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Old 06-20-2019, 10:05 AM
 
1,912 posts, read 4,601,535 times
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Quote:
Originally Posted by jrkliny View Post
A great many of you seem to be trying to be your own doctors. That seems to me to be extremely foolish. We don't have the years of training and experience. Even if we had the skills and the knowledge needed, we cannot perform procedures, run tests or prescribe meds.

Others of you have described the side effects of drugs and the value of exercise, diet and other steps to improve health. Physicians are not stupid. They know the details of these factors especially if you deal with doctors who are specialists in the areas of importance to your health.

If you want to continue to be your own doctors, that is your choice but I think it is an extremely poor choice. Note becoming educated on your health issues is important but that does not mean you ignore medical advice.

It can be difficult to find a good doctor that you trust and can work with. I have a few suggestions that might help.

First, consider your choices in insurance. I am not locked in and limited to using HMO doctors. I do have to pay quite a bit for good supplemental insurance, but I have never had an issue with gatekeepers, with limited choices or with doctors that do not provide services due to poor reimbursement.

When it comes time to pick a new doctor, look at the doctor's medical education and experience. Most doctors now work in groups. Look at the education and experience and board certifications for other members of the group. It is often difficult for a doc to be accepted into a group of excellent doctors or specialists. Exclusive practice groups will select only those physicians who are first rate. Next look for direct referrals from other physicians. If you have a good PCP they should be able to help with finding specialists and visa versa. I avoid referrals from patients who are not knowledge of the medical field. I want first rate docs not people who win popularity contests. There is a lot more I could add but the first step is to realize the importance of finding good docs and the importance of moving on when you are not satisfied.
Good points on selecting a doctor, though it's important to keep in mind that some older adults have insurances with limitations (Medicare Advantage Plans) that have networks, and don't have as many options. Perhaps that is the only insurance option they can afford, and they have to live with a particular network. Also, some doctors don't take new patients any longer with traditional Medicare. I've personally run into this in my research on several retirement locations when I've called specific clinics about establishing care as a new patient. Some physicians close their "panels" to new Medicare patients but continue to see existing Medicare patients.

I've also run into a situation where access is extremely limited in PCP clinics due to retirements or promotions, even where the patient had services for many years, with other doctors not accepting new patients, and the only choice left was a brand new doctor right out of medical school. Not much opportunity to evaluate and compare credentials (which is good advice) if there is only one option. Access can be a real issue.

Good that you have been lucky and haven't had any issue with gatekeepers or access or choices, but that isn't the case for everyone who is retired.

Last edited by xz2y; 06-20-2019 at 10:15 AM..
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Old 06-20-2019, 10:06 AM
 
1,558 posts, read 774,567 times
Reputation: 6784
Quote:
Originally Posted by olderandwiser456 View Post
I lowered my BP quite dramatically by nearly eliminating salt, or greatly reducing salt, in my diet. Processed foods are high in salt, so eating fresh whole foods is the better approach, IMO.
Same here, mostly home-cooked food and not many restaurant meals. But in my case there are probably bad genes involved as well, husband has consistently great BP (104/65 at last week's doc visit) whereas mine hovers in the 120's/80's even though we eat exactly the same diet and exercise together as well. So to be realistic, I'll probably have to take meds eventually.
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Old 06-20-2019, 10:13 AM
 
Location: Knoxville, TN
1,236 posts, read 585,282 times
Reputation: 2710
Quote:
Originally Posted by athena53 View Post
Scary stuff- thanks for all the above. I'd read about the osteonecrosis risk, as well as unexplained fractures from "normal" activities such as walking down a step, with Boniva and Fosamax. When I had one of my dental implants I asked my oral surgeon about the implications of either of those meds. He said, "If you were on Boniva or Fosamax I'd have you sign a whole new set of waivers." He'd already supplied a very thorough list of anything that could go wrong with an implant and I'd had to sign it indicating that I understood the risks. He's very good- I now have 5 implants and no problems whatsoever. I want to keep it that way. I think I'll just keep up with the calcium, the magnesium and my cardio workouts.
I keep my hand weights in front of the TV and do reps while I am watching. It's an easy way to get in some extra bone-friendly exercise.
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Old 06-20-2019, 10:14 AM
 
2,066 posts, read 699,344 times
Reputation: 5294
Quote:
Originally Posted by jrkliny View Post
A great many of you seem to be trying to be your own doctors. That seems to me to be extremely foolish. We don't have the years of training and experience. Even if we had the skills and the knowledge needed, we cannot perform procedures, run tests or prescribe meds.

I have the same attitude towards doctors, dentists, auto mechanics, financial advisors and anyone else I hire for their expertise: I'll try and find one I trust but whatever they advise, I will do my own research, get a second opinion if necessary, and then make a decision. I'm the one who has to live with the results. I respect doctors- I have a couple in my family- but medicine is not an exact science and few medical issues have sraightforward "cookbook" solutions.
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Old 06-20-2019, 10:35 AM
 
1,912 posts, read 4,601,535 times
Reputation: 1340
Quote:
Originally Posted by athena53 View Post
I have the same attitude towards doctors, dentists, auto mechanics, financial advisors and anyone else I hire for their expertise: I'll try and find one I trust but whatever they advise, I will do my own research, get a second opinion if necessary, and then make a decision. I'm the one who has to live with the results. I respect doctors- I have a couple in my family- but medicine is not an exact science and few medical issues have sraightforward "cookbook" solutions.
Bingo! Do your research, get a second opinion if needed, and make a decision. I also have doctors in the family and have worked in healthcare, so I have high regard for good physicians. As in any field, medicine has highly qualified and poorly qualified professionals, and weeding out the chaff takes a lot of work and research. But the important point, as you mention, is that we as patients, have to live with the result, so it's necessary to make the best choices you can.

Glad you mentioned other fields (auto mechanics, financial advisors) and I would add dentists, who can vary widely in their expertise and training.
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Old 06-20-2019, 10:37 AM
 
1,912 posts, read 4,601,535 times
Reputation: 1340
Quote:
Originally Posted by JOinGA View Post
I keep my hand weights in front of the TV and do reps while I am watching. It's an easy way to get in some extra bone-friendly exercise.
I love that idea! I have the Apple watch that "reminds" me to get up and move around every hour, which comes in handy if I'm on the computer and forget how much time is passing! Yikes!
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Old 06-20-2019, 10:56 AM
 
6,211 posts, read 4,715,040 times
Reputation: 12693
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Originally Posted by NYgal1542 View Post
jrkliny: You are, of course, entitled to your opinion.
I will make every effort to not judge you.
Please afford me the same courtesy.
I have no idea what you are writing about. We complained numerous times about your physicians. Others have done the same. I tried to post some ideas that might be helpful for anyone trying to change doctors.
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Old 06-20-2019, 11:02 AM
 
Location: Central NY
4,651 posts, read 3,235,973 times
Reputation: 11907
Quote:
Originally Posted by jrkliny View Post
I have no idea what you are writing about. We complained numerous times about your physicians. Others have done the same. I tried to post some ideas that might be helpful for anyone trying to change doctors.



I am sorry you are not able to figure out what I wrote.

Seems to be easily understood by others.

I can't imagine what your problem is.
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Old 06-20-2019, 11:02 AM
 
700 posts, read 537,876 times
Reputation: 544
Quote:
Originally Posted by jrkliny View Post
Others of you have described the side effects of drugs and the value of exercise, diet and other steps to improve health. Physicians are not stupid. They know the details of these factors especially if you deal with doctors who are specialists in the areas of importance to your health.
I agree that "physicians are not stupid," but many of them (in my experience) don't take the time to even mention diet and exercise as the first line a defense. I'm sure they know about these factors, but most just focus on recommending a drug to solve the problem in that 15 minute appointment. That may be appropriate in some situations, but not all.

The bigger issue is that the medical school curriculum emphasizes disease and diagnosis, but should provide training in the science and practice of cost-effective health promotion. I also think that medical schools need to teach prevention strategies alongside treatment approaches, and emphasize lifestyle modification. Needless to say, medical school training is a larger, more complex issue and that's another thread!
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Old 06-20-2019, 11:06 AM
 
700 posts, read 537,876 times
Reputation: 544
Quote:
Originally Posted by CatTX View Post
Same here, mostly home-cooked food and not many restaurant meals. But in my case there are probably bad genes involved as well, husband has consistently great BP (104/65 at last week's doc visit) whereas mine hovers in the 120's/80's even though we eat exactly the same diet and exercise together as well. So to be realistic, I'll probably have to take meds eventually.
Monitoring BP at home with good equipment can be a good idea. I also take the spreadsheet to doc appointments. I use an Omron BP device at home and have even brought it to a doc app't to be tested. There are a lot of brands on the market and plenty of reviews to peruse.
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