Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
How would you handle this? Sorry for the length but maybe it will be enough info for you to adequately understand the situation.
Went to doctors (ARPN) for general checkup. It included an EKG, which,the woman taking it said was great and no different from one taken a few years ago.
ARPN mentioned my heart rate was elevated. This, I could actually "feel". I also knew and was never asked about, that I had also had 4 cups of coffee and an allergy pill less than 2 hours before.
This remark was the ONLY one ...(medical one)..she made during the entire visit.
Nothing more was discussed, other than my definitely declining a mammogram.
Few days later,I get a call from an imaging center wanting to schedule a mammogram and one for a chest Xray (which I had also declined verbally in the office....I am a smoker...previous ones have been fine and am symptomless))
Next day comes a call to schedule an appt with a heart doctor(Heart Rhythm Specialist). Looking at my patient portal, it stated that this was in consult with patient.....NOT true.
Declining these appointments is not the problem but how do I handle this with my PCP? I'm certainly not going to schedule ( and pay for ) another appointment to discuss this with her.....is just ignoring it and stating my dissatisfaction next time the way to go?
Or should I be looking for someone new
BTW...I have a blood pressure cuff and an Oximeter, both which have shown an acceptable heart rate the last couple of days...moderately high but under 100....I'm an 80 year old female
How would you handle this? Sorry for the length but maybe it will be enough info for you to adequately understand the situation.
Went to doctors (ARPN) for general checkup. It included an EKG, which,the woman taking it said was great and no different from one taken a few years ago.
ARPN mentioned my heart rate was elevated. This, I could actually "feel". I also knew and was never asked about, that I had also had 4 cups of coffee and an allergy pill less than 2 hours before.
This remark was the ONLY one ...(medical one)..she made during the entire visit.
Nothing more was discussed, other than my definitely declining a mammogram.
Few days later,I get a call from an imaging center wanting to schedule a mammogram and one for a chest Xray (which I had also declined verbally in the office....I am a smoker...previous ones have been fine and am symptomless))
Next day comes a call to schedule an appt with a heart doctor(Heart Rhythm Specialist). Looking at my patient portal, it stated that this was in consult with patient.....NOT true.
Declining these appointments is not the problem but how do I handle this with my PCP? I'm certainly not going to schedule ( and pay for ) another appointment to discuss this with her.....is just ignoring it and stating my dissatisfaction next time the way to go?
Or should I be looking for someone new
BTW...I have a blood pressure cuff and an Oximeter, both which have shown an acceptable heart rate the last couple of days...moderately high but under 100....I'm an 80 year old female
It is the money, honey.
Be glad that you don’t have several health insurances - like the veterans and the military do: they got hunted down for all kinds of tests as well.
Some bored people actually like it and use their PCP visits every 3 months!!! not(counting various specialists) as social calls
Some think if they are at the doctors every 6-8 weeks they will live for ever!
The consummate consumers that some are.
Our relative - 88y.o.- got fed up with the doctor requesting tests and stopped going to the PCP.
The result was the PCP stopped prescribing the daily medication after a year. Be aware of that.
We were all extremely concerned and flabbergasted…
So 3 years later - the relative is still going strong without any healthcare pet se and no meds. Happy as a clam.
You just have to keep declining what you feel could be excessive testing.
The majority of a LIFETIME healthcare expenses occur in the last year of someone’s life - per research.
If they keep testing - they will find something to treat.
Will it extend your life? Or just brings the misery and fears experienced during the course of futile treatments?
As many answers as there are people in your age group…
Last edited by L00k4ward; 05-25-2023 at 05:24 AM..
You bring up a valid topic for discussion, old_cold, illustrating the problems docs face trying to balance good clinical judgement vs the the legal system's insistence that docs must be 100% correct or face obscene financial penalties.
In your case, the question is what to do about a sinus tachycardia noted one time in an 80 y/o woman?...Sinus tach is always physiologic-- it has a reason for being present-- drinking caffeine, exercising, anxiety, hyperthyroidism, anemia, AV fistula, etc etc...It's never a problem for an electrophysiologist....but there's (legal) safety in asking for consultation from specialists.
..and then there's the question of what is reasonable expectations for the need for fancy medical care in the case of pts of advanced age-- Not to be funny, but how agressive in diagnostic testing and treatment should we get in dealing with pts who have a limited survival time under the best of circumstances?...Those questions can't be answered without getting into rationed care unless we allow out clinicians some slack in exercising clinical judgement. ...but the lawyers & politicians woulld neverlet that happen. It makes too much sense and provides no profits for them.
I understand, guido , what suggestions a medical provider feels he/she should suggest or encourage, but the main part of my post is that these referrals were done ....sprung on me...without discussing it with me and, in the instance of the mammogram...the one that was mentioned... despite my refusal.
A different ARPN has, in the past, suggested things...like a mammo...and when I declined, simple put "Non Compliant" in my file.
So, I'll repeat my question......
Declining these appointments is not the problem but how do I handle this with my PCP? I'm certainly not going to schedule ( and pay for ) another appointment to discuss this with her.....is just ignoring it and stating my dissatisfaction next time the way to go?
Or should I be looking for someone new?
And to anybody...what would you be inclined to do?
ARPN mentioned my heart rate was elevated. This, I could actually "feel". I also knew and was never asked about, that I had also had 4 cups of coffee and an allergy pill less than 2 hours before.
Sorry, you brought all of this on yourself. Who has four cups of coffee less than two hours before a check-up?
You're 80. Yes, they are going to want heart tests and things of that nature if anything is even remotely off. Why? Because if they don't do it, and you keel over of a heart attack, your family can come back and try to sue them for negligence. Now that you won't do the tests--which, with the exception of a mammogram, are absolutely NOT unreasonable for an 80-year-old smoker with a rapid heartbeat--it goes into your records that you chose not to follow medical advice.
What do you do with your PCP? Nothing. No one can force you to undergo tests or procedures. It's just that your PCP will probably ask you about it at your next visit. Come prepared with reasons why you did not go.
Don't get me wrong. I don't do every test they want me to do, either. But I have reason for not doing them other than "I don't wanna."
You bring up a valid topic for discussion, old_cold, illustrating the problems docs face trying to balance good clinical judgement vs the the legal system's insistence that docs must be 100% correct or face obscene financial penalties.
In your case, the question is what to do about a sinus tachycardia noted one time in an 80 y/o woman?...Sinus tach is always physiologic-- it has a reason for being present-- drinking caffeine, exercising, anxiety, hyperthyroidism, anemia, AV fistula, etc etc...It's never a problem for an electrophysiologist....but there's (legal) safety in asking for consultation from specialists.
..and then there's the question of what is reasonable expectations for the need for fancy medical care in the case of pts of advanced age-- Not to be funny, but how agressive in diagnostic testing and treatment should we get in dealing with pts who have a limited survival time under the best of circumstances?...Those questions can't be answered without getting into rationed care unless we allow out clinicians some slack in exercising clinical judgement. ...but the lawyers & politicians woulld neverlet that happen. It makes too much sense and provides no profits for them.
If anything, the OP should take it as a sign of their optimism that they want a mammogram for her. They only recommend mammograms in women her age if the woman's life expectancy is at least another five years. Apparently they think she will live at least another five years even though she smokes.
I've never had a test ordered that didn't need to be done. But I have bronchiectasis, which is like spinning the Wheel of Fortune. And it lands on...coccidioidomycosis! A year and a half for treatment of that, then the wheel lands on...allergic bronchopulmonary aspergillosis! 3 months on antifungals... I can hardly wait to see what's next.
I never assume I know more than my physicians. The only exceptions are the two "doctors" who insulted me and accused me of hypochondria.
I've never had a test ordered that didn't need to be done. But I have bronchiectasis, which is like spinning the Wheel of Fortune. And it lands on...coccidioidomycosis! A year and a half for treatment of that, then the wheel lands on...allergic bronchopulmonary aspergillosis! 3 months on antifungals... I can hardly wait to see what's next.
I never assume I know more than my physicians. The only exceptions are the two "doctors" who insulted me and accused me of hypochondria.
Unfortunately, way too many people do think they know more than their physicians. They think googling something is the equivalent of four years of medical school, a residency, and continuing medical education. It's totally Dunning-Kruger because they have no idea how much they don't know.
But on the flipside, people do need to be active participants in their own health care. It's a team approach between patient and doctor. If patients don't communicate with their doctors, their doctors have no way of knowing why patients don't follow medical advice.
There are a LOT of reasons why people don't follow medical advice, and a lot of those reasons make sense to patients and quite often make sense to their doctors. For example, say a doctor prescribes a medication. The patient took the medication a long time ago and it had awful side effects, so the patient doesn't want to take it now. Well, how is the doctor supposed to know that if the patient doesn't tell the doctor why they haven't taken it? Tell the doctor, the doctor might find a better medication for you.
There are also all kinds of barriers to care: Reliable transportation, money for copayments, can't get time off for appointments, or inability to get childcare while the parent is in treatment for something (this happens with substance use disorders a lot). Doctors aren't naive to this stuff. They know it happens and believe me, it frustrates them because no patient should go without care because of stuff like that.
But some of these things can also be addressed. For example, a lot of church groups or volunteer groups have services to take people, especially seniors, to appointments. Frankly, I think that would be a good community service project for local college students who have cars--and services like that should be extended to single people who need colonoscopies and whose friends work but I won't get started on that particular rant.
I understand, guido , what suggestions a medical provider feels he/she should suggest or encourage, but the main part of my post is that these referrals were done ....sprung on me...without discussing it with me and, in the instance of the mammogram...the one that was mentioned... despite my refusal.
A different ARPN has, in the past, suggested things...like a mammo...and when I declined, simple put "Non Compliant" in my file.
So, I'll repeat my question......
Declining these appointments is not the problem but how do I handle this with my PCP? I'm certainly not going to schedule ( and pay for ) another appointment to discuss this with her.....is just ignoring it and stating my dissatisfaction next time the way to go?
Or should I be looking for someone new?
And to anybody...what would you be inclined to do?
i have told my pcp the next time I saw her that I didnt take the tests she wanted done. Sometimes I have found that she didn't remember cause what Im seeing her for isnt related to the tests! I also dont do wellness exams. dont believe in them Each to their own. Also keep an eye open for another dr but friends tell me that many drs will get rid of patients who wont do everything the dr wants. So that may not get you anywhere.
just let it go until the next time you see her.
Please register to post and access all features of our very popular forum. It is free and quick. Over $68,000 in prizes has already been given out to active posters on our forum. Additional giveaways are planned.
Detailed information about all U.S. cities, counties, and zip codes on our site: City-data.com.
Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
