I'm really starting to Dislike and Distrust Doc's

I don’t mean to call you out on anything but I think quick fix goes beyond prescription pain killers, ambulance calls and dr visits.

mahtofire14 wrote:

Headaches, fevers, when all people need to do is take a freaking tylenol.

This sort of contradicts this:

mahtofire14 wrote:

Our society these days are so focused on lightning quick responses and fixes that the second they have any kind of twinge or pain they call the hospital or the ambulance.

I feel Tylenol is only an another example of how drug companies have a death grip on us. Literally!!!

Ok, now I do disagree with everything you said…….You certainly take things to the extreme Biggill.

mahtofire14 wrote:

Ok, now I do disagree with everything you said…….You certainly take things to the extreme Biggill.

Why is that? What benefit does Tylenol have to treat a fever? Fever is your bodies defense mechanism against infection. Chills force you to seek a warm place to help elevate your body temperature. Aches, headaches and exhaustion force you to prevent movement so you can heal. There are certain bacteria that can’t live in conditions above 102F. There are studies that show fever suppression prolongs illness which elongates the window for spreading the illness. Even the Mayo now recommends not treating a fever at 102 Or less. https://www.mayoclinic.org/diseases-conditions/fever/in-depth/fever/art-20050997

Fever reducers have their place but they are far far overused today.

Celiac disease can cause headaches, joint pain and skin rashes, among the other more common symptoms like abdominal pain and fatigue. It also has a genetic component. Check and see if your daughter and wife had a blood test called “tissue transglutaminase” performed. If so, and it was positive, they have Celiac. Stop eating gluten and no drugs will be needed. Their symptoms will go away.

If they haven’t had the test done, request it, but have them continue their regular diet. If they stop eating gluten beforehand, it may show a false negative.

Another one to look out for is Lyme’s disease. That S.O.B. is a tough one to test for though.

mahtofire14 wrote:

BEING ABLE TO TOLERATE A SMALL AMOUNT OF PAIN

I’m an RN on a post surgical floor where we also see a lot of fractures. I don’t mean to generalize, but its sad to see how each of the different generations react to pain. There are exceptions to this, but I’ll get this little old lady who fell and broke her hip only wanting Tylenol or.. if she gets crazy, an ibuprofen for pain. Then, we will get some middle age blue collar man in with a scheduled hip replacement requesting for his max dose of Oxycodone as early as he can get it. One of the first things I noticed when I first started.

Most other countries don’t use any source of narcotic for these same surgeries but our patients absolutely demand it. Everyone is so quick to blame docs, but don’t understand how most of our patients “require” these narcs.

You know what you call the guy that graduates at the bottom of his med school class?

Doctor.

tbro16 wrote:

<div class=”d4p-bbt-quote-title”>mahtofire14 wrote:</div>
BEING ABLE TO TOLERATE A SMALL AMOUNT OF PAIN

I’m an RN on a post surgical floor where we also see a lot of fractures. I don’t mean to generalize, but its sad to see how each of the different generations react to pain. There are exceptions to this, but I’ll get this little old lady who fell and broke her hip only wanting Tylenol or.. if she gets crazy, an ibuprofen for pain. Then, we will get some middle age blue collar man in with a scheduled hip replacement requesting for his max dose of Oxycodone as early as he can get it. One of the first things I noticed when I first started.

Most other countries don’t use any source of narcotic for these same surgeries but our patients absolutely demand it. Everyone is so quick to blame docs, but don’t understand how most of our patients “require” these narcs.

I do the same job and have noticed the same thing. Younger male patients are, hands down, the biggest wimps. They can be some of the worst patients to have. I’ve seen them stay in the hospital for 5-15 days due to poor pain control and refusal to work with therapies for the same surgery that generally requires a 2 night stay and doesn’t require inpatient rehabilitation afterwards.

ClownColor wrote:

First and foremost, make sure you are actually seeing a doc and not a NP or alike (sorry if someone one here is in the role).

I disagree with this. My family has had excellent experiences with NPs, PAs, etc. Both my wife and I have switched primary care to a NP. It has been my experience that these professionals spend more time gathering information and assessing the presenting concern. They are also always in consultation, primarily because of how thier roles are structured under physicians. This means that they are less likely to “wing it” and more likely to consult with one, or several others. Consultation is ongoing learning, and a wise professor once told me that fancy doctorates “expire” in about 8 years without ongoing study and learning.

I’ve had hit or miss experiences with residents/students (to be expexted) but the NPs my family has seen have been great. Wife and I are both in health care.

mahtofire14, Bass Thumb, and tbro, thanks for your first hand experience in this discussion.

Something that has been touched on and I think needs to be revisited, a GP is just that, a GP. They are not specialists in every field. They won’t have all the answers for every ailment.

Specialists cost more money. A good GP coordinates health care decisions either by treating high probability outcomes first or by coordinating care for the patient through multiple specialists and chronic conditions.

They use evidence based treatment methods. Meaning treating what is statistically the most effective outcome to common problems based on the problem presented to them.

The question becomes, should the most cost effective treatments that treat known common ailments be the first treatment?
The trade off would be, have them keep the patient for a day or longer to get to the root of the problem at a cost of thousands of dollars for something that often could be cleared up with a dose of penicillin or a Tylenol.

If 90% of the time the antibiotic and or Tylenol works, should they really be spending thousands digging deeper on every case?
If so, we would be here complaining about the blatant overcharging in health care for unnecessary testing and care.

TV has taught that all our problems should be remedied in a half hour. Vanity aside, it may take some time to to resolve an issue.

fishthumper wrote:

The wife is now seeing a Dermatologist. She just had to jump thru lots of Hoops prior to being referred to one. Now its 2 pills and them Blood work and repeat for several weeks to see if the new oral med is working.

What you’re describing sounds more like an insurance company problem than a doctor problem.

You have to understand that now it’s really the insurance companies that are dictating much of the care you receive and the order you receive it in by nature of what they will and won’t pay for. They also dictate the ORDER in which care must be delivered, so essentially the insurance company is now as much in control of your healthcare as your doctor is.

For example, my wife just had hip surgery, but even though the ortho said there was no way anything except surgery would heal this tear, the insurance company mandates that he HAD to send her through a course of PT sessions first. Again, the ortho said to her that this was like prescribing PT for a broken arm, but appealing this would take weeks and actually delay the surgery. So off to 4 weeks of useless PT she went, just to satisfy the insrance company.

Insurance companies now dictate that before seeing a specialist in certain cases, the primary care doctor’s treatment has to be given a period of time to work. Again, it’s all about cost cutting and limiting your choices.

Also, because of the insurance company’s RX formulary, doctors now often have to try a cheaper medicine first, even if they feel a more expensive one offers a better chance. The insurance company will simply deny payment unless you follow their rules.

The key here is to start asking questions about why your doctor is following the course of treatment he’s following. Is it what he/she wants to do or is he/she doing it because the insurance company mandates it be done this way?

Sorry that both your wife and daughter are having health problems, but I suspect your frustration with the course of treatment is being driven more by your insurance company than the doctors.

Grouse

tindall wrote:

I disagree with this. My family has had excellent experiences with NPs, PAs, etc. Both my wife and I have switched primary care to a NP. It has been my experience that these professionals spend more time gathering information and assessing the presenting concern. They are also always in consultation, primarily because of how thier roles are structured under physicians. This means that they are less likely to “wing it” and more likely to consult with one, or several others. Consultation is ongoing learning, and a wise professor once told me that fancy doctorates “expire” in about 8 years without ongoing study and learning.

I’ve had hit or miss experiences with residents/students (to be expexted) but the NPs my family has seen have been great. Wife and I are both in health care.

Agreed. That was bad advice. A Dr isn’t necessary all the time. It is often worth seeing a NP or PA. I’ve been seen by PA specialists, audiology and gastroenterology with great outcomes.

I suppose his next advice will that brand name drugs are also required for the best outcome.

TheFamousGrouse wrote:

What you’re describing sounds more like an insurance company problem than a doctor problem.

You have to understand that now it’s really the insurance companies that are dictating much of the care you receive and the order you receive it in by nature of what they will and won’t pay for. They also dictate the ORDER in which care must be delivered, so essentially the insurance company is now as much in control of your healthcare as your doctor is.

For example, my wife just had hip surgery, but even though the ortho said there was no way anything except surgery would heal this tear, the insurance company mandates that he HAD to send her through a course of PT sessions first. Again, the ortho said to her that this was like prescribing PT for a broken arm, but appealing this would take weeks and actually delay the surgery. So off to 4 weeks of useless PT she went, just to satisfy the insrance company.

Insurance companies now dictate that before seeing a specialist in certain cases, the primary care doctor’s treatment has to be given a period of time to work. Again, it’s all about cost cutting and limiting your choices.

Also, because of the insurance company’s RX formulary, doctors now often have to try a cheaper medicine first, even if they feel a more expensive one offers a better chance. The insurance company will simply deny payment unless you follow their rules.

The key here is to start asking questions about why your doctor is following the course of treatment he’s following. Is it what he/she wants to do or is he/she doing it because the insurance company mandates it be done this way?

Sorry that both your wife and daughter are having health problems, but I suspect your frustration with the course of treatment is being driven more by your insurance company than the doctors.

Grouse

The theory behind this is based on statistical evidence. Not that I agree with it.

Patients often turn to multiple providers for resolution.

The provider can only see the care they delivered. They cannot see what happens to the patient after they leave. For that reason, they do not have all of the data to create the probabilities of outcomes based on given treatments. This is a common issue for care givers. They issue a prescription, PT, surgery, and or Rx, and never see the patient again. They don’t find out how it turned out for the patient.

The insurer can see all the care sought by the patient regardless of provider visited and aggregate up all of the treatments through the outcomes to see which treatments create the best affordable outcomes.

IMO, this process needs an easier way to be bypassed when the outcome Dx is clear.

Anecdotally, I had a coworker go through the same mess. Stepped off a curb while on vacation and thought he sprained something. Saw his Dr after returning home from vacation. Rules said he had to go through PT.
He had a torn cartilage in his hip. During that PT the torn cartilage broke up worse and ended up with bone on bone in his hip socket.
Had he gone through arthroscopic surgery instead of PT it could have been fixed right away. Instead he ended up with painful cortisone injections in his hip while waiting for a painful hip replacement surgery.

On the news last week about doctors leaving the medical profession , either retiring or quitting early . Why? Burnout, doctors being overwhelmed with paper work. Instead of actually doing what they were trained to do , they are being forced to deal excessive amounts of paper /computer work. Which takes time away from being a doctor.

Kyhl wrote:

<div class=”d4p-bbt-quote-title”>tindall wrote:</div>
I disagree with this. My family has had excellent experiences with NPs, PAs, etc. Both my wife and I have switched primary care to a NP. It has been my experience that these professionals spend more time gathering information and assessing the presenting concern. They are also always in consultation, primarily because of how thier roles are structured under physicians. This means that they are less likely to “wing it” and more likely to consult with one, or several others. Consultation is ongoing learning, and a wise professor once told me that fancy doctorates “expire” in about 8 years without ongoing study and learning.

I’ve had hit or miss experiences with residents/students (to be expexted) but the NPs my family has seen have been great. Wife and I are both in health care.

Agreed. That was bad advice. A Dr isn’t necessary all the time. It is often worth seeing a NP or PA. I’ve been seen by PA specialists, audiology and gastroenterology with great outcomes.

I suppose his next advice will that brand name drugs are also required for the best outcome.

EDIT. I want to say sooooo much but it’s off topic.

To each their own…and well, to your side comment…We would you even say that about drugs? Next time you need Chemo ask for the generic brand!

Well the Daughters Blood work came back as all mostly normal. The only thing not within the normal range was her Iron Level was a little on the low side. I’m waiting for my wife to forward me the full results. So on one side I guess all the blood work being normal is a good thing. On the other hand we still are right where we were before. Still headaches and dizziness. I’m sure they will want us to bring her back in and then refer us to a specialist. I think we may try a few different things ourselves prior to starting down the specialist route. That is unless the problem continues or gets worse.
I still believe the whole medical situation is a real BIG MESS and I don’t see anything getting any better anytime soon. As much as I’m totally against anymore government involvement, I’m not sure how this situation can be fixed without them stepping in. I just don’t think with the devide between the parties right now they are capable of fixing anything.

Did you check if they had the tissue transglutaminase test?

Celiac causes malabsorption which can decrease iron absorbed from your diet.

walleyevision wrote:

Did you check if they had the tissue transglutaminase test?

Celiac causes malabsorption which can decrease iron absorbed from your diet.

I was kind of thinking the same thing. Headaches is also one of the symptoms of celiac disease.

walleyevision wrote:

Did you check if they had the tissue transglutaminase test?

Celiac causes malabsorption which can decrease iron absorbed from your diet.

They did not run the blood work for Celiac. My wife called them and asked if this test was done or could be done and was told No and No with the original blood Draw. She would need to go back in and have a new blood draw done to have that test done. The Dr. did not think that was the cause as she doesn’t have any of the other normal symptoms that are associated with it. If she continues to have the problem and they need to do anymore blood work I’ll make sure they run the test for sure.

How old is your daughter, and how often does she use a tablet or smart phone?

fishthumper wrote:

Well the Daughters Blood work came back as all mostly normal. The only thing not within the normal range was her Iron Level was a little on the low side. I’m waiting for my wife to forward me the full results. So on one side I guess all the blood work being normal is a good thing. On the other hand we still are right where we were before. Still headaches and dizziness.

Unfortunately, this demonstrates that some conditions are simply hard to diagnose. The problem with “headaches and dizziness” as symptoms is that they are symptoms of almost every condition known to medicine and they rule out almost none of them.

I agree you should certainly try some common sense things on your own, but not honing in on relatively rare conditions. When was her last full eye exam? Do symptoms go away if screen and phone time is cut down to 5 minutes per hour or less? And then there’s diet to consider, you don’t mention age, but regardless at almost every age there are dietary issues that should be considered.

Grouse

ClownColor wrote:

EDIT. I want to say sooooo much but it’s off topic.

To each their own…and well, to your side comment…We would you even say that about drugs? Next time you need Chemo ask for the generic brand!

You are right. I steered it off topic and hit a nerve. My apologies for striking the nerve.

fishthumper wrote:

<div class=”d4p-bbt-quote-title”>walleyevision wrote:</div>
Did you check if they had the tissue transglutaminase test?

Celiac causes malabsorption which can decrease iron absorbed from your diet.

They did not run the blood work for Celiac. My wife called them and asked if this test was done or could be done and was told No and No with the original blood Draw. She would need to go back in and have a new blood draw done to have that test done. The Dr. did not think that was the cause as she doesn’t have any of the other normal symptoms that are associated with it. If she continues to have the problem and they need to do anymore blood work I’ll make sure they run the test for sure.

Has she had a head CT? I would hope to God that its not this but a lot of things pushing on the brain or optic nerves can cause headaches, diziness, nausea, etc. I would hope they would’ve ruled that out already.

tornadochaser wrote:

How old is your daughter, and how often does she use a tablet or smart phone?

She’s 15 – Way to Much. I’m going to start putting a limit on that !!!!

The only thing I will add to this discussion is that it can be extremely helpful to find a general practitioner that you trust and build a relationship with them. This can be helpful in coming to a correct diagnosis because any prior relationship/knowledge between the patient and the physician can narrow down uncertainty when diagnosing the issue. Secondly it can be greatly helpful to have an advocate “inside” the system who knows you when it comes to being able to get you to the appropriate specialist with the least amount of delay.

As pointed out earlier this is similar to other professions as well… Three very important things to make your life easier in cases where things go wrong are primary care Dr. you know and trust prior to becoming ill, a mechanic who you know and trust prior to having vehicle issues, and a good insurance agent who you know and trust prior to filing a claim. Good old fashioned personal relationships really can be valuable!

Will

mahtofire14 wrote:

Has she had a head CT? I would hope to God that its not this but a lot of things pushing on the brain or optic nerves can cause headaches, diziness, nausea, etc. I would hope they would’ve ruled that out already.

No they have not done a CT yet. My guess is we are more than a few visits to several specialist away from that point. Currently her headaches and dizziness are not debilitating. But they are bad and often enough to get in the way of her normally daily life. I think I have a few ideas I want to try with her prior to taking this any further with the medical profession. At least as long as the situation does not progress or start to cause her any additional problems. I think several small factors may be coming into play here. Her current diet, Sleep patterns, unnecessary stress, and electronic device use just to name a few. I don’t think I’m going to be the most popular parent for awhile, but if that is what it takes for her to start feeling better and develop a healthy lifestyle – then so be it.

Will Roseberg wrote:

and a good insurance agent who you know and trust prior to filing a claim. Good old fashioned personal relationships really can be valuable!

I’m not sure I can trust My insurance agent I am a insurance agent and my insurance agent.

Will

There are so many causes of headaches. Some of the more common such as caffeine, artificial sweeteners, msg, and even nitrates. Some simple things that curtailed my migraines significantly.

Good luck

tbro16 wrote:

<div class=”d4p-bbt-quote-title”>mahtofire14 wrote:</div>
BEING ABLE TO TOLERATE A SMALL AMOUNT OF PAIN

There are exceptions to this, but I’ll get this little old lady who fell and broke her hip only wanting Tylenol or.. if she gets crazy, an ibuprofen for pain. Then, we will get some middle age blue collar man in with a scheduled hip replacement requesting for his max dose of Oxycodone as early as he can get it. One of the first things I noticed when I first started.

I would assume most of this is because back when that old lady was young the oxy wasnt a thing. Now they give them to you for hangnails. Every one this day and age knows it and it’s easily abused. I would think it’s as easy as giving them out and prescribing them to make some money. Other wise the doc would know best and say no.

ClownColor wrote:

First and foremost, make sure you are actually seeing a doc and not a NP or alike (sorry if someone one here is in the role).

I’m sorry you have and share this opinion Bob. I’m not going to change your experiences by posting on a fishing forum but hope others/readers keep an open mind.

As a physician assistant I like to say I know what I know, and I know what I don’t know. When I don’t have the answer I’m talking with my physician colleagues and the patient benefits from that extra set of eyes/ears.

Practicing (yes) medicine is hard…whether you’re a PA, RN, CNS, NP, med student, intern, resident, fellow, physician, surgeon or specialist. Patients don’t always (or even often) “read the textbook.”

As in any profession there are good providers and there may be a few bad ones. Thanks to those who already spoke up in defense of our majority during this thread. My PA/NP colleagues are some of the most dedicated, capable, caring providers I know.

You’ve all touched on some big issues with healthcare-far more than I dare get into.

fishthumper-I wish your family health!

-tg
I’m not a doctor. You can call me Rich.

Is your daughter on any daily medications or get any regularly scheduled injections? (Sorry if this was already answered, I started skimming after a while).