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

Posted by codered032 @codered032, 4 days ago

I am new to this group so I will try to keep this short. I am 74yo, have been relatively stable health. I have arthritis and have had joint replacement surgery which has been successful. I was diagnosed with a rare kidney disease in 2019 and treated with a nephrologist. I have been in remission for over two years. Medical treatment has become so specialized. The doctor will only address his area of treatment. Nobody looks at the patient as a whole person. Office visits are limited to 15 minutes and I am lucky if I speak with the doctor for five of those 15 minutes. I am currently on no prescription medication for chronic illness. Last year I attempted to establish a relationship with a gerontologist who never examined me. She reviewed my health history, that was obtained by the nursing assistant, asked a few questions, ordered routine labs, and never scheduled a follow up visit. Recently I called to ask for pain management because I was having an arthritis crisis and her only suggestion was Tylenol. I attend warm water therapy 3-4 X week and Tylenol was of little benefit. She showed no concern for my current condition. I have never asked for pain medication nor have I ever complained about my arthritis. I got the impression that she thinks that at 74 I am going to have pain and that I have to adjust to it. I know that at this stage of my life I need a trusting primary physician who is willing to listen and be interested in my overall health. Any suggestions for finding a doctor who is interested in providing care for aging patients?

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kisu | @kisu | 3 days ago

The day before my six-month (my preference) checkup with my primary care physician, I prepare a concise list of health concerns. I give this list to the nurse when I arrive for my appointment, so the doctor can review it beforehand. My doctor appreciates this practice, as it helps us stay focused during my 15-minute appointment, and ensures all my concerns are addressed. I've specifically asked to maintain these six-month visits, and my doctor has agreed, saying I can see her as often as I like. I have traditional Medicare. You have mentioned that your doctor did not ask for a follow-up. Advocate for yourself and always have an appointment before you leave the office especially if all your concerns are not addressed.
I also have two other doctors, and I keep my primary care physician fully informed about my care.

Previously, I used a concierge medical service for a year, but it was a very negative experience. Not all concierge is good.

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missey | @missey | 2 days ago
In reply to @ginger123 "After having similar experiences, I joined a Conceirage practice. It’s an additional monthly expense, but gives..." + (show)
@ginger123

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.

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Hardly anybody has that kind of money to spend these days!

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willow5 | @willow5 | 2 days ago

Have you looked inro red light therapy for your arthritis? My pain doc at UCSF recommended the Usuie brand (it is what she uses.) and the price is reasonable compared to some of the other brands. They have a good return policy. Consistency is the key. Can’t hurt to try for 20 days and return i you do not find improvement.

I’m 72. I’m concerned, in aging, about ageism as I age. I am pretty active and hope to remain so like my friends in their 80s. I think that both my parents were treated with a lower standard of care when they were in their mid 80s. No proof, just a feeling I have.

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1 reply
gravity3 | @gravity3 | 2 days ago
In reply to @vic83 "I agree with the suggestion to go in with a one-page list of concerns. Only I..." + (show)
@vic83

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.

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Went to my PCP last week. New sign in his exam room about patients keeping their issues to two during a visit!

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2 replies
vic83 | @vic83 | 2 days ago
In reply to @gravity3 "Went to my PCP last week. New sign in his exam room about patients keeping their..." + (show)
@gravity3

Went to my PCP last week. New sign in his exam room about patients keeping their issues to two during a visit!

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That would concern me.

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3 replies
BeBold | @bebold | 2 days ago
In reply to @sueinmn "@codered032 I'm going to suggest a Family Practice or Adult Practice Advanced Practice Certified Nurse Practitioner..." + (show)
@sueinmn

@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.

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I agree. In fact, I have very few male physicians. I call my Doctorate level "Nurse" my PCP. She listens. When I couldn't get any "male" doctors to listen to me that I had a bad fall and hurt my hip. Nobody would listen and all blamed my back. I was 6 months trying to do but eventually giving up on life when she syepped in and finally someone did just an MRI. Torn Gluteal muscle and torn hip labrum in 2 places. Validly painful.

I have an appt at Mayo in Jacksonville on Wednesday with a really good hip surgeon. I have CRPS and need a dr who has even heard of it. I'm driving alone (just turned 70) but giving myself 2 days to get there - 300+ miles. I made this appt about 4 months ago and I will be there. Hook or crook. Anyway, yeah, my female RN/PCP is also certified for psych as well as family practice. So she is able to do everything but readily refers me to people. She also employs a "chronic care nurse specialist" to call her more complicated pts once a month to check in.

She is not perfect but pretty much lets me ask or say no (hardly ever do) to everything. I am also an RN but I think she is just kind.

She just started a thing where on Fridays, no longer volunteering at the jail, she will be doing home visits.

Right? Yeah, lucky. I di my best to stay away from males Drs as its always gaslighting. I has a partially collapsed lung with long covid and was short of breathe just walking to the kitchen. He pulmonologist notr my collapsed lung in my insurance notes but added "its very possible that her SOB is related to her weight." I'm a size 16/18. Not thin but not unaverage kind of in the US.

Yes. I get it and I am totally validating your experience as sadly not unusual anymore. Sad.

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BeBold | @bebold | 2 days ago
In reply to @willow5 "Have you looked inro red light therapy for your arthritis? My pain doc at UCSF recommended..." + (show)
@willow5

Have you looked inro red light therapy for your arthritis? My pain doc at UCSF recommended the Usuie brand (it is what she uses.) and the price is reasonable compared to some of the other brands. They have a good return policy. Consistency is the key. Can’t hurt to try for 20 days and return i you do not find improvement.

I’m 72. I’m concerned, in aging, about ageism as I age. I am pretty active and hope to remain so like my friends in their 80s. I think that both my parents were treated with a lower standard of care when they were in their mid 80s. No proof, just a feeling I have.

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Same for parents. The nursing home literally killed him. Literally. And agism is real. I turned 70 last week. And having been disabled since I was 24, im totally afraid of SSA getting D/C'd. But I won't be the only elderly person living on the street. And the doctors who mostly practice replacing joints on the elderly will also no longer be employed. Such shortsightedness. Without medicare and the ACA, I wonder if even Mayo would remain standing. Fear on top of all of it is unfair and also top down ageism and ableism. Sorry but at some point we need to be able to talk about this defining moment.

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kb2014 | @kb2014 | 2 days ago
In reply to @dianekbrown "I'll b 71 y/o in several days and a woman. First of all, almost all my..." + (show)
@dianekbrown

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!

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I completely understand your concerns. Specislists have limited time and AI has become part of a new normal. I was in a direct primary care practice. I liked it. I had a good NP but she was forced out due to cost cutting measures. I do my own research and typically come in with ideas for a treatment plan and questions to ask. As hard as it may be addressing one issue at a time works. Also just taking time to find a provider that will work in your situation. Reading reviews of providers help too.

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