feeling right".)

When you do see the doctor, can you pinpoint what's bothering you, with a straight answer to, "What brings you here today?" (sore throat, stiff joints, pain in a certain place)

Or do you expect to give a long laundry list of every ache and pain, with detailed answers about every symptom, and have it all figured out and explained in 15-20 minutes?

What are your expectations for your problem-oriented physician visits? Are they realistic?

[oldmunchkin]

First of all, everyone should make a list of things they want to ask the doctor about. If it seems like a "laundry list" so be it. We should all take responsibility for our care, and be an enlightened patient. For instance, if you have "joint pain", you will probably need to be a bit more specific. "Doctor, my hips and knees are swelling up and are very painful. It gets worse when I stand up after sitting or lying down." If you have done any research, you should tell your doctor what you found, and what treatment options you would feel comfortable with.

How long to wait before making an appointment depends on a number of things. If it's a sudden, extremely obvious or bothersome problem, you should try to get in as soon as possible. On the other hand, if you are one of the millions without medical insurance, you probably try to go as long as possible between visits. Up until I got sick, I was regularly seeing my doctor, exactly once a year for prescription renewals. Even now, I only go once every month to 6 weeks, simply because I can't afford to go any more often. I also can't afford any follow-up visits or visits to specialists, so those don't get scheduled at all!

Your questions beg the other side of the story too. What are your expectations from your doctor? Do you expect him to listen to your concerns and act on those concerns? Is it reasonable to expect him/her to spend time talking over the things that concern you the most, those that bother you worse than they do him? Is it reasonable to expect that you know how your body is supposed to feel? And if it doesn't feel right, do you expect him to try to ease your concerns by working with you to fix those concerns?

[GGT]

Sounds like the difference between a complete physical and a 15 minute office visit. Anyone who's recently been hospitalized and evaluated by many different services shouldn't expect an hour long complete physical for what's basically a discharge follow-up visit.

[oldmunchkin]

Sounds like the difference between a complete physical and a 15 minute office visit. Anyone who's recently been hospitalized and evaluated by many different services shouldn't expect an hour long complete physical for what's basically a discharge follow-up visit.

I was asked, when I called to talked to the I-gotta-know-all-the-details person at the front desk, if I was just doing a follow-up or if I had other concerns I wanted to discuss with the doctor. I told her I had other concerns, that I couldn't afford to come just for a follow-up. She blocked out an hour for him to talk with me. As we spoke, I noticed he wouldn't answer certain questions or discuss certain concerns I had. All he wanted to talk about was my normal blood tests, and get my prescriptions written. He didn't seem to want to think I might have any kind of problems that were not related to my previous illness. It almost seemed like my medical identity stopped the day I was released from WMC.

[GGT]

Yet, you had an entire HOUR with your doctor. Did he not do a physical exam or look at your chart history? Sounds like he did all that plus more, including reviewing your blood tests, looking at your meds and renewing prescriptions. Do you really believe if he'd seen danger signs from your subjective complaints, physical exam, review of labs and meds....that he wouldn't have done something you needed? Really?

[GGT]

....She blocked out an hour for him to talk with me....

You should consider yourself lucky.

I was trying to recall any time I had one full hour of a physician's full and undivided attention. Not with two long labors and C-section deliveries. Not with breast tumor removal surgeries, including needle-location biopsies under radiology. Not even a pharmaceutical psychiatrist who works in 15 minute increments, or a MSW or family therapist who works in 45 minute increments.

My ex had less than one hour of attention from his surgeon before undergoing mitral vale repair open heart surgery. There was time spent on analysis and planning that neither of us knew about. He had much more than one hour of his surgeon's expert attention during surgery, and the days post-op, but he was knocked out and doesn't remember a damn thing. He doesn't remember the times after midnight that I'd see the surgeon check in on him, talk to the nurses, read his chart, write some orders.

Everything after that arrived in 15-20-30 minute increments, until he could do the physical and respiratory therapy on his own, and be discharged.

[Lor]

...or feel "right". How long do you wait to make an appointment with a doctor?

That would depend on the severity of what I'm worried about. I've never been scared of the doctors but I tend not to go for silly things. If I get certain pains in my personal parts, my heart or a vital organ then I'll go.

When you do make the appointment, are you clear or super vague? (Fever longer than a week, a rash that won't go away, or just "not feeling right".)

Clear.

When you do see the doctor, can you pinpoint what's bothering you, with a straight answer to, "What brings you here today?" (sore throat, stiff joints, pain in a certain place)

Or do you expect to give a long laundry list of every ache and pain, with detailed answers about every symptom, and have it all figured out and explained in 15-20 minutes?

What are your expectations for your problem-oriented physician visits? Are they realistic?

I usually get straight to the point. The last time i went to the doctors was a few months ago, the time before that was last year and before that was a few years ago. My last known prescription was in 1999.

[GGT]

Was hoping for more replies. Then we could see when our different expectations are cultural, or related to national health services vs private insurance.

"On the other hand, if you are one of the millions without medical insurance, you probably try to go as long as possible between visits. Up until I got sick, I was regularly seeing my doctor, exactly once a year for prescription renewals. Even now, I only go once every month to 6 weeks, simply because I can't afford to go any more often. I also can't afford any follow-up visits or visits to specialists, so those don't get scheduled at all!"

[Dreadnaught]

I think a lot has to do with age and general physical well-being.

I have a weakish eyeglasses prescription but I haven't had my eyes re-checked since 1999 (or gotten new glasses). I had to cancel an appointment for an echocardiogram in 2003 and never rescheduled.

These are things that aren't critical, but that I really should do. Yet I have no desire to make the time for them because I feel fine and I'm busy. But if I had more time on my hands and actually felt chest pains or couldn't see well, I would probably make the time.

[GGT]

Why would your physician prescribe an echocardiogram that wasn't necessary? Why did you feel comfortable canceling that, but others may have tried hard to figure out how to get it and pay for it, because their doctor recommended it?

[Flixy]

Last two times I went to the doctor, I was clear, and it was fairly obvious what the issue was, just needed a prescription and a referral for an x ray. Took maybe two minutes to get that, spent a few more chatting about my life, where I went to college, and that was basically it.

Also, gp visits are always fully insured for everyone here. They want the bar low for people to seek medical advice, and they act as triage for hospitals (you are NOT supposed to go directly to an ER here if you have something). Gp's are cheaper than the ER after all.

[GGT]

Setting the bar low for people seeking medical advice from a GP is called preventative medicine, but the US doesn't operate that way. Instead, we have millions of people using the ER, either to get a chest x-ray and a prescription, or for more advanced care because a simple office visit was too expensive.

[Flixy]

Which is odd, considering ER visits cost more than a GP visit.

[GGT]

No one ever said the US system made sense.

[Dreadnaught]

Why would your physician prescribe an echocardiogram that wasn't necessary? Why did you feel comfortable canceling that, but others may have tried hard to figure out how to get it and pay for it, because their doctor recommended it?

Arguably I did need it and still should get one. But that's arguable enough that when I had to cancel it (for scheduling reasons) I didn't feel a rush to re-schedule. It's a long story. I next thought about it when I didn't have insurance during college for a chunk of time, but obviously wasn't going to schedule then.

[Rageaholic]

The last time I visited a doctor was in 2003 (possibly 2002?) for an ear infection. Well, actually I just went to a walk-in clinic - I couldn't tell you the last time I went to an actual doctor doctor, but it would've been a few years before that. I was pretty clear about the problem, due to my ear hurting like a bastard. In hindsight, I probably waited a bit longer than I should've to get it looked at.

(Edit: Wow, I could've sworn I'd posted here before, but apparently not. Uh, hi. )

[GGT]

uh, HI! A walk-in-clinic still means seeing a doctor. They're staffed by actual doctor doctors.

[Rageaholic]

True. But for the sake of clarification, when I said "doctor doctor" I meant like a family physician. I probably should've just said that in the first place.

[oldmunchkin]

Yet, you had an entire HOUR with your doctor. Did he not do a physical exam or look at your chart history? Sounds like he did all that plus more, including reviewing your blood tests, looking at your meds and renewing prescriptions. Do you really believe if he'd seen danger signs from your subjective complaints, physical exam, review of labs and meds....that he wouldn't have done something you needed? Really?

I think we can positively say that this specific doctor won't be here much longer. Why? Because he does take time to talk to his patients and doesn't just rush people thru in 15 minute frames. He isn't as interested in the bottom line as he is in the patients themselves! Of course, every time we get a decent doctor in BFE the hospital board finds a reason to fire them and then hire doctors who have had their license in jeopardy in other states!

Past all that, Dr. P. did not take anything I was saying seriously. It was kinda like, "Oh well, if I ignore her complaints, she will shut up about them." IMO, a doctor should take any and all of a patients complaints seriously. For example, he was dwelling on another normal blood test. Well shit, the last 4 have been normal, so lets move away from that nonsense...ok? Let's discuss the fact that my waist is all of a sudden 38 inches! Let's discuss WHY! Let's discuss the fact that I am losing hair with all the speed of a person on chemo! Let's discuss WHY! Let's discuss my joints, which are stiff to the point of being almost frozen. Let's discuss WHY!

I mean, c'mon! I explained to the beast at the front desk, when I called, what I needed to discuss with Dr. P. I explained I needed new scripts for my Protonix, Premarin, and Lyrica, so I can get them directly from Pfizer. I explained I also had some concerns that needed to be addressed. Beast carved out the time for me since she knows I don't have the money to come over a separate time for each concern. Dr. P. wrote the scripts, checked my chart from last visit to this one, and told me I was gaining too much weight! Well NO SHIT! But, when I told him I really thought a lot of it was fluid retention, he balked at that!

I told him my hair was falling out. I told him that last appointment, and the one before that, and the one before that. My hair does NOT fall out for no reason. Every time my hair does this, I am seriously ill or have a major infection. He acted like it was all vanity on my part, and was nothing to worry about...because all my blood work is normal. Well, something is wrong, and I can feel it.

Is some of my problem based on intuition or "gut feelings"? Sure. After all, who knows my body better than I do?