Dr's & routine physicals: are my expectations too high?

[momz]

yeah, those well visits are just to review your screenings, what has been done, what are you do for, anything been missed. The recommended screenings are based on your age. That's pretty much all a well visit is. Anything more in depth is a referred as a problem visit. So, if you are having any specific concerns, schedule a problem visit to discuss it.

The advantage of a well visit is to 1. find a hidden problem through screening and 2. maintain a relationship with your doctor so that when you need them, you can get an appointment.

If you skip your well visits too long, you will be removed from the active patient list and when you call for a problem, they will say you're not a patient of that practice.

 

[Silver saucer]

I found it can depend on the terminology of what Im asking for. I once scheduled a pap and that was exactly what I received. Nothing more. What I wanted and should have asked for was a complete annual physical. That seemed to take care of the issue for me. I also learned to ask when booking appts to ask for length of time etc.
Good luck! Its so hard to find doc you like and trust.

 

[ndelaware]

My last doctor's appointment was about 18 years ago, I guess I am the wrong person to ask.

 

[Karin1984]

It sounds more like a different opinion of the word 'well', the doctor seems to think it means only checking some vitals (probably as you are healthy and no concerns). To you it means something more eloborate.

Discuss it with your doctor, maybe for your next appointment it shouldnt be "a routine well" visit but schedule a "thorough check up examining X, Y and Z'.

 

[AnnaS]

I started to go for annual physical with my primary about 10 + years ago.

I make my appointment early in the am so I can fast. She draws blood. I also give urine sample. They give me a breathing test (forget the name/blow into a tube - put down fire type of thing) to check lungs. They ask me a ton of questions for memory. Say months of the year backwards, tell me something to remember and 15 minutes later ask me what the word/phrase was. I also fill out a sheet about sleeping pattern, depression, etc. I am given an EKG. There is the usual check my throat, ears and listen to my lungs. She also does a breast examination and touches my stomach/pelvic area. She makes sure she has all tests from mammo, OB/GYN, asks me when last dentist, eye appointment was and last colonoscopy. She wants to make sure I go.

She did ask if I had been anywhere since COVID (vacation/she knows we go away/to FL/cruises all the time). She asked me if I had been sick or had been tested. I said no to both. Have not been anywhere for months/did not babysit for months and not sick. No need for testing and don't plan to.

She is very good and thorough. I love that she calls me a day later with my results. Not all doctors do this (I know my DH's primary does not).

 

[John VN]

On my last doctor appointment. It wasn’t the same because of covid. She Usually checks my prostate since my dad had prostate cancer. Nope not that time. Covid is going to cost more lives in the future than the actual covid deaths.

I hope that at least a PSA test was performed along with your other blood work. Prostate Cancer (PCa) can be present even if not felt during a DRE. Sadly it is the number 2 cancer killer of men and it doesn't have to be because with proper monitoring that is cost effective and easily done the death numbers could be reduced.

 

[aprilgail]

My gen family practitioner does my yearly- does hearing test, ekg, breathing test, blood pressure, full blood work up and give me my yearly referral for mammo.- They eventually call you with blood results but I always just go online and look myself.

 

[loves to dive]

That's about how mine go too except they take the blood there in the office. They schedule my mamo appt. and hand me a Cologuard test, they do the results there in the office. I have to go in every three months to get my prescriptions filled (they swear it's an insurance thing but last year I didn't have insurance and they still insisted). Usually for the 3 month visit it goes: nurse weighs me and takes me to the exam room. Another nurse comes in and opens the computer, takes temp, blood pressure and pulse ox. Doc comes in checks heart and lungs and asks how I'm doing and do my prescriptions need to go to the same place. That's it. Since Covid 19 they still insist I come in person. Same routine except oddly enough they don't take a temp. The Doc doesn't listen to heart and lungs in an effort to keep distance. Just asks if I'm having any problems breathing. I get an annual mamo (have no other lady parts so no other exams necessary). I used to get a bone density every two years because the doc had the machine in their office. The machine broke and they said it wasn't worth the money to get it fixed and since insurance, for some odd reason, won't cover it at anywhere else, I just don't get one. I'm 63, weight within what it should be for my body stature and age, have osteopenia, and have had two biopsy's on breasts but otherwise in great health.

 

[Imzadi]

I was actually very surprised not a single question came up about COVID... how are you coping with it, etc. I live alone and while I wouldn't say I'm depressed or anything, the social isolation has been hard. I've been working at home since March and our 10 minute conversation was probably the longest in-person discussion I had that week. No questions about diet or exercise this visit. I hear you on getting in and out fast - on the one hand, I'm happy to have a quick visit because I find them stressful but on the other - well, I'm only there once every year or two so I want a decent checkup.

Did you bring up any questions you have? I wanted to know if any pre-existing conditions I have put me at high risk for COVID if it gets worse this fall & winter. Only one condition does and I'm scheduled to get a lung function test done to rule me out or in as high risk.

If your doctor didn't seem open to any questions, then next time, shop around for a new doctor.

 

[happily single]

Several of you mentioned seeing an internal medicine doctor as opposed to a family practice. Can you explain in more detail what the difference is? Would the internal medicine be able to see/treat you for a pulled back? Sinus infection, etc?

I just had my annual visit in May. The medical assistant did the weight/height, blood pressure, temp, etc. She handed me my medication list and asked me to review it. She asked if I had any issues or concerns to talk tot he doctor about.

The doctor then comes in, reviews her computer file, does the quick exam while I'm still in street clothes, tells me I need annual blood work. She will also ask how I'm feeling, if there is anything she can do to support me, etc. I'm torn on how I feel about her as a doctor, but I do feel her annual exams are complete

 

[a1tinkfans]

I left a family medical practice.
I see specialists as needed, Gyn, Local oncol, But Memorial Sloan Kettering For Any C q/concerns, Opthamologist, etc
They are all board certified.
I see an Internist as my regular dr. and get the care I feel is appropriate, never rushed. I especially like his demeanor/approach as both caring and confident which makes me feel confident. They too typically only call with issues/concerns with blood but I requested a call Every time and they comply. He calls after hours ..and I truly appreciate that.
I am also quite happy with his follow up and help ( the oncologist never called me with results that she sat on for a week. That office required dr to speak with me ( regardless of results). My internist was kind enough to access it and put me at ease until she could call, well over a week later ( which I find unacceptable)

 

[shh]

Part of the problem might be that you're seeing a physician with a specialty of Family Practice. I've had bad luck with them. If you want a more thorough & comprehensive annual physical, go to a doctor with a specialty of Internal Medicine instead. Every time I've seen a FP doctor, it's the 10-15 min and out the door routine. But with Internal Medicine docs? They actually sit down, listen, ask questions, & consider my feedback when coming up with a plan.

good advice...you nailed it. Mine's a FP too. I was just thinking to myself after posting if switching to an IM might be better

 

[shh]

The advantage of a well visit is to 1. find a hidden problem through screening and 2. maintain a relationship with your doctor so that when you need them, you can get an appointment.

Agreed. But that would be so much more valuable if we didn't have a few baseline screenings that were arbitrarily decided upon as appropriate for the entire population, just based on something so generic as age.

If we each could get an "allowance" of wellness spend per year - and the doc could gear our screenings to each person's individual risks and history, we could catch so much proactively early on.

But they shoehorn everyone into the same tests for blood sugar, cholesterol, etc.

Just using me as one anecdotal example, I have zero family, lifestyle or personal history of things that are big risks for many (heart disease, diabetes) - with many years of negative testing to prove it. However, I DO need different basic screenings for things I'm actually at higher risk for, but none of those are covered under annual wellness/ bloodwork testing.

So I pay 100% out of pocket for every preventive screening I need...and get a bunch for free that I really don't. Illogical.

"If you skip your well visits too long, you will be removed from the active patient list and when you call for a problem, they will say you're not a patient of that practice."

Good point...that does have value.

 

[shh]

tell me something to remember and 15 minutes later ask me what the word/phrase was.

Crap...I'd fail that now - and I think (hope) I'm reasonably functional cognitively. But my short term memory's always been less than great even when I was a kid.

"She is very good and thorough. I love that she calls me a day later with my results. Not all doctors do this (I know my DH's primary does not)."

I'll say! I've never heard of any primary doc around here doing all that. Lucky you - hold on to her! I live in FL...it's been really hard for me to find medical services that are both reputable and caring - sometimes the doc is great, but front office staff is really rude and dismissive - just make you feel like an intrusion on their day. Sometimes the staff is nice, but the doc isn't really welcoming or personable.

 

[tvguy]

My Doctor is pretty thorough. But he offers a lot of tests, which this year have really drained my bank account. His response when everything comes back normal....."well we have a baseline on file now"

 

[AnnaS]

Crap...I'd fail that now - and I think (hope) I'm reasonably functional cognitively. But my short term memory's always been less than great even when I was a kid.

"She is very good and thorough. I love that she calls me a day later with my results. Not all doctors do this (I know my DH's primary does not)."

I'll say! I've never heard of any primary doc around here doing all that. Lucky you - hold on to her! I live in FL...it's been really hard for me to find medical services that are both reputable and caring - sometimes the doc is great, but front office staff is really rude and dismissive - just make you feel like an intrusion on their day. Sometimes the staff is nice, but the doc isn't really welcoming or personable.

I know what you mean about the memory. I am starting to leave post it notes everywhere.

My Physical was on 8/26 and my Doctor's last day at the practice she was in was 9/10. I am following her. She is joining another doctor/office. Besides the practice they were in, they were doctors for the Fire Department and Police Department (retired from that). She happens to be a good friend of a friend of mine (did not know that until years after going to her) and my doctor's sister had hired my sister as a caregiver for their mom (also did not know that until after the fact). Small world.

All doctors are definitely not the same. Some no bedside manner, some barely give you the time of day/listen, don't take you seriously, office staff is horrible, might have long waits. I have heard it all as many for sure. I have been telling my sister to leave hers since she is always complaining.

I hope the office people and the routine will be the same where she is going.

 

[kymom99]

I had a well visit yesterday. I was concerned about reflux and barretts esophagus since my dad had it and my sister currently has it. I like that he isn't big on pushing prescriptions. Previously he suggested I try OTC prilosec which I did but its a 14 day course. Shortly after the 14 days the discomfort would return. He told me he didn't think my symptoms were severe enough to need a scope and that I should not be afraid to take the prilosec for a couple months straight then stop and see how things are. He said if I'm not healing completely then the heartburn would return and that's probably what is happening. I asked for a bloodwork order prior to the appointment so we had the results for the appointment. He said everything looked perfectly normal and keep doing what I'm doing. He did not mention the 15 covid lockdown pounds I gained.

I'm perfectly fine with this type of doctor visit.

 

[unrequited23]

I worked in a small pulmonology practice many years ago. The appointment blocks were 15 mins long, with three patients scheduled per block for one Dr. Yup, 5 minute appointments.

 

[Walt4ever]

Lately I've been really underwhelmed by doctor's appointments... am I expecting too much?

Personally, I think having a good relationship with your doc is important. If the one you have isn't right, ask friends, family, etc., for recommendations and change. Change every year if you need to until you find the right one. I found mine via a co-worker of my daughter's. The co-worker recommended him to daughter, who recommended him to me.

I don't think family or internal makes a difference, it's the person doing the job. Mine is a family doc and is great. Might take an hour of waiting to see him, which can aggravate some people, but he spends time. I think I was in there 3 hours one time, but that was a "we'll work you in" appointment, not a routine one. It's not something that rattles me. For annual physicals, I get the whole workup in his office (EKG, chest xray, blood drawn, etc), then get scheduled for a follow up 2 weeks later to review blood workup. That one is shorter, but he goes over every line, what's good, what's bad, how to fix what's bad (he's not big on meds being the first option). If anything is particularly bad, he has me come back in 3 months to see if whatever his fix was improved it. For those, he tells me to come in first think one morning to get my blood drawn and schedule an appointment a week or so later when the results are back. He then goes thru them line by line again comparing, then makes any adjustments needed if any.

I'm about to switch gyn because I'm not happy with him. I had been going to his older brother for years, he had delivered my youngest two, then he retired, so sort of fell into seeing the younger one (same practice). Not the same, so will be switching before my next annual.

If you do decide to change, I'd recommend not going to another one in the same office. It may be awkward. I had an ENT that I had been going to, who happened to be a woman. Had an appointment with another ENT in the same office, who happened to be a man. He left the door open when he walked in with her standing just outside to ask me why I changed. I don't know if she thought it was because she was a woman, or wanted feedback if it was an issue with her personality/style, or what. But the truth was my sinus's were hurting and she didn't have an appointment available that day so I asked for just whoever was available. The whole thing made me not want to go back there again!