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Author: WendyBG Big gold star, 5000 posts Top Favorite Fools Top Recommended Fools Feste Award Winner! Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: of 884988  
Subject: Annual physical worthwhile for well? Date: 1/21/2013 8:34 PM
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http://well.blogs.nytimes.com/2013/01/21/a-check-on-physical...


New York Times, January 21, 2013
A Check on Physicals
By JANE E. BRODY

...

... an estimated 44.4 million adults in the United States undergo preventive exams each year....

The Nordic Cochrane Center in Copenhagen analyzed the findings of 14 scientifically designed clinical trials of routine checkups that followed participants for up to 22 years. The team found no benefit to the risk of death or serious illness among seemingly healthy people who had general checkups, compared with people who did not....

Among possible harms from health checks, they listed “overdiagnosis, overtreatment, distress or injury from invasive follow-up tests, distress due to false positive test results, false reassurance due to false negative test results, adverse psychosocial effects due to labeling, and difficulties with getting insurance.”...

“We did not find an effect on total or cause-specific mortality from general health checks in adult populations unselected for risk factors or disease. For the causes of death most likely to be influenced by health checks, cardiovascular mortality and cancer mortality, there were no reductions either.”...
[end quote]

This applies to people who are healthy. It doesn't apply if someone develops a symptom. If you develop unexplained pain, shortness of breath, digestive problems, a lump, a skin lesion that doesn’t heal, or unusual fatigue or depression, consult your doctor without delay.

Personally, I get a blood test once a year that checks glucose, HDL, LDL and triglycerides and measures of thyroid, kidney, liver, etc. It costs $100. I also go for a routine physical which my insurance mostly covers to make sure I am listed as an active patient before I go on Medicare in several years. (Like many practices, it does not take new Medicare patients.)

I beg to differ that the wellness check makes no difference. When my blood test showed high triglycerides (even though I felt fine), I radically changed my diet (gave up carbs). If I hadn't done that, I might have diabetes now.

I think that annual physicals make sense for people who are willing to make lifestyle changes if their health parameters start to deteriorate. I think that annual physicals don't make sense if a person wouldn't change regardless.

The issue of overdiagnosis is serious. Plenty of evidence is coming in that early diagnosis (of, e.g. tiny breast calcifications found on mammograms) may lead to overtreatment of a benign condition. This is a caution to do research in such a case.

Bottom line: There's probably no harm (and possibly significant savings) in skipping an annual physical for healthy people. But it's not cut and dried.

Wendy
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Author: BlueGrits Big gold star, 5000 posts Top Recommended Fools Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870752 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/21/2013 9:44 PM
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It might be that those conscientious enough to have annual physicals are similarly vigilant when it comes to their own health.

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Author: ataloss Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870760 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/22/2013 6:47 AM
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Keep immunizations up to date, and get the screening tests specifically recommended based on your age, gender and known risk factors, including your family and personal medical history.

Probably if you could easily do only this you would be fine. Usually the doctor has another agenda. Reminds me of the car dealer who wanted to do an expensive 60,000 mile service. I just wanted what was required in the owner's manual.

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Author: VeeEnn Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870763 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/22/2013 9:01 AM
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Usually the doctor has another agenda.

What....to get rich quick by recommending lifestyle changes that're going to make you sicker, maybe?

I have a pal who's a cardiologist and his mother made a cross stitch sampler for his office....Please keep us in business..START SMOKING

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Author: MetroChick Big funky green star, 20000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870764 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/22/2013 9:10 AM
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There's probably no harm (and possibly significant savings) in skipping an annual physical for healthy people. But it's not cut and dried.

One issue is our population of "healthy" adults in the US is falling as overweight/obesity rates increase. In surveys I've seen, a lot of adults also don't want their doctor bringing up their weight problem with them. So we probably have a significant population who has their heads in the sand that they're "healthy", who are at risk of disease caused by being overweight. So if you tell the US population "you don't have to go to the doctor once a year if you're healthy", you're probably going to get a lot who over-estimate their "healthiness".

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Author: VeeEnn Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870765 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/22/2013 9:35 AM
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So if you tell the US population "you don't have to go to the doctor once a year if you're healthy", you're probably going to get a lot who over-estimate their "healthiness".

Well, that's the problem with these medical soundbites.....when all you read is a quick message, you miss out on all the caveats. I suspect this blog is the result of a press release concerning some study or other that the blogster's reproducing uncritically without even looking at the original study.....a.k.a. Science By Press Release.

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Author: Brooklyn1948 Big red star, 1000 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870766 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/22/2013 9:45 AM
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I have an excellent doctor. I see her once a year for a physical.
Under my husband's current insurance plan I paid nothing for the physical. She found a lump on my thyroid which turned out to be nothing, thank goodness. I also see an obgyn each year and she too found a lump. She is not on my insurance plan but she is one of the best doctors in the neighborhood and I trust her implicitly. I am currently being monitored by an oncologist but so far I am OK.
I cannot say enough good things about these doctors although I have had a few bad ones in the past.

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Author: toberead Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870767 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/22/2013 9:46 AM
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This applies to people who are healthy. It doesn't apply if someone develops a symptom.

Another problem is that if you don't go to the doctor regularly, you may not be able to get in to see the doctor if you have an emergency. Many doctor's won't prioritize "new" patients, no matter how sick they are. And if you haven't been to a doctor for several years, they may consider you a new patient. (My current primary care doctor says they cull out the charts of any patients who haven't been there in 2-3 years.)

I moved to a new city and was there about a year. I didn't have any particular reason to go to a doctor so I didn't go. Then I started having serious symptoms. I called about 20 doctors, but not one would see me right away - the soonest one could "squeeze" me in was 9 weeks. (I explained that I was having serious pain and bleeding, but the doctor's offices just said, we can't get a new patient in any sooner.) I ended up in the ER - which was not really the best place to go with this type of problem, and I ended up spending a lot more money than I needed to. All they could really do was stabilize me and then find a regular doctor who could be forced to see me right away - the actual exam and tests were done in the doctor's office. But I had to go through the ER because no doctor would see a "strange" patient on short notice.

Karen

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Author: Lea77 Big red star, 1000 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870768 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/22/2013 9:55 AM
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I'm a little leery of all these studies that worry about overdiagnosis rather than early diagnosis. I'm not convinced they aren't more worried about money than health. How many people will die from possibly being misdiagnosed initially compared to remaining undiagnosed? I would guess not many.

What may be interesting is the cardiovascular study, since I have heard many versions of the theory that our LDL is not necessarily the best thing to check (or at least that it's more complicated, ie fluffy ldl versus tiny LDL, HDL is more predictive for women, etc). And that lipids may do more harm that good. So I would be interested in more studies on that. Maybe it's not that a physical is no good, maybe they should be checking different things?

Me, I get free HDL/LDL/Triglycerides/Blood sugars checks at work yearly, but I haven't gone beyond that.

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Author: Lea77 Big red star, 1000 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870770 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/22/2013 9:58 AM
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In surveys I've seen, a lot of adults also don't want their doctor bringing up their weight problem with them.

I think most adults who are overweight know it and most doctors don't know how to fix it, or at least they don't have any more knowledge on this than their patients. So, I'm not sure that doctors bringing it up would make much of a difference.

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Author: Windowseat Big funky green star, 20000 posts Feste Award Nominee! Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870773 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/22/2013 10:47 AM
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Me, I get free HDL/LDL/Triglycerides/Blood sugars checks at work yearly, but I haven't gone beyond that.

An occasional check of your blood pressure is also helpful.

There are a lot of problems that patients don't recognize as being serious that a doctor might recognize as trouble. It's possible that a yearly exam isn't necessary, but seeing someone at least every 18 to 24 months can be helpful in catching problems.

Nancy

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Author: Windowseat Big funky green star, 20000 posts Feste Award Nominee! Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870774 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/22/2013 10:50 AM
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Another problem is that if you don't go to the doctor regularly, you may not be able to get in to see the doctor if you have an emergency. Many doctor's won't prioritize "new" patients, no matter how sick they are. And if you haven't been to a doctor for several years, they may consider you a new patient. (My current primary care doctor says they cull out the charts of any patients who haven't been there in 2-3 years.)

My own doctors are all with Mass General, and a couple of years ago when my own doctor didn't have an opening within the next couple of days, she told me to try the walk-in clinic in a neighboring town. This is also run by Mass General, and I went over and saw a doctor there.

Nancy

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Author: Lea77 Big red star, 1000 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870775 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/22/2013 10:51 AM
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An occasional check of your blood pressure is also helpful.

Oh yeah, I forgot that one. I usually get a blood pressure check when I give blood (as well as an iron check) but I haven't in a while. But between blood drives, the occasional use of my parents/grandparents/aunt and uncle's home blood pressure cuff, and the free blood pressure machines they have at stores I think I get that once a year as well. Oh, and they take it when I'm at the doctors office for anything!

Blood pressure is probably the easiest test to get done for free.

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Author: vkg Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870778 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/22/2013 11:31 AM
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overdiagnosis rather than early diagnosis. I'm not convinced they aren't more worried about money than health. How many people will die from possibly being misdiagnosed initially compared to remaining undiagnosed.

Prostate cancer is one of the most controversial. For those with no family history, the risk of treatment is significant. For those with family history, a first PSA test at 50 is too late.

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Author: joelxwil Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870779 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/22/2013 11:36 AM
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I think that if an annual physical were not a good preventive measure, my wife's insurance company would not pay the entire cost, as opposed to everything but the deductable, which is substantial.

Of course the insurance company could be wrong, but what is the harm? Nothing that I can see.

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Author: Retrograde Big red star, 1000 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870781 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/22/2013 11:45 AM
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Blood pressure is probably the easiest test to get done for free.

High blood pressure is also frequently symptomless, so people can walk around thinking they are "healthy" and miss a condition that is causing damage.

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Author: Retrograde Big red star, 1000 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870782 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/22/2013 11:53 AM
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Bottom line: There's probably no harm (and possibly significant savings) in skipping an annual physical for healthy people. But it's not cut and dried.

A lot of people walk around thinking they are healthy when they aren't. For example, high blood pressure is usually symptomless but that doesn't mean it isn't doing damage. The same with high cholesterol, cervical dysplasia and other conditions. The reason insurance companies pay for preventative exams is that they find it cheaper in the long run to catch conditions early while they are still treatable. If you wait until you show symptoms then you have let the damage continue unchecked.

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Author: martybl Big red star, 1000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870783 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/22/2013 12:11 PM
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[T]o get rich quick by recommending lifestyle changes . . .

So what about the critical January checkup with a personal trainer - are you recommending one? Be fun to do a randomized controlled studies with the truly "well" comparing annual visits with a primary care provider to annual visits with a trainer.

My hope would be that if the trainer arm proved to be superior or even non-inferior that we could start taking gym expenses as credits or deductions on our income tax. Between gym membership, trainer visits, and workout shoes and clothes I spend roughly $4000/year. Not a great amount in terms of medical expenses, but enough that it'd be nice to get some credit for it on my taxes.

martybl

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Author: PSUEngineer Big funky green star, 20000 posts Top Favorite Fools Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870785 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/22/2013 12:56 PM
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I check my blood pressure every morning.

PSU

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Author: riprock45 Big red star, 1000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870787 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/22/2013 1:29 PM
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What with being an airline pilot and all (now retired), I had a medical every 6 months for over 40 years.

If I had not, I'd be dead now twice over.

In my early 50's I was super fit, and playing A-division squash. I played hard, did extra fitness work in the gym and on the rowing machine.

On one of the routine medicals, we found that one of my chordae had snapped and the mitral valve in my heart was leaking badly. I had no symptoms and was unaware. The condition was monitored for several years until the leak became severe. At that point I had heart surgery to repair the valve. My Cardiologist said that, had the surgery not been done, I would have died in 3 years or so due to heart failure. At no time was I aware of any symptoms, even up to the day of the op.

Some years later I had my medical; included in the procedure was a blood test with CBC (Complete Blood count). I got a frantic call from the doctor ("Don't go flying!").

Turns out I had been diagnosed with Chronic Lymphocytic Leukaemia (note Canadian spelling) based on the cell counts from the blood test. It was just beginning to take effect. We caught it early. I had no sysmptoms at all, and again was unaware. It was monitored for a couple of years until it reached the stage that it should be treated. I had a mild session of Chemotherapy, and the CLL is now in remission.

I suppose some might wonder about the flying.

I was back at work training in the simulators 8 weeks after the heart op, and was cleared to fly after 12 weeks (I think I set a record with that one). Remember I was was super fit in those days.

I was cleared to fly 2 months after the CLL was diagnosed. I had no symptoms, the cancer had no effect on my ability to work, and there was no danger of, as the authorities put it, "sudden or subtle incapacitation".

I will admit to some emotional unease for a few weeks after the diagnosis. As brave as one might be, a Cancer diagnosis brings unwelcome intimations of mortality, and that's a distraction. It took a while to come to terms with it. Once I did I was fine, and went back to work.

As I approached mandatory retirement age (65), the CLL had advanced to the treatable stage so I underwent a 3-month chemo program. Due to the side effects of the chemo, I was unable to fly. Just after the chemo was complete I reached 65 and retired.

Totally off topic: My last flight was a line training flight to Venice. It was the first time in my career that I had a lady co-pilot.

Rip

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Author: MetroChick Big funky green star, 20000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870788 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/22/2013 1:35 PM
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In surveys I've seen, a lot of adults also don't want their doctor bringing up their weight problem with them.
---------------------------------------------------
I think most adults who are overweight know it and most doctors don't know how to fix it, or at least they don't have any more knowledge on this than their patients. So, I'm not sure that doctors bringing it up would make much of a difference.


But that's why it's important to see a doctor at least annually, because (for example) if you're borderline Type II diabetic and say you don't want to go on medication because "you'll lose the weight", it's important for after a couple years of that for a doctor to have a talk about medication if they see you're not losing the weight.

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Author: VeeEnn Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870789 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/22/2013 1:36 PM
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So what about the critical January checkup with a personal trainer - are you recommending one? Be fun to do a randomized controlled studies with the truly "well" comparing annual visits with a primary care provider to annual visits with a trainer.

I dunno, marty....I earned probably below minimum wage recoomeding such simple expedients to dental health as diligent brushing and flossing and avoiding sugary snacks. Plenty of RCTs to demonstrate the value of that.

I suspect that a good many of my clients spend as much as this on gym membership and personal trainer services etc. etc......with no dent whatsoever in their health, wellbeing and general out-of-shapeness (not unlike the folk who kept me in business as a dentist ;) )

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Author: MetroChick Big funky green star, 20000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870790 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/22/2013 1:39 PM
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I check my blood pressure every morning.

Why? Are you on medication that you need to closely monitor it? I'm on HBP meds, and check mine with a home machine every couple of weeks - but I don't do it in the morning since it's always lower when I've first woken up.

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Author: PSUEngineer Big funky green star, 20000 posts Top Favorite Fools Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870791 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/22/2013 1:47 PM
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Why? Are you on medication that you need to closely monitor it? I'm on HBP meds, and check mine with a home machine every couple of weeks - but I don't do it in the morning since it's always lower when I've first woken up.

Yes, I'm on blood pressure medicine. I monitor my blood pressure to see if the medication is working. I may have been exaggerating some with the every day. I've changed medications several times. With each change, I monitor every day to see if the new medication is working. If it is, I monitor less frequently. When I have migraines, I check more frequently. Often my blood pressure is elevated when I am having a migraine.

PSU

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Author: joelxwil Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870792 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/22/2013 1:58 PM
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I check my blood pressure every morning.

Why? Are you on medication that you need to closely monitor it? I'm on HBP meds, and check mine with a home machine every couple of weeks - but I don't do it in the morning since it's always lower when I've first woken up.


Well, mine, while normal, is usually higher in the morning. It is probably best to take your blood pressure at random times during the day to see if you exhibit a pattern of some kind.

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Author: tconi Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870793 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/22/2013 2:11 PM
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It is probably best to take your blood pressure at random times during the day to see if you exhibit a pattern of some kind.


And Make a Spreadsheet to track it...



peace & hobbies
t

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Author: Lea77 Big red star, 1000 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870794 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/22/2013 2:23 PM
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But that's why it's important to see a doctor at least annually, because (for example) if you're borderline Type II diabetic and say you don't want to go on medication because "you'll lose the weight", it's important for after a couple years of that for a doctor to have a talk about medication if they see you're not losing the weight.

If you are diabetic (or borderline) then your doctor should discuss all treatment options with you, of course. I'm just talking about otherwise healthy adults. There could potentially be some sort of 'doctor authority' coming with discussing weight, but I'm just not convinced that most of the doctors advice would go beyond anything the average patient hasn't already heard.

And in some cases, it could do harm. Considering that studies show those in the slightly overweight category actually have better mortality numbers than those in the average or underweight category. And don't even get me started on the ones using the BMI scale with children, because I have seen so many ways that can go south.

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Author: MetroChick Big funky green star, 20000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870795 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/22/2013 2:41 PM
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If you are diabetic (or borderline) then your doctor should discuss all treatment options with you, of course.

But if you're developing Type II diabetes from being overweight, you might not know it without going to the doctor.

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Author: VeeEnn Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870796 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/22/2013 2:53 PM
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Considering that studies show those in the slightly overweight category actually have better mortality numbers than those in the average or underweight category.

Would these be studies that you've found via a newspaper article or an Internet resource......a.k.a. Science By Press Release ??

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Author: Lea77 Big red star, 1000 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870798 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/22/2013 3:11 PM
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But if you're developing Type II diabetes from being overweight, you might not know it without going to the doctor.

I'm not anti going to the doctor. As I said, I get my lipid profile, etc, done every year.

On the point Karen made, it's not just the doctor you need to check in with periodically, even if you are entirely healthy. AR just passed a law that you can't get the otc cold medicine they put behind the counter now unless you have a 'relationship' with your a pharmacist. I'm not entirely sure what the level of relationship has to be because nobody would tell me, but I couldn't pick up cold meds at walgreens because I got my last prescription filled at Krogers. The LBYM aspect of this, is that shopping around for the best price on this stuff is impossible now.

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Author: VeeEnn Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870799 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/22/2013 3:30 PM
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AR just passed a law that you can't get the otc cold medicine they put behind the counter now unless you have a 'relationship' with your a pharmacist. I'm not entirely sure what the level of relationship has to be because nobody would tell me, but I couldn't pick up cold meds at walgreens because I got my last prescription filled at Krogers. The LBYM aspect of this, is that shopping around for the best price on this stuff is impossible now.

Not sure what your "new" law might be, but if you're trying to purchase anything that contains ephedrine and you're "shopping around" for your cold meds, you're going to look like a meth lab user and enabler (I know, it's crazy.....but it's not my law)

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Author: Windowseat Big funky green star, 20000 posts Feste Award Nominee! Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870800 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/22/2013 3:31 PM
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Found on CNN, published in JAMA, still debated, but interesting.

http://www.cnn.com/2013/01/16/health/weight-study/index.html...

Nancy

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Author: Lea77 Big red star, 1000 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870801 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/22/2013 4:51 PM
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and you're "shopping around" for your cold meds

I'm not talking about buying bunches! I'm talking about if it's 10 bucks at Walgreens and 20 at Krogers, but you filled your last prescription at Kroger you are stuck with the 20bucks. I just think the whole thing is stupid as hell, especially since the whole reason I was trying to buy at Walgreens was because it was the day before thanksgiving and I didn't want to deal with the mess at Krogers.

Also, the lady at Walgreen had the nerve to tell me it would just be 'easier' to get a prescription. This at 7 or 8 pm on the night before thanksgiving. Yeah, that's WAY easier than just buying OTC meds at Walgreens! Sheesh.

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Author: Brooklyn1948 Big red star, 1000 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870802 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/22/2013 5:44 PM
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In surveys I've seen, a lot of adults also don't want their doctor bringing up their weight problem with them.


I am glad you brought this up. I have a childhood friend who is my age, 60+. She is obese and has been for the past 30 years. She now has type 2 diabetes and has to take injections. Pray tell. Has no one told her that she needs to lose 100 pounds and if she did she might not have to take injections every day? I am no slim Jim myself but I looked at the weight charts and if I gain a few pounds I will be in the danger zone for type 2 diabetes myself. You needn't be morbidly obese to get type 2 diabetes either.

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Author: Brooklyn1948 Big red star, 1000 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870803 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/22/2013 5:48 PM
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An occasional check of your blood pressure is also helpful.


Absolutely! Both my great grandmother and grandmother died in their early 40's of massive strokes due to high blood pressure. My blood pressure started climbing up about 5 years ago. I ran out of medicine and called the doctor but it was the weekend and I could not get anyone to call in a prescription. I have a blood pressure monitor (cost $50)
and I started monitoring my own blood pressure and sure enough it went up day by day. I will never run out of medicine again!

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Author: flightdoc101 Two stars, 250 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870806 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/22/2013 6:27 PM
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May I offer my perspective?

The "complete physical" as once administered is pretty archaic. You do not need a neurologic exam if you have no neurologic complaint.

Nowadays, the "physical" is an opportunity for your doctor to review your health screening and see what might be needed: blood work, Pap and Mammo, DEXA scam, colnoscopy, etc; discuss more controversial screening like prostate and explain where the controversy lies; update vaccinations; discuss risky lifestyle choices from poor diet to promiscuity; and even safe storage of firearms.

Undiagnosed depression is common and a great destroyer of quality of life. The same can be said of anxiety. It is often unappreciated even by the sufferer. Elders may be showing early signs of dementia and while there is no meaningful treatment, that does not mean there is nothing to do.

When you come to seem me for stitches or with a headache, I am not going to have a chance to look at your whole picture.

You are always free to not avail yourself of this attention. But why turn your back on hundreds of years of refined understanding of health?
I always thought it was a smart money play to hear what your doctor has to say. I listen to mine....

fd

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Author: ataloss Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870809 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/22/2013 7:46 PM
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What....to get rich quick by recommending lifestyle changes that're going to make you sicker, maybe?

I have a pal who's a cardiologist and his mother made a cross stitch sampler for his office....Please keep us in business..START SMOKING


probably the lab tests, bone density, ekg are more reliable revenue generators (not the only reason and not for all docs)

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Author: Brooklyn1948 Big red star, 1000 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870814 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/23/2013 7:55 AM
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I always thought it was a smart money play to hear what your doctor has to say. I listen to mine....


I think we all need to be our own advocates when it comes to our health.
I have been on osteoporosis meds off and on for years. Several years ago I went to a world renown specialist in Manhattan. He put me on
an injectible drug for two years. After the two year period was up he was only happy with progress being made in the spine. He said "oh well, we will give you another drug that will be beneficial to the hips".
Really? Seriously? Injecting myself for two years in the stomach was not enough? I never went back to him.
Fast forward a few years and I told my internist that I would no longer take those osteoporosis drugs. I decided on a more natural treatment that I found in a book published in the 1960's. Two years later she advised me to have another bone density test. She said if the results weren't good I would have to go back on the bisphosphonates (osteo drugs). I looked her right in the eye and told her that the FDA now wants you to stop all osteo drugs after FIVE years and that I had more than exceeded that limit!!!! She did not know this. Why not I ask? It's her job.
Oh, and I diagnosed my own DVT ten years ago. Was missed by the doctor AND the tech at the lab. Too long a story to go into.
The moral of this story is that we really need to know what's going on with our own health in conjunction with our doctor who cannot know everything!

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Author: AdvocatusDiaboli Big funky green star, 20000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870815 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/23/2013 8:25 AM
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I beg to differ that the wellness check makes no difference. When my blood test showed high triglycerides (even though I felt fine), I radically changed my diet (gave up carbs). If I hadn't done that, I might have diabetes now.


Most people who show such problematic blood parameters are also overweight.
If you're overweight, you really have all the information you need to know that you should change your diet.

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Author: Lea77 Big red star, 1000 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870817 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/23/2013 9:16 AM
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Most people who show such problematic blood parameters are also overweight.

This kind of advice can hurt people who think because they are thin they are going to have no health problems. High triglycerides are not necessarily related to your weight.

Genetics plays a huge role in this stuff.

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Author: sissylue Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870818 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/23/2013 9:23 AM
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Genetics plays a huge role in this stuff.

I have a sister who weighs substantially more than I do. Her blood pressure is generally 92/55. Mine is .... high, very high without medication. I am a TypeII diabetic. She is not. Her blood sugar is ridiculously low given her weight and what she eats. Sometimes life just ain't fair. While being overweight can be considered statistically unhealthy you've always got those people who just don't fit the generalizations.

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Author: flightdoc101 Two stars, 250 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870820 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/23/2013 9:39 AM
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AD

Most people who show such problematic blood parameters are also overweight.


That is not entirely true. There is also a genetic component independent of weight.

fd

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Author: reallyalldone Big funky green star, 20000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870821 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/23/2013 10:20 AM
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This kind of advice

What kind of medical advice is appropriate to take from an internet message board ?

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Author: PSUEngineer Big funky green star, 20000 posts Top Favorite Fools Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870822 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/23/2013 10:29 AM
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What kind of medical advice is appropriate to take from an internet message board ?

What? Don't you get all your medical advice from the New York Times?

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Author: Lea77 Big red star, 1000 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870823 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/23/2013 10:42 AM
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What kind of medical advice is appropriate to take from an internet message board ?

If people don't go to the doctor they are getting their advice somewhere, and whether it is an 'internet message board' or the NYTimes the general idea that fat=unhealth and thing=healthy is pervasive. And wrong. YMMV.

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Author: Lea77 Big red star, 1000 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870824 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/23/2013 10:42 AM
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thing=thin in case that wasn't obvious.

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Author: Brooklyn1948 Big red star, 1000 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870827 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/23/2013 1:23 PM
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What kind of medical advice is appropriate to take from an internet message board ?


I get better medical advice from the Dailystrenth.com regarding
DVT's than I ever got from my own doctor.

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Author: MetroChick Big funky green star, 20000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870828 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/23/2013 2:07 PM
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I'm not talking about buying bunches! I'm talking about if it's 10 bucks at Walgreens and 20 at Krogers, but you filled your last prescription at Kroger you are stuck with the 20bucks. I just think the whole thing is stupid as hell, especially since the whole reason I was trying to buy at Walgreens was because it was the day before thanksgiving and I didn't want to deal with the mess at Krogers.

AZ sounding like a sucky place to live. This definitely is a case of punishing law-abiding citizens because of what criminals do. What if you're there just for a business trip and catch a cold?

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Author: Lea77 Big red star, 1000 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870830 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/23/2013 2:40 PM
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What if you're there just for a business trip and catch a cold?

No idea. I guess you just buy the other cold medicine, although the one the guy at Walgreens recommended instead seemed to be mostly a pain killer. Which is weird.(it's actually AR - Arkansas, not AZ)

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Author: StockGoddess Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870881 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/25/2013 11:04 PM
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I've actually been debating generating not one but TWO doctors as my "primary" doctor so if one can't work me in....the other could. My current one isn't open on Wednesdays. What if I have an emergency on a Wednesday?

By the same token, maybe two "financial advisors" to compare advice....

Well, why not?

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Author: Windowseat Big funky green star, 20000 posts Feste Award Nominee! Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870882 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/26/2013 12:28 AM
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I've actually been debating generating not one but TWO doctors as my "primary" doctor so if one can't work me in....the other could. My current one isn't open on Wednesdays. What if I have an emergency on a Wednesday?

Will your insurance company allow you to do that? I'd be interested in the results.

Nancy

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Author: VeeEnn Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870890 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/26/2013 6:11 AM
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What if I have an emergency on a Wednesday?

If you have an emergency on any day of the week, your GP, primary care "provider" etc. probably should be your first choice

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Author: VeeEnn Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870891 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/26/2013 6:13 AM
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probably should be your first choice

ooops....make that shouldn't

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Author: medgoddess Big red star, 1000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870892 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/26/2013 7:29 AM
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The whole idea of a PCP is a SINGLE doctor who (theoretically) knows all about you, what specialists you have seen. No insurance company would (rightfully) pay for 2 annual exams by 2 different docs.

Many (not all) PCPs now work in groups or with extenders - they are open to see folks every business day. And quite frankly, the "I need to get in now" appointments are usually something that tincture of time can heal, at least from my POV.

Kristi

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Author: cabinsmama Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870893 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/26/2013 9:05 AM
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Just curious: what does your doctor's office say you should do, if you do have an emergency (non-ER type) on the day they're closed? Seems like they'd have a SOP for that.

cm

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Author: hockeymomof3 Big red star, 1000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870895 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/26/2013 10:09 AM
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if you do have an emergency (non-ER type)

If it is an emergency, that is what ER's are for, if not, then you wait until the office is open?

Unless they offer an urgent care center (our local clinic does) on weekends....but again, that is not your PCP.

Teri

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Author: Brooklyn1948 Big red star, 1000 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870896 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/26/2013 10:14 AM
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By the same token, maybe two "financial advisors" to compare advice....


My husband will be retiring in a few days. We have had a financial advisor for many years but my husband did not think the guy was doing very much of anything for us so he decided to do some research on his own. He notified his advisor of what he intended to do and the advisor spent the weekend coming up with a plan that was much much better than what my DH came up with. Long story short, we decided to stay with our original advisor.

As far as doctor's go, I have the same problem. My doctor works practically part time. I have had two emergencies in the past 3 months and my internist told me to go to the ER. She did not have the equipment necessary to diagnose a blood clot or internal bleeding anyway. I was happy with the treatment that I got at the hospital. I had no choice in the matter anyway.

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Author: cabinsmama Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870898 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/26/2013 10:48 AM
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"Emergency" was probably not the right word to use. I'm thinking more of when you know you really need to be seen and get an Rx asap.

One weekday day being closed wouldn't be a deal breaker if it was a practice I liked, especially if they had a number you could call after hours. And part of a good relationship with your PCP is the doc has a better feel for whether your problem can be managed over the phone if the office is closed.

cm

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Author: vkg Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870903 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/26/2013 1:53 PM
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"I need to get in now" appointments are usually something that tincture of time can heal, at least from my POV.

Kristi


There are urgent issues that shouldn't wait a few days. A reason that I like Kaiser is their urgent care clinic. With injuries that aren't serious enough for any priority in emergency, but require treatment arranging a same day (normally in a few hours) appointment in urgent care is good.

Injuries that require cleaning and maybe a dozen stitches or a dislocated toe require urgent treatment. They aren't going away, and are not critical enough to have any priority in emergency.

Having difficulty breathing or tangling with a black widow spider does get attention in emergency.

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Author: medgoddess Big red star, 1000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870912 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/26/2013 3:23 PM
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vkg,
Believe me, I understand the need for UC - went there 2 weeks ago with my daughter after she fell off a horse (concerned about broken wrist). But I can tell you - most PCP offices are not equipped to deal with many things that are truly urgent - casting, need for XRays, stuff like that. It's not the place for it. UC/ER is.

What I am saying is what most people think is "I need an appointment NOW", really isn't. I am a physician...we leave slots open everyday for these "emergencies". I put them in quotes, because most of the time I start rattling off the push fluids, rest, OTC meds spiel. It's a waste of time and money to run to the doc for every little thing. There are exceptions, but most add-in appointments are not needed. tincture of time.

Kristi

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Author: martybl Big red star, 1000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870918 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/26/2013 7:03 PM
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[W]hat most people think is "I need an appointment NOW", really isn't.

If the medical profession could somehow communicate that the "common cold" is viral and not amenable to treatment with antibacterial antibiotics, the demand for short-term appointments would diminish dramatically. One study I read indicated that if people are afebrile, and have neither adenopathy nor an oropharyngeal exudate on physical exam, the odds of their URI being bacterial are under 5%.

martybl

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Author: medgoddess Big red star, 1000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870920 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/26/2013 7:12 PM
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You're singing to the choir. :)

Kristi

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Author: toberead Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870921 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/26/2013 8:04 PM
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If the medical profession could somehow communicate that the "common cold" is viral and not amenable to treatment with antibacterial antibiotics, the demand for short-term appointments would diminish dramatically.

My experience may be atypical, but are there really that many people who go to the doctor for a cold? (For themselves, not their kids.) I don't know anyone my age who would go to the doctor for a cold, unless it dragged on for weeks and weeks - it's too inconvenient to take time off work and arrange for child care and get an appointment and pay for it. But I mostly work with scientists and they know antibiotics don't work for colds. (I'm not sure if they remember that when it's their young children, but that's a different issue.) My older relatives tend to be quicker to go to the doctor, but most of them have other health issues that could cause complications.

I read a news story recently that said that coughs tend to last 3 or more weeks, even if they're viral - which surprised me. The "mom" wisdom was always that a cough that lasted more than a couple of weeks meant an infection - but evidently it doesn't. If I had a cough for 3 weeks, I probably would have considered a doctor's visit. But now I'll wait a little longer (if I get one - it's been several years).

Karen

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Author: alchook Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870922 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/26/2013 8:28 PM
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But I can tell you - most PCP offices are not equipped to deal with many things that are truly urgent - casting, need for XRays, stuff like that. It's not the place for it. UC/ER is.

Couldn’t a patient needing an x-ray be sent from a physician’s office to a hospital, bypassing the $1000 or so spent in the ER?

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Author: NaggingFool Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870923 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/26/2013 8:38 PM
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But I can tell you - most PCP offices are not equipped to deal with many things that are truly urgent - casting, need for XRays, stuff like that. It's not the place for it. UC/ER is.

Just anothing thing I love about my doctor's practice. They have all that available under the same roof.

- Megan

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Author: vkg Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870927 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/26/2013 9:07 PM
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What I am saying is what most people think is "I need an appointment NOW", really isn't. I am a physician...we leave slots open everyday for these "emergencies". I put them in quotes, because most of the time I start rattling off the push fluids, rest, OTC meds spiel. It's a waste of time and money to run to the doc for every little thing. There are exceptions, but most add-in appointments are not needed. tincture of time.

Kristi


Agreed, seeing a doctor for most cold or flu is useless. My MIL use to demand prescriptions for colds.

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Author: medgoddess Big red star, 1000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870928 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/26/2013 9:08 PM
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Nagging Fool - I can see a family doc doing so. Or one in a multi-specialty practice like Kaiser. But many PCPs are internists or pediatricians, and don't do that stuff in the office. Or don't want the liability of reading XRays (ups the malpractice risk). On some doctoring boards I visit, peds debate whether or not to have suture available. My kids see a solo peds doc. I know for a fact that even if DD was injured during office hours (she wasn't, it was after 6 pm), she wouldn't have been able to deal with a broken bone. The bad sprain it turned out to be - yes. Doable within the office.

As to alchook - yes, I can order XRays. But if the bone is broken - to UC/ER you would go to get it casted or wait until the next day for me to refer you to ortho - diagnosis is but half of the battle. You also have to add in the hassle factor. You call in am. I have lunchtime slots open. You go get labs/XR/whatever. It takes time to be resulted and for me to see the results. This will be a minimum of 90 minutes after the test is done (most labs/stat XR reads take about an hour...and you need to give time for transcription, faxing to office, and then me to see it. Meanwhile, I'm seeing other patients). I then have to decide what to do and get ahold of you again (easier said than done). If by now it's 2-3 pm, you would likely have to wait until the next day to get an urgent appt with the specialist.

And further back...I can personally vouch that there is a metric #$%#^^#-ton of "colds" who call in to get seen. Especially this time of year. Any time off, employers want a note. I'm not giving a note to anyone based on a phone call (too many people lie). Hence, an OV, my spiel, and an off-work note. I'm lucky, I'm OB, only pregnant folks use me as a PCP. It's still a royal pain. I rarely hand out antibiotic scripts.

And don't even get me started on the ER giving antibiotics for every little sniffle. I might go nuts. ;) My latest favorite is diagnosing pneumonia based on a cough x2 days and giving her a Z-pack.

Kristi

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Author: Windowseat Big funky green star, 20000 posts Feste Award Nominee! Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870931 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/26/2013 9:42 PM
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My experience may be atypical, but are there really that many people who go to the doctor for a cold?

I don't go to a doctor for a cold, but my colds have a tendency to turn into bronchitis, and when that deep hoarse cough starts I ask for a cough medicine strong enough to let me sleep at night. If I'm rested, my body had more strength to deal with the cold.

Nancy

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Author: Lea77 Big red star, 1000 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870942 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/27/2013 10:10 AM
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The place I go for office appointment also has an xray machine. I think they do their own labs too.

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Author: Lea77 Big red star, 1000 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870943 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/27/2013 10:13 AM
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giving her a Z-pack.

I work at a hospital and people I work with (although they aren't doctors) get a zpack and antibiotics for just about any persistent cold.

The last time I went to a doctor for a cold he prescribed guafinisen (SP), which I realized is in mucinex, so I am just buying that now.

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Author: martybl Big red star, 1000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870945 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/27/2013 11:18 AM
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The place I go for office appointment also has an xray machine. I think they do their own labs too.

There are significant Stark restrictions on providing radiographic services. Similarly, there are significant CLIA restrictions on providing in-house laboratory services. There exist some exceptions to Stark, which big practices are better positioned to take advantage of, and they are also in a better position to meet CLIA's requirements. It is, however, a very reasonable decision for a small primary care practice to decide not to provide ancillary services, which is the path of least resistance in the current regulatory environment.

martybl

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Author: alchook Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870948 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/27/2013 11:55 AM
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As to alchook - yes, I can order XRays. But if the bone is broken - to UC/ER you would go to get it casted or wait until the next day for me to refer you to ortho - diagnosis is but half of the battle. You also have to add in the hassle factor. You call in am. I have lunchtime slots open. You go get labs/XR/whatever. It takes time to be resulted and for me to see the results. This will be a minimum of 90 minutes after the test is done (most labs/stat XR reads take about an hour...and you need to give time for transcription, faxing to office, and then me to see it. Meanwhile, I'm seeing other patients). I then have to decide what to do and get ahold of you again (easier said than done). If by now it's 2-3 pm, you would likely have to wait until the next day to get an urgent appt with the specialist.


If the bone isn’t broken the patient avoids a $1000 ER visit. If it is broken won’t the ER just call the orthopedist on call--and charge the patient $1000 to do so?

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Author: MetroChick Big funky green star, 20000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 870959 of 884988
Subject: Re: Annual physical worthwhile for well? Date: 1/27/2013 6:18 PM
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I've actually been debating generating not one but TWO doctors as my "primary" doctor so if one can't work me in....the other could. My current one isn't open on Wednesdays. What if I have an emergency on a Wednesday?

Do you have an internist/GP as a "primary" and then a gynie you see, because if so than you probably have 2 doctors who could take some "same-day" appointments.

The only "urgent - need to see a doctor TODAY" experience I've ever had that an office-doctor handles is having a UTI. My gynie does take those same-day, but you have to call in by 7:30am. And if neither can see me, CVS' "Minute-clinic" can handle those (which I found out when I thought I was coming down with one on a national holiday).

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