At 74yo I need a dr who will listen to me

@codered032 I'm going to suggest a Family Practice or Adult Practice Advanced Practice Certified Nurse Practitioner (AP-CNP.) Here is my reasoning - so far your health conditions and medications are not complex and you're are not seeing a lot of doctors, so case management is not the issue - TIME is the issue.

An AP-CNP has a PhD in nursing practice, backed by several thousand hours of hands-on nursing experience. In most clinical situations, NP's are given a longer appointment window (20-30 minutes) for each patient, and in Family Practice, their job is to see the whole picture - not necessarily to treat everything, but to see the "bigger picture" - and to make referrals as needed.

I had the same CNP (for over 20 years - we "grew old together") who was able to see me through lots of complications that required specialists and help manage asthma & pain. It was she who found 2 of my medications reacting with one another - she coordinated the change to a safer situation. She got me to a pulmonologist when my asthma went out of control, and she helped me to finally see that my chronic pain needed a closer look after tylenol & ibuprofen no longer did the job and got me into a pain management clinic that helped me make life changes instead of turning to opioids.

Does the clinic you go to have AP-CNP's? You might want to give it a try.

@codered032 I'm 73-years-old and I hear you! I had a total left hip replacement in 2019. I have osteoarthritis that has progressed enough that there are days I'm very uncomfortable. I have/had osteoporosis and I'm now in the osteopenia range after a year of Evenity injections once a month followed by a Reclast infusion. I see an endocrinologist at Mayo Clinic for osteoporosis.

I had a wonderful primary care provider who retired over 15 years ago. He listened to me, he discussed what he had read from the scientific literature that pertained to me and took time with me. I went through at least 3 primary care providers after he retired because I felt as you described--not listened to and not enough time. I finally "landed" on a primary care practice with a physician who knows me after the 6 years I've been going to the practice and has encouraged me to schedule 30 minutes for an appointment when I feel I need more time. Frankly, it was somewhat serendipitous that this occurred however here is what I did. At our first appointment I spent time with the physician to let him know what was important to me. I tried to do it in a way that showed I was advocating for myself without being too aggressive about it. I told him why I left the previous primary care practice in an effort to let him know that I valued communication. Over the years I've since learned that the practice is run in an efficient and compassionate way. My husband goes to the same practice with a different physician and we agree on this.

I suggest asking your friends who their doctors are and asking why or why not they like working with their doctor. Then, if you decide to make an appointment spend time interviewing the doctor. While my doctor is not specialized in geriatrics he does see a lot of patients in my age group.

What do you think you'd like to do next?

Are you in a location where you have many choices of doctors? If so, study the system, look for biographies and reviews. And that's just a start. Ask friends about their doctors.

At least once a year you can schedule a new doctor for your Annual Wellness Visit. Some clinics will also support "new patient" visits if you change to a new doctor.

In preparation for any visit I suggest you create a one page "Health Concerns" document. Write direct sentences with bullet points. Name each concern, but don't overload details. Edit as necessary to one page or less. This shows you take your health seriously and will invest time and thought into your health needs. Make two copies, one for the doctor and one for you. Take charge of the visit, going through the list point by point with the doctor. A doctor who wants to give whole care will be grateful for your effort. You should be able to go through the list with time left for the doctor to pursue and issues she wants to add. [Keep a copy of this list and update it for every visit.]

Doctors are under great time pressure, but I've found that there are doctors who manage to get a lot covered in the standard visit, and they will usually continue the visit if you stay on topics that matter. My doctor always ends the visit by asking if there's anything else I want to ask her, even when we're overtime.

When we moved to Durham we chose doctors in the Duke system because it is large and broad, offering lots of choices. My first doctor was yucky. I changed to a second doctor who I liked a lot, but she moved to a different location, and was close to retirement, so I found another doctor who is in a nearby clinic. In between visits I communicate with her and her nurse via text message, getting encouragement, self-care advice and quick appointments when needed. She has also referred my wife and me to specialists out of the Duke system when she thought they would offer faster care.

Good luck in your search!

I have recently "joined" an internal medicine clinic affiliated with a medical school and our local medical center. I have been seeing Interns and Residents and find their youth, enthusiasm and current knowledge refreshing.

My wife is seeing a rheumatologist who put her on methotrexate, which has done quite a bit of good. It isn't as good as colchicine, which my wife's GP had ordered for her because he suspected Becet's Disease. The rheumatologist didn't agree with the colchicine, mostly because of her own findings, including that it wasn't Becet's. We both wish she had left my wife on colchicine, but....what're ya gonna do? No prescription for colchicine was forthcoming, and we had to switch to methotrexate. We went from an apparent A solution to a B- solution.
Tylenol or Tramadol are what my wife takes, which I really don't like. The medical community likes it because it presents a lower risk of liver disease than it does a risk of bleeding, the latter being almost zero. Meanwhile, ibuprofen or acetyl-salicylic acid are likely to cause ulcers and/or bleeding. A new analgesic is coming onto the market that apparently has zero risk for bleeding, or so I recall reading lately.

I understand what you’re going through! Doctors are now talking only to their charts that are typically managed by AI. There are mistakes all over my chart since he started doing this and I opted out of it. The warm, compassionate manners are out the door as a result thanking of you and I hope you find a doctor that is old school!

After having similar experiences, I joined a Conceirage practice. It’s an additional monthly expense, but gives me security knowing I have access to my doctor 24/7, same day or next day appts, min of 30 minute visits, and good referrals. If budget will allow, I’d recommend investigating this. The monthly fees vary….. mine is $325. In the big picture of things, it’s worth juggling the priorities, if possible.

I agree with the suggestion to go in with a one-page list of concerns. Only I would modify that.
I now go to a general doctor's appointment with a 1) summary of critical health issues 2) list of surgeries, exams and tests.
For my Specialist appointments I add a Status update noting any changes since the last visit.
I now have a lengthy medical record and no doctor can spend the time figuring it out. They are happy to see a well written summary...and I find that their NOTES are more accurate now.

Between one organization and another I see a need to learn how to work with computer records. Some places pull in everything from everywhere creating great confusion. They need to set up programs to separate critical current health info vs. secondary less significant health data.

I know your frustration! I have multiple Drs (78 yrs) for various comorbidities and still don’t know who to go to for issues as they overlap - I get that, but there should be some one Dr. for overview. GO??? We’re not invisible!

I'll b 71 y/o in several days and a woman. First of all, almost all my Dr's are women. They're more apt to listen to you and not to treat you like a hypochondriac. I went w one of those concierge services. It's expensive buy MDVIP agreed to 150$ a month. She spends 45 -60 min with me. Answers all my questions, coordinates my care with specialists so that I can get into that office sooner than later. She's great!!! Good luck to you, honey!