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Our Health Care System- my appt today personified issues...

2,051 Views | 20 Replies | Last: 1 mo ago by Aston04
Aston04
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My annual "wellness" physical appt (that I am required to take from my work) gave a good example of what's wrong with our healthcare system imo:

-Couldn't get in to my doctor (tried to book my doc a couple months ago), instead saw nurse practitioner I have never seen before at same office.
-He rushed me through a series of questions from his computer. Even asked me if I was "still taking" two medications I have never taken before (not sure how that got in their system).
-When detailing my medical history, it felt like he had trouble following along and just wanted to keep answering boxes in his computer.
-Didn't bother to celebrate my successes (great blood pressure, HDL going up over time, weight in appropriate range, me reporting I lift and run frequently, don't smoke, etc).
-Physically only checked my breathing and blood pressure.

I feel fortunate I wasn't reliant today (at least as far as I know) on his help or encouragement.
Captain Winky
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It sounds like you were checking off a box by getting the physical just like he was checking off the boxes he needed to. What kind of celebration were you expecting?
Aston04
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AG
Captain Winky said:

It sounds like you were checking off a box by getting the physical just like he was checking off the boxes he needed to. What kind of celebration were you expecting?


Maybe a good job? Maybe - why is it your fitness/diet working so well? Or how long have been exercising? Or what do you do to exercise? Or any kind of analysis what's going on with my hdl (he didn't notice).. or analysis of the blood data..or noticing I have a serious food allergy on my chart and asking how that's going?

Other than listening to me breathe, a trained monkey could have done as well as he did ..

Not good healthcare.
aggiederelict
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God forbid someone expect to be heard as a patient. Patient centered care requires the provider to actually care but our system isn't set up very well for that.
RustyBoltz
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AG
Here's your blue star. Feel better?

There's a lot of issues with our healthcare system but quick, efficient, non-intrusive wellness visits to lower your employers' insurance costs is hardly one of them.
zachsccr
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Except if patients were more incentivized to go BEFORE there was a major problem, the majority of health care costs would go way down. We spend a grossly disproportionate amount on the already very sick.

It's much easier to handle 1 issue than someone with 18 comorbidities. The OP making cholesterol changes and life style changes to reenforce the improvements should be celebrated.
TurboVelo
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zachsccr said:

Except if patients were more incentivized to go BEFORE there was a major problem, the majority of health care costs would go way down. We spend a grossly disproportionate amount on the already very sick.

It's much easier to handle 1 issue than someone with 18 comorbidities. The OP making cholesterol changes and life style changes to reenforce the improvements should be celebrated.
If patients want to be incentivized and celebrated, they should start by giving a spit about their own healthcare in the first place. Instead, he's only going because his employer required it, but then he's expecting special treatment when he gets there?

My doctor is a personal friend and rides with me regularly. I can ask him questions on rides or shoot him a text. He personally cares about my health, and DOES celebrate my successes (and gets onto me about the things I'm doing wrong).

If you want that level of service, seek out a provider that you want to have a relationship with. Don't use the one contracted by your employer that you only see because your employer requires it.

And yes, the OP should be celebrated. Making those changes and sticking to them isn't easy, as this board can attest to. We've seen our own successes and failures. So I'm also giving him a blue star (and with sincerity).
Aston04
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Honestly- I need zero reinforcement at this point from a stranger. I've been working my a** off for 10 years to maintain a really good level of fitness for my age. I find it self-motivating and feel like I'm missing out if I go a couple days not working...

But if the nurse pract is not even encouraging healthy behavior at a wellness visit, it's discouraging on what he's actually doing in these visits with people. On the flip side, is he even bothering to advise obese people (etc) to lose weight? Probably not imo. With the very little attention to detail he gave- I find it very unlikely he would uncover much of anything at these visits...

I remember getting a physical (with an actual md) 15 years ago and it being very different. Much more inquiry to what's going on and ruling out possible concerns...
P.U.T.U
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More and more doctors offices and places like CVS are using nurse practitioners, I went to a new doc and he complained about it for 20 minutes which was annoying.

At the end of the day you are responsible for your own health, to most medical and insurance companies now you are just a number.
Matsui
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AG
i hear you - its not great
tejas_ayanem
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I've never had a doc encourage me to continue a healthy lifestyle, but I am also not unhealthy.
KidDoc
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Good on you for taking care of yourself!

From your narrative that is a horrible yearly well exam. Completely unacceptable. We get paid good money to do those and they need to be comprehensive. I only see kids but for my teens I go over BMI changes (good or bad), vision, hearing, blood pressure, head to toe exam, depression screen, their hobbies and interests, long term plans and how to achieve them, sleep quality and habits, substance abuse concerns, sexual health, any chronic issues that are on their problem list. If the problem is gone, delete it from the list.

Sad to hear that you had an unacceptable experience. Try and schedule with a PCP a year in advance to establish the relationship and if you get another unacceptable visit then find a better doc.
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Lavender Gooms
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What KidDoc said - lazy and unacceptable. Sorry you had a bad experience. Not all of us perform such lazy exams. I do all of my annual physicals the exact same from head to toe. Plus health maintenance things like age appropriate cancer screenings and vaccines, alcohol and tobacco, and lab reviews.

I will say it's definitely a challenge to develop much of a patient/provider relationship with my 1 time a year (max) patients, but it can be done.

Given it sounds like you're overall healthy, just make it a point to wait for the annual exam with your regular PCP if possible.
TurboVelo
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Aston04 said:

Honestly- I need zero reinforcement at this point from a stranger. I've been working my a** off for 10 years to maintain a really good level of fitness for my age. I find it self-motivating and feel like I'm missing out if I go a couple days not working...

But if the nurse pract is not even encouraging healthy behavior at a wellness visit, it's discouraging on what he's actually doing in these visits with people. On the flip side, is he even bothering to advise obese people (etc) to lose weight? Probably not imo. With the very little attention to detail he gave- I find it very unlikely he would uncover much of anything at these visits...

I remember getting a physical (with an actual md) 15 years ago and it being very different. Much more inquiry to what's going on and ruling out possible concerns...
Yet, you started this entire thread and condemnation of a system because you weren't reinforced enough by a stranger that you didn't want to see, and only encountered because you were required by your employer.

It's not the Nurse Practioner's job to do anything other than record data. You're asking a grocery store cashier for diet advice...

If you want an actual relationship with an MD, maybe give a spit more than showing up when your job is on the line.
Aston04
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I've gone to my annual physical every year for 17 years. Not sure why the attitude.

Max Power
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Unfortunately there's good an bad apples in every industry, including healthcare. I finally told my doctor a couple of months ago about anxiety I've been having for about 3 years now. My appointment ended up being with his physician's assistant. She was good during the Q&A session and to follow up with that they did a full blood panel, chest x-ray, and an EKG. I'm 44 so I get that they needed to check me up and down to see if there were any signs of heart disease or other underlying issues. Everything came back good, but it was like she was surprised/confused that a guy my age takes care of himself. I wasn't joking when I said I exercise regularly, don't smoke, don't drink, etc. Maybe that's more a result of the rest of the populace they're used to treating over there but it felt like the Q&A was legit, only to be followed up by a witch hunt afterward, like they were trying to catch me in about something I had said.
True Anomaly
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Max Power said:

Unfortunately there's good an bad apples in every industry, including healthcare. I finally told my doctor a couple of months ago about anxiety I've been having for about 3 years now. My appointment ended up being with his physician's assistant. She was good during the Q&A session and to follow up with that they did a full blood panel, chest x-ray, and an EKG. I'm 44 so I get that they needed to check me up and down to see if there were any signs of heart disease or other underlying issues. Everything came back good, but it was like she was surprised/confused that a guy my age takes care of himself. I wasn't joking when I said I exercise regularly, don't smoke, don't drink, etc. Maybe that's more a result of the rest of the populace they're used to treating over there but it felt like the Q&A was legit, only to be followed up by a witch hunt afterward, like they were trying to catch me in about something I had said.
Exactly this

I'm also 44, and my PCP is shocked I'm in as good a shape as I am. But he's still ensuring that there aren't subtle signs of asymptomatic disease that could rear its ugly head later on and to get in front of it early.
Claude!
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I actually just had an appointment with my primary care physician (I guess technically she's a PA). She's actually the fourth or fifth PCP I've had in five years at this practice, but she and all the others have been genuinely good. Seems to ask the right questions and is interested in the answers, gets on me about what I need to do, and celebrates my success.
Diggity
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AG
hopefully he at least measured your BRI

https://www.healthline.com/health-news/is-the-body-roundness-index-the-new-bmi-what-it-says-about-your-health
BadMoonRisin
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Didn't even stick a finger in your butt
Aston04
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BadMoonRisin said:

Didn't even stick a finger in your butt
lol

Colon cancer is a concern to me based upon gut issues I've had in the past ....

But no.
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