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

Posted by codered032 @codered032, Feb 14 5:32am

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?

Interested in more discussions like this? Go to the Aging Well Support Group.

True- it’s hard to find a ‘team’ but that is what it takes. GO for overview and specialists for particular. I have been told by several snow that there is nothing they can do for me. My pain dr. Tries to keep me comfortable - I take as little as possible. But at 78 with my muscle atrophy it’s up to me to PT as hard as I can and try to hold on. Bravery is essential! Yup

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@vgen

I am 75.. I have found a great Nurse Practitioner who is in my primary care physicians group. She’s wonderful and ran additional tests when my primary care doctor thought my condition was a result from covid. Sent me to a rheumatologist and found my pain was from Polymyalgia Rheumatica. Never heard of it before my diagnosis. My POINT is don't think your getting less if you consult with a Nurse Practitioner or a Physicians Assistant. They have more time to consult and are very knowledgeable.

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The only person who was kind and diagnosed me right away was a nurse practitioner. I have post herpetic neuralgia and I live a life of chronic pain. It is a condition caused by the shingles. He's retired now and doctors aren't familiar. I'm treated like a crazy old lady.

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I’m not sure of an answer. You can ask local people who they prefer as a primary. I have a great one. I can send him a private message at anytime through the portal. He responds within hours.

I normally select my own specialists within a large system that has a patient portal. There, I can view my tests results, notes, and communicate with my doctors. They respond promptly, often the same day and address my question, prescribing at times, or scheduling me to be seen if necessary. The specialists happen to be with Duke Health. Not sure if you are in central NC. I find them all extremely attentive and afterwards encourage me to rate them on how they were and how they could better serve my needs.

What type of arthritis do you have?

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@gravity3

This is not specific to my doc. It is indicative of medicine in the u.s. today. This is not a criticism of the individual providers but of the insurance companies and their stranglehold on medical care.

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u r correct. I feel the same way you feel I will keep far away. from. docs

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@petrullo

u r correct. I feel the same way you feel I will keep far away. from. docs

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Want to be clear that it is the system itself is my worry.

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@petrullo

u r correct. I feel the same way you feel I will keep far away. from. docs

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I feel same way

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@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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Sue,
Thank you much for your suggestion for a nurse practitioner. I will certainly explore this option. My inaction with NP has always been positive.

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@catartist

True- it’s hard to find a ‘team’ but that is what it takes. GO for overview and specialists for particular. I have been told by several snow that there is nothing they can do for me. My pain dr. Tries to keep me comfortable - I take as little as possible. But at 78 with my muscle atrophy it’s up to me to PT as hard as I can and try to hold on. Bravery is essential! Yup

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Thank you for your support. I attend a warm water pool several times a week. I have developed, with research, my own personal routine. But on occasions I have flare up that Tylenol doesn’t help. Because of my kidney disease, I try to avoid as much as possible anti inflammatories. There are days when it is a real struggle just to walk.

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@edsutton

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!

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Thank you so much for sharing. I will certainly make a note of your great suggestions

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@codered032

Thank you for your support. I attend a warm water pool several times a week. I have developed, with research, my own personal routine. But on occasions I have flare up that Tylenol doesn’t help. Because of my kidney disease, I try to avoid as much as possible anti inflammatories. There are days when it is a real struggle just to walk.

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I do know - and wish you strength ! It takes that - for sure!

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