21

votes

If you could change one thing about your doctor visit experience ,with paleo in mind, what would it be?

Answered on September 12, 2014
Created March 28, 2011 at 11:30 PM

Help me help you more........I want to hear what you really want, what you really need and why you want it. I also would not mind hearing some of your experiences both good and bad no matter what. Thanks.

F3920b85be76a5d8cf466d805bfb99e4

(638)

on March 11, 2012
at 05:30 PM

btw, I am on the hunt again for a new doc, one who will be a partner in my health care, who will look at the whole picture, and who is not so eager to send me off with a handful of pharmRx's. I would like to be able to order certain labs, and work via email or web-base, for interpretation and action plans to improve health markers as determined by labs.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on July 31, 2011
at 07:40 PM

I do it......to become better than I was yesterday. And now I am committed to doing it everyday I am alive whether or not some dont see the angle I am coming at this from. Thanks for the kind words.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on July 31, 2011
at 07:14 PM

plus one............ i still come back to read it daily.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on July 31, 2011
at 07:12 PM

plus one................

A4d49e0dbea9544eb2f86624e2adc7fd

(172)

on May 29, 2011
at 01:39 PM

I find that I have some patients that are really interested in helping themselves and for them I am more apt to Rx them "alternative" treatments/therapies because I know they will do them the way I say and, for the most part, they will get results. I have others that will absolutely not hear what I am saying and they want mainstream medicine only. These tend to be the patients that have a more extreme presentation of their condition and, I hate to say this, are lazy. How do we motivate the populous to care about themselves?

F6ea948ab43dc51d72509c0989e670fe

(1639)

on May 26, 2011
at 05:06 AM

Thanks! I actually used them, they got the test this morning. Should find out the results in the next 5-10 days...I hope. Just based on the blood test my adrenals were out of wack. So curiosity...I started reading 'the monk whole sold his ferarri'. How much control of the body (symptoms, states, etc) do you think the mind is in control of?

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on May 25, 2011
at 07:21 PM

i like this.....and I will add this. How about a weekly chat room? Plus one for you!

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on May 25, 2011
at 07:20 PM

i use zrtlabs.com They send the test to the patient with instructions and send you the direct result......then you bring it to your doc to interpret with you. My patients like it because they feel like part of the plan.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on May 18, 2011
at 12:36 AM

Its the name of my blog.

559aa134ff5e6c8bcd608ba8dc505628

(3631)

on May 17, 2011
at 05:47 PM

the word-choices in these comments say so much: patients = "customers", fellow health professionals = "competitors".

Cf5c9ba3c06cf300ae23c52778dfd317

(545)

on May 17, 2011
at 03:07 PM

So you're "The Quilt" now? What does that mean?

E17addea7e1019a6cdbaec44f0b12728

(170)

on May 17, 2011
at 03:40 AM

Monthly discuss could range from a book, movie (food inc, etc) childbirth (business of having babies). GArdening, detox.

F6ea948ab43dc51d72509c0989e670fe

(1639)

on May 16, 2011
at 09:30 PM

My doc only does the blood one, so I got that, and then went and ordered the home saliva test (with the 4 that you take throughout the day) just to make sure I get it fixed...it's money out of pocket, but I really really want to make sure I get a handle on this. I know something is messed up, it's just a question of what.

61b801de5dc345b557cd4623d4a4f26b

(2682)

on May 16, 2011
at 12:28 PM

For those interested, the visit with my new doctor was promising. She actually listened, asked questions, and was able to offer a potential diagnosis and follow-up plan.

F6ea948ab43dc51d72509c0989e670fe

(1639)

on May 16, 2011
at 04:51 AM

I've gotten the blackout blinds, gotten rid of 90% of the stress, and am getting the diet close to 100%. No outrageous workouts either. At most 2-4 30 minute sessions a week. KB swings, no scary metcon sessions. I'm sure I'll have a fun question to ask this next week...

F6ea948ab43dc51d72509c0989e670fe

(1639)

on May 16, 2011
at 04:49 AM

Thanks! I was starting to think that I have issues with cortisol. Sleep disturbances, a cpap machine, stress, and I love staying up till 2 a.m. and hate waking up early. I was going to talk to her about it this week. In addition to the possible leptin resistance, adrenals (well, cortisol), and possibly some sort of dopamine/seratonin disruption as well. My weight loss/fat loss has stalled, so I've started eliminating options. And yes, I would love to figure it out without being a yogi :)

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on May 15, 2011
at 11:22 PM

There is a doc in Chicago who will it down with you for close to an hour to talk.......to be his patient will cost a bunch....but to go and see what he does for an hour he will do gratis.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on May 15, 2011
at 01:01 PM

most of us are not......but that is because of how we were taught. Most docs however want to help but many dont know that what they recommend take a person the wrong way. Every mile you go in the wrong direction becomes a two mile mistake. To remedy that requires a paradigm shift in thinking. Your decision as the patient is to find that doc who thinks differently and then foster that relationship with congruent behavior. Once the desired effect occurs then you need to tell all your friends about what you found. Then the standard of care of all docs changes due to natural selection

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on May 15, 2011
at 12:56 PM

some of us are.....some of us understand that the true essence of doctoring is all based upon physiology. It is the one constant. To understand the cell is to understand the disorder of the cell and the human. The environment constantly changes and make understand it all tough when you think about disease from the environments perspective. My paradigm is to understand the physiology first and then the impact of the environment.....makes understanding evolutionary biology and disease a manageable proposition. Then I can effect change with my thought secretions and therapy.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on May 15, 2011
at 12:52 PM

ok.....here is a free tip. basd upon the above I will bet you I can solve the thyroid mystery. Go ask your doc or NP to order you a salivary cortisol test. My bet is it will be abnormal. When it is I bet they throw their hands up and tell you to meditate or get a pedicure or exercise less to reduce your stress......I will tell you why it happened. Its due to high CRH. CRH directly dampens TSH and down regulates metabolism. Once you control CRH your thyroid function will return. When you get the test and see I am right you can then ask me how to help that without becoming a yogi

F6ea948ab43dc51d72509c0989e670fe

(1639)

on May 15, 2011
at 06:05 AM

Holy cow. The pictures speak for themselves... :)

Medium avatar

(5136)

on May 15, 2011
at 05:23 AM

and i'd be thrilled to pay up if I just felt that some helpful action was taken to actually diagnose/remedy the situation beyond broad speculation and "meh... maybe this, or may be that" leaving my to deal with it on my own.

Medium avatar

(5136)

on May 15, 2011
at 05:21 AM

if i thought their approach was a bit too laissez faire, but if it's costing me just under $200 every time I go to a doctor, well then, getting no really helpful information just becomes expensive, annoying and frustrating.

Medium avatar

(5136)

on May 15, 2011
at 05:19 AM

yeah, this falls in line with an issue I have which is essentially the notion that "i'm healthy enough". Essentially it is a blow off diagnosis for chronic pain issue based on the fact that I "seem" pretty damn healthy. Apparently my issues are not progressed enough for them to think seriously about, even though i personally, would like to keep my chronic pains from progressing. This is a serious issue I have with docs, the generally (recently) lowered standards for overall acceptable health. I wouldn't have an issue with this if going to the doctor were cheap, and I could just switch doctors

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on May 15, 2011
at 12:41 AM

Good post I up voted it this.....I still come back to see new posts. I can tell you as a doc I am constantly challenging myself and my beliefs and my training. I think if you treat people to keep them healthy there is no way you get sued.....but there are many patients who just want CW care. They want a Rx when I offer a book......so I show them the door and let them go to my competitors

69a2a5deb24d5b8d3aae3d9652fac564

(1020)

on May 14, 2011
at 06:57 PM

should have read: "Our guff should not be with doctors"

69a2a5deb24d5b8d3aae3d9652fac564

(1020)

on May 14, 2011
at 06:54 PM

And by "for-profit" I mean profitable for everyone else OTHER than those on the front line of healthcare, ie Pharmaceutical companies, Lawyers, Insurance, etc.

69a2a5deb24d5b8d3aae3d9652fac564

(1020)

on May 14, 2011
at 06:52 PM

The man had PVD, and his hands were non-functioning. He had no nursng care at home. What was he supposed to do? Doing self trach care and g-tube feedings with no dexterity...it was only a matter of time before the man aspirated and died. Our guff is and should not be with doctors, (I got your back on that one Dr. K) but rather with lawyers and insurance companies. And the fact that healthcare is a for-profit endeavor first. Docs and nurses deserve to be paid, but the system of lawsuits and "defensive medicine" is broken.

69a2a5deb24d5b8d3aae3d9652fac564

(1020)

on May 14, 2011
at 06:52 PM

Additionally, people with insurance are more likely to get regular preventative checkups, and thus throughtout the span of their lifetime, require (on average) fewer medical interventions. To parallel Dr. K's examples of patient neglect due to fiscal relativity, here in the US I've had to discharge a patient with a trach, g-tube, NPO and several multi-drug resistant organisms back home alone, because he ran out of insurance. It's ludicrous.

69a2a5deb24d5b8d3aae3d9652fac564

(1020)

on May 14, 2011
at 06:49 PM

The issue is where you want to pick your healthcare costs? The Canadian model IMO has a bit of an edge in the fact that they work on the front end of the healthcare process. Back-end medical costs are typically long term and much more expensive. Front-end costs (aka preventative) are the least expensive and most effective. In the US, a huge chunck of the population goes without insurance, making the ER their first line of defense for healthcare. It's also the most expensive form of healthcare.

Medium avatar

(5136)

on May 14, 2011
at 05:03 PM

Melissa - exactly! you're so smart.

91219405abedbfd400ce00dea242a00f

(1044)

on May 14, 2011
at 04:13 PM

I think the major problem with our current system is how scared many physicians become to go against the grain because of lawsuit-happy patients. The idea of a standard of care becomes flawed if you are unable to disagree with it. If I do not prescribe statins to a patient with high cholesterol because I don't personally believe in it, and something goes wrong, I do not think any kind of paleo logic is going to save me from the hungry lawyers. I haven't experienced this myself as I'm still a student, but this is how it has basically been presented to me.

Medium avatar

(5136)

on May 14, 2011
at 03:46 PM

they were always criticizing me for what i explained was my diet. And it was always a case of me thinking "ok, but look at me and look at you. you look like hell. wait for the test." then of course the numbers were on my side. But my point is, there are some good docs in the Chicago area (at least I found some at NW) if your insurance covers it

Medium avatar

(5136)

on May 14, 2011
at 03:43 PM

Sherpamelissa, i had health insurance for a year once upon a time (it was pretty cool, i actually went to the dentist!) and so i decided I was going to the best doctors possible. This still cost me a little more than i expected but it was interesting. I went to Northwestern downtown Chicago and of course I explained that I eat a really high fat diet and avoid grains and am very particular about my fats. That was the first time I actually heard approval of my diet. I would go to some Polsih clinics occasionally to utilize their super cheap self pay blood work and

Medium avatar

(5136)

on May 14, 2011
at 03:34 PM

about #4, i'd much rather go see a doc annually/biannually to get some blood work run, a physical exam and hear "yup, you're doing just as well as you were last year" than never go see a doctor, if i thought that doctor was truly well informed.

A480640a53eb5dc8966f49141942f705

on May 08, 2011
at 11:17 PM

Also directlabs.com

0e4e5882872d6a7c472ea51aec457e66

(1994)

on May 01, 2011
at 05:56 PM

A mixture of some of those essential oils worked very well for my mother in law when she came home from Hospital with MRSA.

0e4e5882872d6a7c472ea51aec457e66

(1994)

on May 01, 2011
at 05:53 PM

This is an other alternative aproach to overcome MRSA: http://blog.aromapraxis.de/2011/04/14/letzte-chance-bei-mrsa-atherische-ole/ Eliane Zimmermann recommends following essential oils: Thymus vulgaris, Thymian Ct. Thymol, Thymus vulgaris, Thymian Ct. Carvacrol, Thymus serpyllum, Satureja montana, Origanum vulgare, Corydothymus capitatus, Thymbra spicata, Syzygium aromaticum, Cinnamomum zeylanicum fol., Ocimum sanctum (Tulsi), Pimenta dioica, Pimenta racemosa, Leptospermum scoparium (Manuka), and Melaleuca alternifolia. Lavender is also good to activate otherwise ineffective antibiotics.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on April 26, 2011
at 01:48 PM

Out of pocket is disclosed upfront in my case

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on April 25, 2011
at 10:24 PM

http://i574.photobucket.com/albums/ss187/livinlowcarbman/DSC_0023.jpg?t=1298846164

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on April 25, 2011
at 10:19 PM

yes.....you can go to Jimmy Moore's site and I believe he has a picture of me in his network of docs.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on April 25, 2011
at 10:18 PM

depends upon what your going for. If its a new doc.....well visit discuss with them their philosophy of keeping you well and how the practice works. Ask to speak to a a new patient and an older ones to get insight. I ask my patients to talk all the time to one another.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on April 25, 2011
at 10:17 PM

Evidence based medicine = this. The real problem with evidenced based medicine is who is collecting the evidence and is it helpful? See cholesterol and dietary recs are evidence one that they all have their heads up their asses.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on April 25, 2011
at 10:15 PM

well that is what medicine is becoming. cookbook medicine is what the government is advocating. That is what walgreens offers via its NP and nurses in their medi clinics.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on April 25, 2011
at 10:14 PM

so you get gas when you have no money? How shall the doctor pay to keep the lights on and the malpractice paid? You do realize that if I were to see you for free and something bad happen to you, legally you could still sue me even though I was doing the service for nothing? I guess you dont get it. Many of us do many things for free. We no longer can. When you make 23 dollars to see a medicare patient for an hour.......1+1 does not equal zero in my world. You had better wake up to that reality. We care as a profession but you also have to be realistic.

E5a41bcb2819c818cc0d92489e7c35f2

(300)

on April 25, 2011
at 10:11 PM

Prepaidlab.com rocks! My naturopath actually recommends that her patients go through them rather than other places, as they're significantly cheaper than any other place here in Portland for some tests.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on April 25, 2011
at 10:10 PM

so do we all. But there is a limit to resources.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on April 25, 2011
at 10:08 PM

not a fan of concierge medicine as it is constructed.....but I am a fan of services done ala carte for those who want them sans insurance. I have many patients ask to see me about diet and nutrition issues and hormone issues outside of my practice. Its just not feasible in that system. But that is why I am asking this question. I have a few outside the box ideas to solve it.

E5a41bcb2819c818cc0d92489e7c35f2

(300)

on April 25, 2011
at 10:08 PM

What were the sites your NP referred you to for more info on your blood test results? I just had some of those same tests drawn for on Friday and I'd love to see the resources!

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on April 25, 2011
at 10:04 PM

i cant give a RX i dont believe will help

7e746be2f0e550a8cd7df881322ae705

(18701)

on April 25, 2011
at 05:33 PM

I think it's awesome that you improved your arthritis issues with your own research and dietary changes! Awesome.

9f9fa49265e03ddd2bf2bba5477a556b

(3184)

on March 30, 2011
at 07:33 PM

I'm not following Dr. K. The paper you're talking about from the London group was, as best as I can tell, Cutler and Wilson (2004). Subsequent published research, best as I can tell, has only shown allicin working synergistically--e.g. no one has replicated the Staphylococcus inhibition shown by C&W. As far as garlic pre-op--pre-op for those who tested positive for what? And when are you publishing these results?

77877f762c40637911396daa19b53094

(78467)

on March 30, 2011
at 05:05 PM

I really like this answer b/c it touches on something important. Many in the MD community and also in holistic medicine (ND etc.) are going integrative. Yay! However, as they emphasize meditation and relieving stress they often still put patients in the same old position of a stressful visit and add more stress by not spending enough time. I used to say that I quit Kaiser because the stress of being their patient was taking years off my life:) Having no health insurance was less stressful on a daily basis. Emotions are part and parcel of medical care, not to be ignored and/or medicated.

77877f762c40637911396daa19b53094

(78467)

on March 30, 2011
at 04:14 PM

In San Fran there are a few docs who have advertised that they don't take insurance at all. (in other words they don't do the time consuming paperwork and spend that time with the patient!) They charge for each visit/service and it is up to the patient to fill out the paperwork for insurance or pay in cash. I really like that idea because it makes the fees for services more reasonable and the doc spends more time doing the doctoring.

77877f762c40637911396daa19b53094

(78467)

on March 30, 2011
at 04:09 PM

I guess I understand the whole price/managed care thing, but if a doctor takes patients who are paying out of pocket then they have to let me know how much $$ eventually. Why can't I know before I go? I'm not talking about going into Kaiser and asking. I don't even think they take out of pocket patients.

61b801de5dc345b557cd4623d4a4f26b

(2682)

on March 30, 2011
at 02:46 PM

I agree on the CV. It would be great to get some insight before making appts.

Medium avatar

(12379)

on March 29, 2011
at 10:03 PM

Fair enough. All I can give is my opinion and my experience. I was diagnosed and treated for cervical cancer in October of this past year. There were 3 weeks between diagnosis and treatment. I think that this was good. And I am happy with the speed of my treatment. I am only one voice, and I am sure there are others that have very different experiences. I know this is going to sound very Polyanna of me, but I wish that we could fix the broken systems so that people were treated quickly and fairly no matter what.

Bad3a78e228c67a7513c28f17c36b3cf

(1387)

on March 29, 2011
at 09:54 PM

Thanks! Good to know!

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on March 29, 2011
at 09:40 PM

I doubt you'd find any pro insurance company stances behind me. That number came from MNI neurosurgery clinics over the last 5 yrs. They cant get what they need because the money goes bye bye the last quarter. Once its gone you wait. Neurosurgery issues generally cant wait. Ask Liam Neeson or about that. (Natasha Richardson) Ironically this happened in Canada too.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on March 29, 2011
at 09:36 PM

I base it on weight. For a 70 kg person I ask them to eat 6 cloves a day for two weeks prior to and 2 weeks post any hospital based proceedure......except Xrays.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on March 29, 2011
at 09:34 PM

I worded it strongly because I completely disagree with you. That is my right. Context matters. I have seen Canadians die needlessly because they could not get a tumor removed because the money was gone the last quarter of the yr. You seem to think that is a good system. Its as crappy as ours is if you look at the context of the case. I have seen people die waiting for leukemia treatments and drugs that went unfunded because the system is a zero sum game. Works great if you get sick at the correct time of the yr or month. I cant tell folks when to get ill.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on March 29, 2011
at 09:31 PM

Bree I personally know four neurosurgeons at MNI in Montreal......that number came from them. And they told me if you need a surgery done Oct to Dec chances are youre going to Mayo to get it done accross the border. Balanced and Fair. Canada aint all that. Never said we were either.........

E2b9c679315c7c9c7265783dde89f350

(1303)

on March 29, 2011
at 08:51 PM

Perhaps an offer of "I recommend this book/article, but if you just want the pill to take care of the symptoms, then I can prescribe that too." would be enough? My doc was close- she prescribed the pill and suggested South Beach (I never did SB and stopped the pill, but it planted the idea for me long term, and helped me short term.

Bad3a78e228c67a7513c28f17c36b3cf

(1387)

on March 29, 2011
at 08:50 PM

How much garlic do you have them eat?

Medium avatar

(12379)

on March 29, 2011
at 06:13 PM

that you worded your comment. I hope that I am misinterpreting it. I was trying to be positive in my answer - and let you know what my experience in health care is.

Medium avatar

(12379)

on March 29, 2011
at 06:12 PM

Dr K. I did not mean to bash in any way. I disagree with the 40% of Canadians that go to the US. I have heard the bad stories of waitlists etc in Canada; however I think the good stories far outweigh the bad. When I had my son I had once a month visits, regular massage and chiropractic care, in-home post-natal and breastfeeding care for free. No system is perfect. I just really believe in the right to free healthcare. "Canada does not equal the US in any measure" is just a rude statement. Dr. K I really value everything that you have to say on PH, but I am really taken back with the way

F1b39d4f620876330312f4925bd51900

(4090)

on March 29, 2011
at 05:46 PM

I agree on the pre-interview (maybe call it a consultation). It is important to find a doctor that is right for you. I have had a few of these and laid out my health issues and what I have tried (in a super quick summary), then I simply ask..do you have any new ideas for me? If so, I make an appt.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on March 29, 2011
at 05:32 PM

No RG.....this was done pre op for those who tested positive bty nasal swab. We cancell their surgery and make them eat garlic for 2 weeks and then let the ID guys do what they want which is a bunch of nothing and we cut. And amazingly we have not had one MRSA case in 3 yrs.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on March 29, 2011
at 05:30 PM

That is why 40% of Canadians come to the US for care they cant get in Canada. This is not a bashing session.....its a thread to make things better. Free creates more problems in our system. Canada does not equal the US in any measure.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on March 29, 2011
at 05:28 PM

I disagree. It is a business. And to deny that is not a reality. We here are trying to make it better. If one does not have gas money at the station one never questions why you dont get gas. Why is going to the doctor any different. I see patients without insurance all the time and make it dirt cheap and they can pay it off on a CC. That includes surgery they need. We are not trying to kill people. Just keep the lights on and the malpractice paid.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on March 29, 2011
at 05:26 PM

i would encourage you to ask for the last appt of the day all the time.....doc has no where to go after that.....they can spend time. I spend up to an hour with some folks this way.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on March 29, 2011
at 05:24 PM

i learned 10 years ago not to do this

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on March 29, 2011
at 05:23 PM

everyday I do this.....but 50% of patients dont want a book sadly. They want a Rx and they get pissed and go bash me on the internet. It works both ways folks for us.

7e746be2f0e550a8cd7df881322ae705

(18701)

on March 29, 2011
at 04:58 PM

I want a doctor who asks me the questions that I don't know to ask. I am not a doctor, so please educate me on how to be a healthier person. - - YES!

Medium avatar

(12379)

on March 29, 2011
at 04:35 PM

You are so right - healthcare is not a business. I am so sorry to hear that you were turned away while pregnant - I think that is shameful!

Bad3a78e228c67a7513c28f17c36b3cf

(1387)

on March 29, 2011
at 04:20 PM

Yes, I have read about the allicin. I also thought this was very interesting http://www.harvesthomeorganics.com/documents/staphresearch.pdf even if it was funded by the oregano company.

7e746be2f0e550a8cd7df881322ae705

(18701)

on March 29, 2011
at 03:53 PM

Yes, my doctors very often talk down to me.

9f9fa49265e03ddd2bf2bba5477a556b

(3184)

on March 29, 2011
at 03:21 PM

Cutler and Wilson was 2004. Not to nitpick. But I hope you don't prescribe this based on 1 paper. Cai et al. (2007) found that allicin alone was not particularly effective, but worked synergistically with beta lactams. A similar effect has been seen with Candida infections (Khodavani et al. 2010). Of course, if you had a MRSA infection you should have been sent to an ID doc stat. And it is unlikely it was MRSA if you took a full round of antibiotics and the infection really didn't clear and you were still alive.

9f9fa49265e03ddd2bf2bba5477a556b

(3184)

on March 29, 2011
at 02:58 PM

Physicians overbook because of insurance/government pay policies. Without volume they're not going to make ends meet and be able to run a successful practice (economically successful, maybe not so successful for the rushed patients). Again, if you don't want to be rushed, you're going to have to pay out of pocket. I found several concierge docs in Los Angeles (of all places) with annual costs that run less to slightly more than a Crossfit gym membership. All guarantee non-rushed appointments and even walk in appointments. They can do that because they're not spending hours doing paperwork.

04293f705870e1837b8670d3c1cd5f67

(2261)

on March 29, 2011
at 02:27 PM

I am glad to hear about prepaidlab.com., I wouldn't mind paying for a lab once in awhile to get an idea.

Aebee51dc2b93b209980a89fa4a70c1e

(1982)

on March 29, 2011
at 02:18 PM

Maybe Drs.shouldn't make it a policy to intentionally overbook, and then they wouldn't be so rushed.

7e746be2f0e550a8cd7df881322ae705

(18701)

on March 29, 2011
at 02:05 PM

I do come in prepared with questions and I rarely get through them all, the doctor is very rushed. I do get afternoon appointments, but it doesn't seem to help. When I told my doctor about Paleo and made the decision to get off the blood pressure / water retention meds, she told me I needed to eat grains. She was suspicious, not impressed by my weight loss and taking my health into my own hands. She did schedule an EKG which came out good, so I am now officially off the meds. Hopefully finding a new doctor soon.

77732bf6bf2b8a360f523ef87c3b7523

(6157)

on March 29, 2011
at 01:41 PM

I think the better solution is simply to switch to salary. Incentives are very, very powerful. Unfortunately, the incentive to do switch from PPP to salary is lacking. lol

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on March 29, 2011
at 12:24 PM

Eating garlic for ten days and putting garlic extract on the wound would have done the trick too. Study out of east London showed this in 2009.

4b97e3bb2ee4a9588783f5d56d687da1

(22913)

on March 29, 2011
at 08:55 AM

@Jae. Word of mouth will bring new clients.

04293f705870e1837b8670d3c1cd5f67

(2261)

on March 29, 2011
at 03:55 AM

P. S. I have Group Health (through hubby's work) I like it very much, but I didn't pick the coverage.

77732bf6bf2b8a360f523ef87c3b7523

(6157)

on March 29, 2011
at 03:40 AM

Unfortunately #4 is against financial self-interest for any doctor who is paid per procedure and not a simple salary.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on March 29, 2011
at 03:19 AM

Well I am not satisfied with a lot in my own profession but my issues may be different than a patients. This thread could be very helpful to me and to others. Thanks for your kind words but I think the customers know what is wrong with us docs.....and I want to hear it loud and clear.

B1fcaceba952861d0324bdb291edbbe0

(3159)

on March 29, 2011
at 03:14 AM

Dr.K, I commented but also just wanted to say, it's when doctors take an avid interest in providing the patient with what they want and having a sincere desire to heal them that matters most. From reading your posts throughout the forum, I definitely think you have these qualities.

B1fcaceba952861d0324bdb291edbbe0

(3159)

on March 29, 2011
at 03:13 AM

Dr.K, I commented but also just wanted to say, it's when doctors take an avid interest in providing the patient with what they want and having a sincere desire to heal them that matters most. From your posts throughout the forum, you have these qualities.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on March 29, 2011
at 02:31 AM

its illegal to give out prices over the phone due to manage care contracts.......but we usually get around that easy.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on March 29, 2011
at 02:29 AM

Do you come in with prepared questions? Do you ask for the last appt of the day? If you do this is the time of the day I am not rushed and I schedule this time for my patients who need it or who have broken metabolisms that need extra TLC

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on March 29, 2011
at 02:26 AM

The interview would be easy to execute. I never thought that patients would want a CV.

D67e7b481854b02110d5a5b21d6789b1

(4111)

on March 29, 2011
at 02:00 AM

the interview suggestion is golden! if that can't happen, then a published curriculum vitae with education, background and treatment philosophy would be nice too.

7e746be2f0e550a8cd7df881322ae705

(18701)

on March 29, 2011
at 01:40 AM

I was given Xanax without asking for it! It was bizarre. I am jealous of your nurse practicioner. I had one for awhile and adored him. He moved to another practice though and I wasn't told where he went. He had been previously obese and understood a lot of what I had gone through.

Cc2a43461ec5b2b7ba5d55215ea0f068

(236)

on March 29, 2011
at 12:47 AM

I'm willing to pay cash for the standard routine stuff and have major medical for just that - major, unexpected injury or illness. That's what "insurance" really was always meant to be. IMO, of course.

4b97e3bb2ee4a9588783f5d56d687da1

(22913)

on March 29, 2011
at 12:45 AM

also agreed, practice what you preach is mandatory.

4b97e3bb2ee4a9588783f5d56d687da1

(22913)

on March 29, 2011
at 12:45 AM

hah, id love for a doc to hand me a book... instead of a prescription.

4b97e3bb2ee4a9588783f5d56d687da1

(22913)

on March 29, 2011
at 12:33 AM

You'd need to establish that trust before ever selling services online. Personally I'd rather have my Doctor like my Food. Local.

4b97e3bb2ee4a9588783f5d56d687da1

(22913)

on March 29, 2011
at 12:30 AM

Angelo Coppola sums it up quite nicely: " Human beings are not broken by default". It really pulls together how I feel about this "whole" lifestyle change for me and mine.

4b97e3bb2ee4a9588783f5d56d687da1

(22913)

on March 29, 2011
at 12:29 AM

@Dr.K: Id love to have web based diagnostic testing I could trust. as for wellness advice, me personally,no. I went out and learned how to read about health. I say "learned how to read about health" because its a far different skill than just reading stuff on the internet. I could see it being a benefit for someone that does have the time to read, yet they'd be trusting you the same as Blog X.

34a367e60db77270bd7096dc04270fdc

(4171)

on March 29, 2011
at 12:20 AM

I love what you said too Stephen - I personally have not seen a doctor in almost a decade because I hate them. I recently went with my husband to his routine appointment to a new doctor (we just moved). This man told my husband that because he's type 2 diabetic (he's also about 20-30 lbs overweight) he will never be healthy, he will never manage his diabetes without meds or by changing anything about his lifestyle and if he doesn't agree to get on a statin drug he will have a heart attack and he will not live as long. I'm fed up with trying to find a doctor that isn't a complete idiot.

Cab7e4ef73c5d7d7a77e1c3d7f5773a1

(7304)

on March 28, 2011
at 11:56 PM

Yes! I had to be very persistent. They were like oh, you got one 6 months ago. Yes, 6 months ago!!

06d21b99c58283ce575e36c4ecd4a458

(9948)

on March 28, 2011
at 11:56 PM

You can get your own Vit D3 test in Tacoma for $59.80 at http://www.prepaidlab.com/View-all-products-in-shop.html?keyword=25+hydroxy You pay for the testing. No insurance.

06d21b99c58283ce575e36c4ecd4a458

(9948)

on March 28, 2011
at 11:53 PM

You can get your own Vit D3 test in Tacoma for $60 at http://www.prepaidlab.com/View-all-products-in-shop/Page-8-20.html?keyword=vit+d You pay for the testing. No insurance.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on March 28, 2011
at 11:50 PM

And if your doctor refuses ask why. If the answer is not good find a new doc. Our job is to keep you well and fit.....and healthy not just when your sick either.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on March 28, 2011
at 11:49 PM

I love this Stephen. Tell me what caused you to have this philosophy. I can see the passion in which you wrote it on the page. Help me make make the experience better. Do you think offering a web based dirt cheap service would be viable option for someone like yourself who just wanted wellness advice?

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on March 28, 2011
at 11:47 PM

correct. We can order your D level anytime. But it may cost you. That is not our fault. You signed up for that coverage.

4b97e3bb2ee4a9588783f5d56d687da1

(22913)

on March 28, 2011
at 11:42 PM

thats not your doc, thats your insurance.

  • Ed71ab1c75c6a9bd217a599db0a3e117

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30 Answers

19
4b97e3bb2ee4a9588783f5d56d687da1

on March 28, 2011
at 11:42 PM

  1. Functional Medicine.
    • Not optional, must be based on solving the ROOT problem.
  2. Honesty
    • A Doc that can say: "I don't know, but ill find out for you"
  3. Useful Tests.
    • Nutrient Deficiency, Complete Allergen Testing, A1C, Lipid Density.
  4. A desire to very rarely see me again professionally.
    • Self explanatory.
  5. Drugs as a Last Resort, not the first.

I want a doctor to be Educated about how to diagnose issues. Not how to prescribe band-aids.

Personally, im only concerned with doctors now, if I have a traumatic accident.

If something did happen, I would seek a doctor that was fully committed to Diagnosing the Root Cause, and would have that discussion before coming in.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on March 28, 2011
at 11:49 PM

I love this Stephen. Tell me what caused you to have this philosophy. I can see the passion in which you wrote it on the page. Help me make make the experience better. Do you think offering a web based dirt cheap service would be viable option for someone like yourself who just wanted wellness advice?

4b97e3bb2ee4a9588783f5d56d687da1

(22913)

on March 29, 2011
at 12:33 AM

You'd need to establish that trust before ever selling services online. Personally I'd rather have my Doctor like my Food. Local.

4b97e3bb2ee4a9588783f5d56d687da1

(22913)

on March 29, 2011
at 12:29 AM

@Dr.K: Id love to have web based diagnostic testing I could trust. as for wellness advice, me personally,no. I went out and learned how to read about health. I say "learned how to read about health" because its a far different skill than just reading stuff on the internet. I could see it being a benefit for someone that does have the time to read, yet they'd be trusting you the same as Blog X.

4b97e3bb2ee4a9588783f5d56d687da1

(22913)

on March 29, 2011
at 08:55 AM

@Jae. Word of mouth will bring new clients.

4b97e3bb2ee4a9588783f5d56d687da1

(22913)

on March 29, 2011
at 12:30 AM

Angelo Coppola sums it up quite nicely: " Human beings are not broken by default". It really pulls together how I feel about this "whole" lifestyle change for me and mine.

77732bf6bf2b8a360f523ef87c3b7523

(6157)

on March 29, 2011
at 03:40 AM

Unfortunately #4 is against financial self-interest for any doctor who is paid per procedure and not a simple salary.

34a367e60db77270bd7096dc04270fdc

(4171)

on March 29, 2011
at 12:20 AM

I love what you said too Stephen - I personally have not seen a doctor in almost a decade because I hate them. I recently went with my husband to his routine appointment to a new doctor (we just moved). This man told my husband that because he's type 2 diabetic (he's also about 20-30 lbs overweight) he will never be healthy, he will never manage his diabetes without meds or by changing anything about his lifestyle and if he doesn't agree to get on a statin drug he will have a heart attack and he will not live as long. I'm fed up with trying to find a doctor that isn't a complete idiot.

77732bf6bf2b8a360f523ef87c3b7523

(6157)

on March 29, 2011
at 01:41 PM

I think the better solution is simply to switch to salary. Incentives are very, very powerful. Unfortunately, the incentive to do switch from PPP to salary is lacking. lol

Medium avatar

(5136)

on May 14, 2011
at 03:34 PM

about #4, i'd much rather go see a doc annually/biannually to get some blood work run, a physical exam and hear "yup, you're doing just as well as you were last year" than never go see a doctor, if i thought that doctor was truly well informed.

11
D67e7b481854b02110d5a5b21d6789b1

on March 28, 2011
at 11:53 PM

I want a physician that will view any health problem I may be dealing with as a puzzle to be solved, not just symptoms to ameliorate with drugs. What a change it would be to get a recommendation to read a book instead of a prescription for a pill!

I want a physician who not only is knowledgeable in nutrition-regulated health, but who follows the lifestyle themselves in order to be an example for their patients. I don't want a hair stylist who looks like Don King, so why would I want a doctor who needs ten weeks with Jillian Michaels?

4b97e3bb2ee4a9588783f5d56d687da1

(22913)

on March 29, 2011
at 12:45 AM

hah, id love for a doc to hand me a book... instead of a prescription.

4b97e3bb2ee4a9588783f5d56d687da1

(22913)

on March 29, 2011
at 12:45 AM

also agreed, practice what you preach is mandatory.

E2b9c679315c7c9c7265783dde89f350

(1303)

on March 29, 2011
at 08:51 PM

Perhaps an offer of "I recommend this book/article, but if you just want the pill to take care of the symptoms, then I can prescribe that too." would be enough? My doc was close- she prescribed the pill and suggested South Beach (I never did SB and stopped the pill, but it planted the idea for me long term, and helped me short term.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on March 29, 2011
at 05:23 PM

everyday I do this.....but 50% of patients dont want a book sadly. They want a Rx and they get pissed and go bash me on the internet. It works both ways folks for us.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on April 25, 2011
at 10:04 PM

i cant give a RX i dont believe will help

4
95601768ec9cb75cc3a9cbcd2271ed14

(2206)

on March 29, 2011
at 01:37 AM

I've had plenty of crappy doctor's experiences throughout the years. Some of my biggest gripes from those are:

-Being treated with suspicion rather than curiosity or concern--at times I've been made to feel like a burden (presenting too many things at once), drug seeker, or hypochondriac who has been taken in by internet scare mongering and am certain that my care suffered from those snap assumptions. For instance, in college I once simply asked for a referral to an allergist from the campus doc. After ten minutes, he told me I was suffering from anxiety and wrote me a valium prescription and refused to give me a referral.

-Having questions met with ambivalence or even hostility. Questioning the efficacay of a proposed intervention, asking for a specific test, asking for clarification, or requesting a copy of test results have all gotten me terse responses and sometimes outright refusals.

-Being encouraged to be a poor advocate for my own health by the paternalistic nature of some doctors and the health care system. The "shut up and take this pill cos daddy know's best" attitude has reigned throughout most of my medical experiences and really disempowered me over time. I'm working hard to rectify this.

My ideal health practitioner would be the opposite of the above. Luckily, my current one is! I recently started going to a sliding scale community health clinic on account of being uninsured for the past nine years and living well below the poverty line. I was assigned to a nurse practitioner who has been the most pleasant surprise in the two times I have seen her. She immediately ordered a complete metabolic panel, A1C, TSH/T3/T4, and a CBC and told me online sites where I could seek additional clarification of my results in case she couldn't get to it all during my appointment. She also explained why she was ordering them since she knew I would be paying out of pocket. She is warm and open to questions and ideas. She lit up when I said I chart my menstrual cycle and seems to respect my knowledge about my body. She said she prefers nutritional & lifestyle interventions and wishes more people were open to them. She has yet to mention drugs. She has yet to say the word cholesterol. She recommends eating gluten-free. She is up on current science. She is a treasure.

7e746be2f0e550a8cd7df881322ae705

(18701)

on March 29, 2011
at 01:40 AM

I was given Xanax without asking for it! It was bizarre. I am jealous of your nurse practicioner. I had one for awhile and adored him. He moved to another practice though and I wasn't told where he went. He had been previously obese and understood a lot of what I had gone through.

E5a41bcb2819c818cc0d92489e7c35f2

(300)

on April 25, 2011
at 10:08 PM

What were the sites your NP referred you to for more info on your blood test results? I just had some of those same tests drawn for on Friday and I'd love to see the resources!

3
Ee7ee29e000bd4918c06ff75b6b1bb12

(195)

on May 15, 2011
at 06:13 PM

These have probably already been mentioned in the above answers, but I would love to see:

  1. clinical problem solving that gets to the base of a problem, rather than symptom treatment only
  2. doctors who show an understanding of true human function and give attention to the fact that everything is connected. More holistic perspectives are needed, I believe.
  3. efficient documentation systems that don't require patients to constantly have to repeat information each visit
  4. doctors who really pay attention to how they obtain info. from patients, understanding how they are phrasing questions and how the patient is understanding the questions asked. The same goes for how information is shared.

3
Aebee51dc2b93b209980a89fa4a70c1e

(1982)

on March 29, 2011
at 02:22 PM

I would also like to find a Dr. who doesn't carry such an air of arrogance (not you, Dr. K.; you seem like a good guy). They routinely talk down to me, brush off my questions, treat my own thoughts about my own health as silly. No, I don't have medical training, but I read a lot about matters of health, and I'm a college professor and fiction writer with seven books published, so I don't exactly need to have basic conversation dumbed-down for me. Also, when I'm kept in waiting rooms for over an hour, I assume that once again the Dr. has overbooked, intentionally, and that the assumption is that his time is more valuable than mine.

7e746be2f0e550a8cd7df881322ae705

(18701)

on March 29, 2011
at 03:53 PM

Yes, my doctors very often talk down to me.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on March 29, 2011
at 05:24 PM

i learned 10 years ago not to do this

3
77877f762c40637911396daa19b53094

(78467)

on March 29, 2011
at 01:41 AM

I would like a doctors to give prices over the phone so I can decide if I want to see them based on what I can afford out of pocket.

I would like doctors to allow patients to interview them (at least a short call over the phone) to determine compatibility.

I would like doctors to be more open minded and up on new medical studies. And if they are not to allow the idea that they could learn from the patient. At least not be openly hostile about my research.

I would like my doctor to ask more questions about what I am doing to keep myself healthy. Focus more on positive ways I'm improving my health. Suggestions to build on that are perfect.

I would like doctors to stop making it seem as though there is a one size fits all program for health. What I think works for me is as important as what the doc thinks will work.

To those doctors who say these simple things are not possible, fine, I will continue taking care of my own health and only go to free clinics where I don't listen to anything they tell me and use them only for blood testing and other lab work.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on March 29, 2011
at 02:31 AM

its illegal to give out prices over the phone due to manage care contracts.......but we usually get around that easy.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on March 29, 2011
at 02:26 AM

The interview would be easy to execute. I never thought that patients would want a CV.

D67e7b481854b02110d5a5b21d6789b1

(4111)

on March 29, 2011
at 02:00 AM

the interview suggestion is golden! if that can't happen, then a published curriculum vitae with education, background and treatment philosophy would be nice too.

F1b39d4f620876330312f4925bd51900

(4090)

on March 29, 2011
at 05:46 PM

I agree on the pre-interview (maybe call it a consultation). It is important to find a doctor that is right for you. I have had a few of these and laid out my health issues and what I have tried (in a super quick summary), then I simply ask..do you have any new ideas for me? If so, I make an appt.

77877f762c40637911396daa19b53094

(78467)

on March 30, 2011
at 04:09 PM

I guess I understand the whole price/managed care thing, but if a doctor takes patients who are paying out of pocket then they have to let me know how much $$ eventually. Why can't I know before I go? I'm not talking about going into Kaiser and asking. I don't even think they take out of pocket patients.

61b801de5dc345b557cd4623d4a4f26b

(2682)

on March 30, 2011
at 02:46 PM

I agree on the CV. It would be great to get some insight before making appts.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on April 26, 2011
at 01:48 PM

Out of pocket is disclosed upfront in my case

3
7e746be2f0e550a8cd7df881322ae705

on March 29, 2011
at 12:53 AM

More than anything I want a doctor that ASKS ME QUESTIONS and LISTENS TO MY ANSWERS.

First the nurse comes in and checks my blood pressure and asks why I'm there. Then the doctor breezes in and updates my prescription because everything is status quo. She never asked how I was doing with anything. When I expressed my desire to figure out WHAT caused my blood pressure issue it just seemed to confuse her. I had medication, things were under control, WHY would I want to know what caused it. I asked about tests and she wasn't even listening. When the results came in, they weren't what I asked for.

I had a doctor that spent more time with me and all the other patients, but he was so good he got extremely busy and it was hard to get into an appointment with him. He was still all about the pills, but at least he talked to me.

Aebee51dc2b93b209980a89fa4a70c1e

(1982)

on March 29, 2011
at 02:18 PM

Maybe Drs.shouldn't make it a policy to intentionally overbook, and then they wouldn't be so rushed.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on March 29, 2011
at 02:29 AM

Do you come in with prepared questions? Do you ask for the last appt of the day? If you do this is the time of the day I am not rushed and I schedule this time for my patients who need it or who have broken metabolisms that need extra TLC

9f9fa49265e03ddd2bf2bba5477a556b

(3184)

on March 29, 2011
at 02:58 PM

Physicians overbook because of insurance/government pay policies. Without volume they're not going to make ends meet and be able to run a successful practice (economically successful, maybe not so successful for the rushed patients). Again, if you don't want to be rushed, you're going to have to pay out of pocket. I found several concierge docs in Los Angeles (of all places) with annual costs that run less to slightly more than a Crossfit gym membership. All guarantee non-rushed appointments and even walk in appointments. They can do that because they're not spending hours doing paperwork.

7e746be2f0e550a8cd7df881322ae705

(18701)

on March 29, 2011
at 02:05 PM

I do come in prepared with questions and I rarely get through them all, the doctor is very rushed. I do get afternoon appointments, but it doesn't seem to help. When I told my doctor about Paleo and made the decision to get off the blood pressure / water retention meds, she told me I needed to eat grains. She was suspicious, not impressed by my weight loss and taking my health into my own hands. She did schedule an EKG which came out good, so I am now officially off the meds. Hopefully finding a new doctor soon.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on March 29, 2011
at 05:26 PM

i would encourage you to ask for the last appt of the day all the time.....doc has no where to go after that.....they can spend time. I spend up to an hour with some folks this way.

Medium avatar

(5136)

on May 14, 2011
at 03:46 PM

they were always criticizing me for what i explained was my diet. And it was always a case of me thinking "ok, but look at me and look at you. you look like hell. wait for the test." then of course the numbers were on my side. But my point is, there are some good docs in the Chicago area (at least I found some at NW) if your insurance covers it

Medium avatar

(5136)

on May 14, 2011
at 03:43 PM

Sherpamelissa, i had health insurance for a year once upon a time (it was pretty cool, i actually went to the dentist!) and so i decided I was going to the best doctors possible. This still cost me a little more than i expected but it was interesting. I went to Northwestern downtown Chicago and of course I explained that I eat a really high fat diet and avoid grains and am very particular about my fats. That was the first time I actually heard approval of my diet. I would go to some Polsih clinics occasionally to utilize their super cheap self pay blood work and

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on May 15, 2011
at 11:22 PM

There is a doc in Chicago who will it down with you for close to an hour to talk.......to be his patient will cost a bunch....but to go and see what he does for an hour he will do gratis.

3
9f9fa49265e03ddd2bf2bba5477a556b

(3184)

on March 29, 2011
at 12:40 AM

It sounds like most people want a doctor to spend more time to them and listen more and just practice better medicine. This is pretty much what patients always want. My question would be how many people are willing to go the concierge medicine route? If you want doctors to practice real medicine, then you're going to need to divorce doctors from both insurance and government paying the tab. The fact is that it is always going to be cheaper to for insurers and government to force physicians into practicing fast food medicine.

Yeah, I can do a decent focused exam and history inside of 15 minutes. If I have to do 3 or 4 an hour and then sit around for hours after work doing paperwork and arguing with your insurance company or Medicare over ordering tests for you, well, that 15 minute exam isn't going to be that great towards the end of the day. Plus, if you have some complicated issues and I can only bill for one chief complaint per visit, or if you want nutritional counseling or whatever--yeah, that isn't going to happen so well under the current system.

I would love to set up the kind of practice that people on here want in a few years when I get done with school and residency, but unless the market is there (and fortunately, I think it is), I won't be able to practice the kind of medicine that I want and that I owe to my patients. So it starts with the patients--you need to demand the kind of service that you want, and it just isn't going to come through your PPO, HMO, government plan or anything like that. So seek out the doctors in your cities that are doing concierge plans and support them. Many of them won't necessarily share your nutritional views, but here's the thing--you're paying them directly. They want to keep you happy as patient and a customer. So they'll research it themselves and hopefully become more open minded, especially if more patients are pushing for it. Direct payment between you and your physician is going to lead to them being more responsive. That, and it makes primary care more lucrative, which means you get more and better doctors choosing it instead of going into subspecialties where they can use their talents after you've trashed your body for years.

So as a future physician, I'm telling you all that I want to help you (well, the greater "you") all and I want to practice good medicine, but consumers have got to create the right market for physicians. I don't want the government coming between me and my patients and I don't want insurers coming between me and my patients. Me and my patients are the only parties that really have a vested interest in my patients health.

I certainly welcome Dr. K or any other practicing physicians thoughts on this, but I, for one, have about zero desire to run a practice (or be part of a practice) that sees patients merely as RVUs.

Cc2a43461ec5b2b7ba5d55215ea0f068

(236)

on March 29, 2011
at 12:47 AM

I'm willing to pay cash for the standard routine stuff and have major medical for just that - major, unexpected injury or illness. That's what "insurance" really was always meant to be. IMO, of course.

77877f762c40637911396daa19b53094

(78467)

on March 30, 2011
at 04:14 PM

In San Fran there are a few docs who have advertised that they don't take insurance at all. (in other words they don't do the time consuming paperwork and spend that time with the patient!) They charge for each visit/service and it is up to the patient to fill out the paperwork for insurance or pay in cash. I really like that idea because it makes the fees for services more reasonable and the doc spends more time doing the doctoring.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on April 25, 2011
at 10:08 PM

not a fan of concierge medicine as it is constructed.....but I am a fan of services done ala carte for those who want them sans insurance. I have many patients ask to see me about diet and nutrition issues and hormone issues outside of my practice. Its just not feasible in that system. But that is why I am asking this question. I have a few outside the box ideas to solve it.

2
F6ea948ab43dc51d72509c0989e670fe

(1639)

on May 15, 2011
at 04:05 AM

A doctor who's willing to listen to me is the highest on the list.

For instance, I have a low thyroid (pre-paleo, I've yet to get it tested after switching 2 months ago). I talked to my doctor about adding a T3 replacement (cytomel) in addition to the T4 I took at the time (synthroid, now levoxyl). He laughed at my efforts to lose weight, my miserable attitude, and what I could only assume was depression at the time.

I fired him after he decided that not only did I not need T3, but I should switch to a low fat high carb diet. I had tried that one before and it was miserable. I have a reasonable suspicion that even if I went back with an incredible lab result, and have lost weight, he would still assume that T3 and paleo would be stupid.

I found a new doctor (well, a naturopath). She takes the time to talk to me, to get me on the right dosages for my T3 (yay!) and T4 meds, and intelligently communicates to me why we should do something, rather than just writing a prescription for something.

Several things I like:

  • knowledge of the endocrine system. Understood the problems I was having with the low thyroid and got me on the correct meds to fix it.

  • Doesn't tell me that paleo is stupid. I'm not sure she understands why I like it, but she likes the results. I'm not sure I've gotten her off the hcg bandwagon, but I might if I can keep the results up. I look and feel better than most people on that diet.

  • Willing to talk. I seriously spent 30 minutes with her one day, going over every detail of the lab results, what we should order next for labs, and how we needed to approach the problem if this didn't work. If I don't understand something, or disagree, she's willing to take the time to explain why she has a certain approach and either to get me to agree, or to find a different option.

  • Willing to let me help run my care. If I know that I'm not feeling as well as I should, that something is not working, we're willing to work together to find a solution. More labs, more tests, and more brainstorming.

  • Willing to order whatever I want for labs. My next one will have a bunch of stuff that's been discussed on here and other places in the paleosphere...sort of curious to see what it's going to be like.

The one major difference between the two docs, and why I switched?

My naturopath is willing to let me assume a bit more control of the patient/doctor relationship. She's willing to listen to my opinions, and appears to respect them. I am a bit leery of doctors, but I find the ones that earn my respect, money and time are the ones who are willing to work with me, instead of ordering me about. I don't want to be on a diet or pills that are killing the majority of americans (yeah, I'm looking at you, low fat/high carb).

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on May 15, 2011
at 12:52 PM

ok.....here is a free tip. basd upon the above I will bet you I can solve the thyroid mystery. Go ask your doc or NP to order you a salivary cortisol test. My bet is it will be abnormal. When it is I bet they throw their hands up and tell you to meditate or get a pedicure or exercise less to reduce your stress......I will tell you why it happened. Its due to high CRH. CRH directly dampens TSH and down regulates metabolism. Once you control CRH your thyroid function will return. When you get the test and see I am right you can then ask me how to help that without becoming a yogi

F6ea948ab43dc51d72509c0989e670fe

(1639)

on May 16, 2011
at 04:49 AM

Thanks! I was starting to think that I have issues with cortisol. Sleep disturbances, a cpap machine, stress, and I love staying up till 2 a.m. and hate waking up early. I was going to talk to her about it this week. In addition to the possible leptin resistance, adrenals (well, cortisol), and possibly some sort of dopamine/seratonin disruption as well. My weight loss/fat loss has stalled, so I've started eliminating options. And yes, I would love to figure it out without being a yogi :)

F6ea948ab43dc51d72509c0989e670fe

(1639)

on May 16, 2011
at 04:51 AM

I've gotten the blackout blinds, gotten rid of 90% of the stress, and am getting the diet close to 100%. No outrageous workouts either. At most 2-4 30 minute sessions a week. KB swings, no scary metcon sessions. I'm sure I'll have a fun question to ask this next week...

F6ea948ab43dc51d72509c0989e670fe

(1639)

on May 16, 2011
at 09:30 PM

My doc only does the blood one, so I got that, and then went and ordered the home saliva test (with the 4 that you take throughout the day) just to make sure I get it fixed...it's money out of pocket, but I really really want to make sure I get a handle on this. I know something is messed up, it's just a question of what.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on May 25, 2011
at 07:20 PM

i use zrtlabs.com They send the test to the patient with instructions and send you the direct result......then you bring it to your doc to interpret with you. My patients like it because they feel like part of the plan.

F6ea948ab43dc51d72509c0989e670fe

(1639)

on May 26, 2011
at 05:06 AM

Thanks! I actually used them, they got the test this morning. Should find out the results in the next 5-10 days...I hope. Just based on the blood test my adrenals were out of wack. So curiosity...I started reading 'the monk whole sold his ferarri'. How much control of the body (symptoms, states, etc) do you think the mind is in control of?

2
61b801de5dc345b557cd4623d4a4f26b

(2682)

on March 30, 2011
at 03:00 PM

My experience with doctors has been what I consider an "assembly line" treatment: they see patient after patient, quick as they can, and are so entrenched in the routine they forget to pause and look up and offer any real suggestions. I suppose my complaint equals a lot of the others on this thread: doctors don't offer their full attention and their treatment suggestions often turn out to be "take a pill."

The last doctor's visit I had, I complained about a specific pain (increasingly more painful menstrual cramps, which I used to never get) and asked the doc what the cause might be and how could I fix the problem. Instead of a solution, I was told that it is safe for me to take up to 8 Advil a day. That was her medical advise.

Dr. K, I have made an appt with a new doctor for early next week. Do you have any suggestions on questions I could ask him or tests I should request? I feel that the doctor/patient relationship is a two-way street and I want to make sure I am holding up my end of the conversation.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on April 25, 2011
at 10:18 PM

depends upon what your going for. If its a new doc.....well visit discuss with them their philosophy of keeping you well and how the practice works. Ask to speak to a a new patient and an older ones to get insight. I ask my patients to talk all the time to one another.

Medium avatar

(5136)

on May 15, 2011
at 05:23 AM

and i'd be thrilled to pay up if I just felt that some helpful action was taken to actually diagnose/remedy the situation beyond broad speculation and "meh... maybe this, or may be that" leaving my to deal with it on my own.

Medium avatar

(5136)

on May 15, 2011
at 05:19 AM

yeah, this falls in line with an issue I have which is essentially the notion that "i'm healthy enough". Essentially it is a blow off diagnosis for chronic pain issue based on the fact that I "seem" pretty damn healthy. Apparently my issues are not progressed enough for them to think seriously about, even though i personally, would like to keep my chronic pains from progressing. This is a serious issue I have with docs, the generally (recently) lowered standards for overall acceptable health. I wouldn't have an issue with this if going to the doctor were cheap, and I could just switch doctors

61b801de5dc345b557cd4623d4a4f26b

(2682)

on May 16, 2011
at 12:28 PM

For those interested, the visit with my new doctor was promising. She actually listened, asked questions, and was able to offer a potential diagnosis and follow-up plan.

Medium avatar

(5136)

on May 15, 2011
at 05:21 AM

if i thought their approach was a bit too laissez faire, but if it's costing me just under $200 every time I go to a doctor, well then, getting no really helpful information just becomes expensive, annoying and frustrating.

2
Medium avatar

(12379)

on March 29, 2011
at 04:32 PM

I want a doctor who understands what my family wants and needs (ie our philosophy on healthcare - drugs, diets etc) I want a doctor who asks me the questions that I don't know to ask. I am not a doctor, so please educate me on how to be a healthier person. Advise me on which chiroproctors, massage therapists etc are the best in our community and provide me with a reference to these best practitioners in my area.

Be the champion of my health and my family's health (even though I am the primary advocate for my family - I need some backup sometimes).

I live in Canada - so my healthcare is free, I feel so sad hearing for all the talk of paying for tests and doctors visits especially the story of being sent away while pregnant - I think that it is shameful that such an advanced country makes their people pay for such a simple right. We all deserve the right to free and equal healthcare

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on March 29, 2011
at 09:34 PM

I worded it strongly because I completely disagree with you. That is my right. Context matters. I have seen Canadians die needlessly because they could not get a tumor removed because the money was gone the last quarter of the yr. You seem to think that is a good system. Its as crappy as ours is if you look at the context of the case. I have seen people die waiting for leukemia treatments and drugs that went unfunded because the system is a zero sum game. Works great if you get sick at the correct time of the yr or month. I cant tell folks when to get ill.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on March 29, 2011
at 05:30 PM

That is why 40% of Canadians come to the US for care they cant get in Canada. This is not a bashing session.....its a thread to make things better. Free creates more problems in our system. Canada does not equal the US in any measure.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on March 29, 2011
at 09:31 PM

Bree I personally know four neurosurgeons at MNI in Montreal......that number came from them. And they told me if you need a surgery done Oct to Dec chances are youre going to Mayo to get it done accross the border. Balanced and Fair. Canada aint all that. Never said we were either.........

Medium avatar

(12379)

on March 29, 2011
at 06:12 PM

Dr K. I did not mean to bash in any way. I disagree with the 40% of Canadians that go to the US. I have heard the bad stories of waitlists etc in Canada; however I think the good stories far outweigh the bad. When I had my son I had once a month visits, regular massage and chiropractic care, in-home post-natal and breastfeeding care for free. No system is perfect. I just really believe in the right to free healthcare. "Canada does not equal the US in any measure" is just a rude statement. Dr. K I really value everything that you have to say on PH, but I am really taken back with the way

Medium avatar

(12379)

on March 29, 2011
at 06:13 PM

that you worded your comment. I hope that I am misinterpreting it. I was trying to be positive in my answer - and let you know what my experience in health care is.

7e746be2f0e550a8cd7df881322ae705

(18701)

on March 29, 2011
at 04:58 PM

I want a doctor who asks me the questions that I don't know to ask. I am not a doctor, so please educate me on how to be a healthier person. - - YES!

Medium avatar

(12379)

on March 29, 2011
at 10:03 PM

Fair enough. All I can give is my opinion and my experience. I was diagnosed and treated for cervical cancer in October of this past year. There were 3 weeks between diagnosis and treatment. I think that this was good. And I am happy with the speed of my treatment. I am only one voice, and I am sure there are others that have very different experiences. I know this is going to sound very Polyanna of me, but I wish that we could fix the broken systems so that people were treated quickly and fairly no matter what.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on April 25, 2011
at 10:10 PM

so do we all. But there is a limit to resources.

Medium avatar

(5136)

on May 14, 2011
at 05:03 PM

Melissa - exactly! you're so smart.

69a2a5deb24d5b8d3aae3d9652fac564

(1020)

on May 14, 2011
at 06:52 PM

Additionally, people with insurance are more likely to get regular preventative checkups, and thus throughtout the span of their lifetime, require (on average) fewer medical interventions. To parallel Dr. K's examples of patient neglect due to fiscal relativity, here in the US I've had to discharge a patient with a trach, g-tube, NPO and several multi-drug resistant organisms back home alone, because he ran out of insurance. It's ludicrous.

69a2a5deb24d5b8d3aae3d9652fac564

(1020)

on May 14, 2011
at 06:52 PM

The man had PVD, and his hands were non-functioning. He had no nursng care at home. What was he supposed to do? Doing self trach care and g-tube feedings with no dexterity...it was only a matter of time before the man aspirated and died. Our guff is and should not be with doctors, (I got your back on that one Dr. K) but rather with lawyers and insurance companies. And the fact that healthcare is a for-profit endeavor first. Docs and nurses deserve to be paid, but the system of lawsuits and "defensive medicine" is broken.

69a2a5deb24d5b8d3aae3d9652fac564

(1020)

on May 14, 2011
at 06:54 PM

And by "for-profit" I mean profitable for everyone else OTHER than those on the front line of healthcare, ie Pharmaceutical companies, Lawyers, Insurance, etc.

69a2a5deb24d5b8d3aae3d9652fac564

(1020)

on May 14, 2011
at 06:49 PM

The issue is where you want to pick your healthcare costs? The Canadian model IMO has a bit of an edge in the fact that they work on the front end of the healthcare process. Back-end medical costs are typically long term and much more expensive. Front-end costs (aka preventative) are the least expensive and most effective. In the US, a huge chunck of the population goes without insurance, making the ER their first line of defense for healthcare. It's also the most expensive form of healthcare.

69a2a5deb24d5b8d3aae3d9652fac564

(1020)

on May 14, 2011
at 06:57 PM

should have read: "Our guff should not be with doctors"

2
Bad3a78e228c67a7513c28f17c36b3cf

(1387)

on March 29, 2011
at 12:16 PM

Doctors are frequently nice people, but I rarely go to one because they simply don't have the answers. They have pills for symptoms. I wish they would try thinking outside the box a little more. Case in point, last summer I finally went to the doctor, because I had an infection on my shin that would not heal. The doc gave me antibiotics (of course) and took a culture. She then called me several days later and said I had MRSA, and proscribed a different antibiotic. Well, I took it dutifully, down to the last pill, and my infection had still not cleared up. I did not go back, because I knew their only response would be to put me on a super duper antibiotic, and I didn't want to create a super duper mrsa bug and have it kicking around my house. I had to figure out the answer myself, and what worked was applying a silver solution several times a day. Started healing in three days, and was fully healed in less than a week. Why can't doctors suggest an approach that doesn't involve a prescription medication?

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on March 29, 2011
at 05:32 PM

No RG.....this was done pre op for those who tested positive bty nasal swab. We cancell their surgery and make them eat garlic for 2 weeks and then let the ID guys do what they want which is a bunch of nothing and we cut. And amazingly we have not had one MRSA case in 3 yrs.

Bad3a78e228c67a7513c28f17c36b3cf

(1387)

on March 29, 2011
at 08:50 PM

How much garlic do you have them eat?

Bad3a78e228c67a7513c28f17c36b3cf

(1387)

on March 29, 2011
at 09:54 PM

Thanks! Good to know!

9f9fa49265e03ddd2bf2bba5477a556b

(3184)

on March 29, 2011
at 03:21 PM

Cutler and Wilson was 2004. Not to nitpick. But I hope you don't prescribe this based on 1 paper. Cai et al. (2007) found that allicin alone was not particularly effective, but worked synergistically with beta lactams. A similar effect has been seen with Candida infections (Khodavani et al. 2010). Of course, if you had a MRSA infection you should have been sent to an ID doc stat. And it is unlikely it was MRSA if you took a full round of antibiotics and the infection really didn't clear and you were still alive.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on March 29, 2011
at 09:36 PM

I base it on weight. For a 70 kg person I ask them to eat 6 cloves a day for two weeks prior to and 2 weeks post any hospital based proceedure......except Xrays.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on March 29, 2011
at 12:24 PM

Eating garlic for ten days and putting garlic extract on the wound would have done the trick too. Study out of east London showed this in 2009.

Bad3a78e228c67a7513c28f17c36b3cf

(1387)

on March 29, 2011
at 04:20 PM

Yes, I have read about the allicin. I also thought this was very interesting http://www.harvesthomeorganics.com/documents/staphresearch.pdf even if it was funded by the oregano company.

9f9fa49265e03ddd2bf2bba5477a556b

(3184)

on March 30, 2011
at 07:33 PM

I'm not following Dr. K. The paper you're talking about from the London group was, as best as I can tell, Cutler and Wilson (2004). Subsequent published research, best as I can tell, has only shown allicin working synergistically--e.g. no one has replicated the Staphylococcus inhibition shown by C&W. As far as garlic pre-op--pre-op for those who tested positive for what? And when are you publishing these results?

0e4e5882872d6a7c472ea51aec457e66

(1994)

on May 01, 2011
at 05:53 PM

This is an other alternative aproach to overcome MRSA: http://blog.aromapraxis.de/2011/04/14/letzte-chance-bei-mrsa-atherische-ole/ Eliane Zimmermann recommends following essential oils: Thymus vulgaris, Thymian Ct. Thymol, Thymus vulgaris, Thymian Ct. Carvacrol, Thymus serpyllum, Satureja montana, Origanum vulgare, Corydothymus capitatus, Thymbra spicata, Syzygium aromaticum, Cinnamomum zeylanicum fol., Ocimum sanctum (Tulsi), Pimenta dioica, Pimenta racemosa, Leptospermum scoparium (Manuka), and Melaleuca alternifolia. Lavender is also good to activate otherwise ineffective antibiotics.

0e4e5882872d6a7c472ea51aec457e66

(1994)

on May 01, 2011
at 05:56 PM

A mixture of some of those essential oils worked very well for my mother in law when she came home from Hospital with MRSA.

2
2193cb1eca1a0eda4b2cad910074634e

on March 29, 2011
at 11:29 AM

I don't usually respond to these sorts of things but I feel a calling to speak up.

Trying to read through the responses was painful. Very painful.

What kind of a doctor would I like to go to? None. I want a partner in wellness. I want a person not a corporate fat head who is only interested in the profit line. I want a partner in health who is a holistic practitioner who recognizes that, I the patient, am not a body part or a symptom but a person. I am a person, whole person. My nutrition effects not only my body's health but my mental health, and ultimately my spiritual health. Sometimes what is hurting isn't my back but my "heart." I want a parter in health who is not egotistic or narcistic. I want a partner in health who knows more than I do about the working of the human body--for crying in the sink how in the world can a doctor care for patients if they do not know the value of cholesterol or that there are different sizes of LDL? BUT want to put me a woman on a statin even though I my HDL is the highest they have ever seen and my Triglycerides are the lowest BUT my LDL is very high? Fortunately I said no and did my own research! I want a partner in health who is honest. Please do not tell a patient with cancer and their family that that they will be just fine and then the patient dies the next week.

I have been involved in the health care crisis in this country for nearly 20 years since I could not get health care while pregnant with my son because I did not have insurance but medicaid. Nothing has changed in this country and will not change until we the patients demand quality care for all people not just those who can afford it. Health care is not a business!

Medium avatar

(12379)

on March 29, 2011
at 04:35 PM

You are so right - healthcare is not a business. I am so sorry to hear that you were turned away while pregnant - I think that is shameful!

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on March 29, 2011
at 05:28 PM

I disagree. It is a business. And to deny that is not a reality. We here are trying to make it better. If one does not have gas money at the station one never questions why you dont get gas. Why is going to the doctor any different. I see patients without insurance all the time and make it dirt cheap and they can pay it off on a CC. That includes surgery they need. We are not trying to kill people. Just keep the lights on and the malpractice paid.

77877f762c40637911396daa19b53094

(78467)

on March 30, 2011
at 05:05 PM

I really like this answer b/c it touches on something important. Many in the MD community and also in holistic medicine (ND etc.) are going integrative. Yay! However, as they emphasize meditation and relieving stress they often still put patients in the same old position of a stressful visit and add more stress by not spending enough time. I used to say that I quit Kaiser because the stress of being their patient was taking years off my life:) Having no health insurance was less stressful on a daily basis. Emotions are part and parcel of medical care, not to be ignored and/or medicated.

2
04293f705870e1837b8670d3c1cd5f67

on March 28, 2011
at 11:38 PM

I would like to be able to get blood tests when I am not sick. For example: At my last visit at the doctor's office I asked for a vitamin D test. They wouldn't do it, and gave me the RDA for vit D. So, I really don't know what my levels are and I live in the NW Washington State and I do supplement with Vit d3. That's one thing..I will probably think of more

Cab7e4ef73c5d7d7a77e1c3d7f5773a1

(7304)

on March 28, 2011
at 11:56 PM

Yes! I had to be very persistent. They were like oh, you got one 6 months ago. Yes, 6 months ago!!

04293f705870e1837b8670d3c1cd5f67

(2261)

on March 29, 2011
at 02:27 PM

I am glad to hear about prepaidlab.com., I wouldn't mind paying for a lab once in awhile to get an idea.

04293f705870e1837b8670d3c1cd5f67

(2261)

on March 29, 2011
at 03:55 AM

P. S. I have Group Health (through hubby's work) I like it very much, but I didn't pick the coverage.

4b97e3bb2ee4a9588783f5d56d687da1

(22913)

on March 28, 2011
at 11:42 PM

thats not your doc, thats your insurance.

06d21b99c58283ce575e36c4ecd4a458

(9948)

on March 28, 2011
at 11:56 PM

You can get your own Vit D3 test in Tacoma for $59.80 at http://www.prepaidlab.com/View-all-products-in-shop.html?keyword=25+hydroxy You pay for the testing. No insurance.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on March 28, 2011
at 11:47 PM

correct. We can order your D level anytime. But it may cost you. That is not our fault. You signed up for that coverage.

06d21b99c58283ce575e36c4ecd4a458

(9948)

on March 28, 2011
at 11:53 PM

You can get your own Vit D3 test in Tacoma for $60 at http://www.prepaidlab.com/View-all-products-in-shop/Page-8-20.html?keyword=vit+d You pay for the testing. No insurance.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on March 28, 2011
at 11:50 PM

And if your doctor refuses ask why. If the answer is not good find a new doc. Our job is to keep you well and fit.....and healthy not just when your sick either.

E5a41bcb2819c818cc0d92489e7c35f2

(300)

on April 25, 2011
at 10:11 PM

Prepaidlab.com rocks! My naturopath actually recommends that her patients go through them rather than other places, as they're significantly cheaper than any other place here in Portland for some tests.

A480640a53eb5dc8966f49141942f705

on May 08, 2011
at 11:17 PM

Also directlabs.com

1
F3920b85be76a5d8cf466d805bfb99e4

(638)

on March 11, 2012
at 05:22 PM

I've had some bad experiences with doctors. I'm 55 yr old female. Ten year ago went to my doctor repeatedly, I did not feel well. Headaches, muscle & joint pain, rashes, fatigue, etc... He ran simply CBC and prescribed a antidepressant. I didn't know better. Went back 60 days later, "doc, I still feel like crap". Answer, "women your age...blah, blah, blah, and prescribed a high blood pressure/diuretic med". A few months later, I'm back and he's stumped. Then he asks if maybe I need to be on an antidepressant! insert eye rolls here. I told him I felt like I couldn't get a good deep breath, and I was having shoulder pain. He sent me to a cardiologist. Cardiologist determined that I needed a camera threaded up my vein to make sure I wasn't experiencing a blockage = now! MD calls me and tells me I have developed hypothyroid and prescribes T4. Cardiologist has nurse give me 8 aspirin and 6 Plavix prior to procedure (no blockage) and gives me a head nod when I explain I just found out about thyroid Dx. Post procedure, nurse cannot get me to stop bleeding, then suddenly and quickly sends me home at shift change. That evening I am rushed to ER with a hematoma in my groin the size of a watermelon! One month follow up with my reg MD I mention that the T4 Rx didn't seem to be helping any of my symptoms. He asked if perhaps I needed an antidepressant. I never went back to see him.

The replacement doctor was hyperfocused on my blood pressure, which was a little high (140/100). She ran the regular tests but added VitD to the list. I was really low, so she gave me RX for the BP, the D, and Chantix to quit smoking. She was not concerned about the recurrent scalp infections (folliculitus?) I'd been going to the walk in clinic about, and had recently been given amoxcyllin for treatment. She thought maybe I should go see a dermatologist? She agreed I should schedule a colonoscop with a gastro doc, since there was colon cancer history in family. Two weeks after appt I called her office, something was not right, I was so tired and achey I couldn't function. I was getting fevers every night. Testing that day showed my RBC had tanked, I was severely anemic, and my bilirubin had increased quite a bit. She suggested I keep the appt with gastro doc and also sent me for ultrasounds which showed my liver and spleen were severely enlarged.

Gastro doc came in and told me he wasn't doing a colonoscopy on my because I was much too sick. From something in the tests, he knew it was a blood problem, not a liver problem. He sent me to a blood doc. The blood doc eventually figured out that I was having a severe drug reaction to the amoxcyllin antibiotic I'd been given 3 months earlier. My body was destroying my red blood cells and it would take months, maybe a year to fully recover.

Each doctor in the chain only focused on a small part of the big picture. Not a single one ever tried to get to the root of the problem, which was the recurrent infections. In my case, doctors are very harmful to my health, they don't care about anything but their narrow little focus, they aren't interesting in finding the cause only in treating the symptoms with pharmaceuticals that again, are harmful to my health. Last week I went for a past due yearly physical, and again the doc was hyperfocused on my blood pressure. I'd lost 40 lbs, but she didn't remark at all on that. I asked for a bunch of labs that she didn't think were "necessary" and when I insisted on a full thyroid panel, not just TSH, she got defensive and told me that doctors couldn't order every lab a patient wanted because that is what drives up health care costs. BS! I told her I pay for all my health care & I expect to be a part of the decision making process. She still wouldn't order all the labs I wanted. The only small satisfaction was the email I received the next day when she saw my lab results, which were, in a word: FANTASTIC. Except for the puzzling high blood pressure, my labs are better than they've been in 15 years!

F3920b85be76a5d8cf466d805bfb99e4

(638)

on March 11, 2012
at 05:30 PM

btw, I am on the hunt again for a new doc, one who will be a partner in my health care, who will look at the whole picture, and who is not so eager to send me off with a handful of pharmRx's. I would like to be able to order certain labs, and work via email or web-base, for interpretation and action plans to improve health markers as determined by labs.

1
B525b3e4b1d6f1cdceec943cdec6eb7d

(1680)

on July 31, 2011
at 07:07 PM

I'm late to the party on this, but can't resist answering.

I want a doctor to be well-informed and up-to-date. When a doctor tells me to eat more carbs, or that a low-carb diet is dangerous and that whole grains are an important part of a balanced diet, that doctor instantly loses all crediblity with me. It's then awfully hard for me to trust that doctor with anything at all. Why should I go back? Clearly the doctor is uninformed or willfully ignorant.

I had a problem with shoulder, arm, and hand pain, and what the doctor recommended/prescribed did nothing. I had to figure out the answer to the problem myself and seek appropriate treatment. It's fine now, but no thanks to the doctor. I had debilitating knee pain - same thing. Medical advice turned out to be completely useless, so I had to hack that problem myself, too. It took me a while, but now I'm fine.

And now the diet thing! Sheesh. Why should I bother seeing a doctor at all, except for emergency cuts and things? I know there are good answers to this, but I find it difficult to go to doctors now. Why should some professional get paid for being useless when I can most often find better answers on my own? Yeah, I'm jaded. Yet I would so love to have a good doctor. For starters, I want a doctor who understands and supports the paleo diet.

So I would like a doctor to help restore my faith in physicians by being up-to-date. Nutrition and diet is an obvious starting point.

If I were a doctor I would have a library of recommended books right there in the waiting room, with books by Gary Taubes, Robb Wolf, and others on prominent display. There would be many copies of those, and patients would be encouraged to borrow them. Each patient would get a suggested reading list of books related to health, diet, fitness, etc. That would be a great start.

Now, Dr K, you have been a massive, massive help to me, and thank you so much for the fantastic content you put on your blog. I read and re-read it. Your advice works. I wish we had more doctors like you!

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on July 31, 2011
at 07:40 PM

I do it......to become better than I was yesterday. And now I am committed to doing it everyday I am alive whether or not some dont see the angle I am coming at this from. Thanks for the kind words.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on July 31, 2011
at 07:14 PM

plus one............ i still come back to read it daily.

1
E17addea7e1019a6cdbaec44f0b12728

on May 17, 2011
at 03:33 AM

be clear about your approach to health up front. Web, blog, collection of articles in the lobby. Invite patients for health discussions/movie etc and think of it as improving your community through education. Stanf firm in what you believe and there will be a clear choice folks will realize.

E17addea7e1019a6cdbaec44f0b12728

(170)

on May 17, 2011
at 03:40 AM

Monthly discuss could range from a book, movie (food inc, etc) childbirth (business of having babies). GArdening, detox.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on May 25, 2011
at 07:21 PM

i like this.....and I will add this. How about a weekly chat room? Plus one for you!

1
510bdda8988ed0d4b0ec0b738b4edb73

(20888)

on May 15, 2011
at 03:20 AM

There have been a bunch of great answers here and I won't go and repeat them, but I agree with lots of what's been posted. Though, my biggest wish is that Doctors were actually "scientists" and not "technicians". I'm implying no disrespect to any of the Doctors out there who actually are scientists, but every time I've seen/talked to a doctor it was just a "diagnosis" of a problem just like when you take your car to a mechanic. There is definitely a place for that. Sometimes, I need to talk to a professional who understands base rates and symptoms and will tell me most likely what's wrong with me, but I also want to have available a doctor who understands things like measurement error, repeatability, statistics, biochemistry - you know, all of those things that they took as pre-meds and immediately forgot (I've taught a lot of pre-meds, I know what they should know).

For example, when ordering a test understand why you're ordering which tests and which are most likely to give you the most meaningful results (and what you'd do given the results of the tests). When the results come back, understand the error in the measurement, understand that the "number" isn't "good" or "bad", but a continuum.

Two examples from my life: I was really sick one time and the doctor wanted me to do a not-too-pleasant test (probably because the protocol was just to do this test). After going through the test it came back negative, but then I went and read up on it (I should have done it first, but I was sick and didn't feel like it), and found out for my specific condition this test had a 50% false positive rate and a 50% false negative rate, i.e., the results contained absolutely no information. (It was a pretty expensive test that my insurance probably didn't want to pay for - and it was wrong).

Second, I was kept in the hospital an extra day because the doctor didn't understand shot noise. I.e., counting error. When "the numbers" came back, they were just under his threshold for sending me home. So I asked him what the test was measuring, and how they counted what the counted from the sample of blood they took. As I back-calculated the numbers, it turns out that the lab tech counted 4 things in their microscope slide and then multiplied up to figure out how much was in me. With simple Poissonian stats, the counting error on N items is sqrt(N), so when counting 4 things, the error there is 50%. So I spent an extra night in the hospital rather than my bed at home.

In both cases, if I were feeling better I could have done a better job arguing and probably won. But I was sick at the time and had to defer to the authority who didn't understand.

So in short: we need lots of "technicians" for the simple stuff and we need good "scientists" for the hard stuff. But limited enrollment in medical school keeps the numbers down to keep the salaries high so everyone is overworked. A two-tier system of doctors would make things more efficient and provide better care to those that need it.

And most importantly, doctors should remember (and apply) biochemistry longer than just to pass their test and then forget it. Because if that were the case, then we'd have no health crisis now.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on May 15, 2011
at 01:01 PM

most of us are not......but that is because of how we were taught. Most docs however want to help but many dont know that what they recommend take a person the wrong way. Every mile you go in the wrong direction becomes a two mile mistake. To remedy that requires a paradigm shift in thinking. Your decision as the patient is to find that doc who thinks differently and then foster that relationship with congruent behavior. Once the desired effect occurs then you need to tell all your friends about what you found. Then the standard of care of all docs changes due to natural selection

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on May 15, 2011
at 12:56 PM

some of us are.....some of us understand that the true essence of doctoring is all based upon physiology. It is the one constant. To understand the cell is to understand the disorder of the cell and the human. The environment constantly changes and make understand it all tough when you think about disease from the environments perspective. My paradigm is to understand the physiology first and then the impact of the environment.....makes understanding evolutionary biology and disease a manageable proposition. Then I can effect change with my thought secretions and therapy.

1
13db020c06c22c2f8b129034ddc013e4

on May 15, 2011
at 02:23 AM

Every easter before I go to sleep I pray for an MD who paid attention in statistics 101. I've found very few who talk in probabilities, rather they lean towards graphic descriptions of absurdly rare afflictions. And don't even get me started on MD inability to grasp the concept of false positive.

1
C0fcb48d7da4f76fac17318efd2cd6b8

on May 14, 2011
at 03:29 PM

This is what I currently LIKE in my doctor:

  1. Much younger than me. Easy to treat him like the pipsqueak he is, easy for me to set boundaries with him.

  2. He thinks the paleo stuff I talk about is interesting.

  3. He tells me he searches the internet to find out more about the paleo diet.

  4. He seems to have the budding capacity to put two and two together: all the really fat people at the hospital (nurses, doctors, patients, receptionists, etc. included) need an update (NEWS FLASH) about human nutrition. What I like about him is at least he's going, "Hmmmm."

  5. He's thinking!

  6. Gives me a bit more time to finish my ranting. See number 1.

1
D8195c5ae6c967027a3133d74969d0e1

on April 25, 2011
at 04:47 PM

At 64 with multiple health disorders - I would like to have the entire profession with a firm grasp on nutrition (of course it would be biased, but at least there might be a knowledgable debate (patient vs MD) )! After 3 rheumatologists - not one discussing diet - it was my own investigation that unearthed the perils of nightshades - and only on paleo boards did I hear last month that cayenne might also be detrimental! My final rheumie - prescribed Enbrel (2 injections per wk) - this was the only med that worked for me - still had to use a cane - but after 4 yrs of intolerable pain and becoming "disabled" prematurely - it was paleo that finally leaves me med-free and although there are aches and pains in several joints (hips - one wrist - and one knee(osteo)), the difference in qol is night and day!!! Regarding diverticular disease (2 surgeries thus far) - a month prior to going on paleo - I was told to "up my fiber" due to diverticulosis - I said - "if I upped it any more I'd be a bran muffin"! That being said since I've been primarily vegetarian for the past 10-14 yrs (a decision made because of the severity of diverticulitis and a botched bowel resection)! My urologist, my 4th since my prostate cancer diagnosis (I suppose any guy who gets that particular cancer realizes his life will forever be one of a castrated bull - and the blame will forever lie with the deliverer of the news!), that said I don't give up easily - now I'm more or less satisfied with my urologist - who has listened to my complaints and is taking several diagnostic procedures that may eliminate what problems in that area I don't have! This approach is the first time in 4 years of my feeling I'm being listened to - and not dismissed with a "doctor knows best" attitude - and a certain degree of empathy as well!!! Hope these types of experiences can help bring about a few answers! Thanks for putting this out there! More credit to you!

7e746be2f0e550a8cd7df881322ae705

(18701)

on April 25, 2011
at 05:33 PM

I think it's awesome that you improved your arthritis issues with your own research and dietary changes! Awesome.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on July 31, 2011
at 07:12 PM

plus one................

1
2f931662684a7747be36255c8b486228

(1049)

on April 25, 2011
at 04:20 PM

Maybe the medical profession should take a look at how every other service in exchange for monetary compensation functions. You either clearly see in a window what you get and choose. Not an option with health or you get a detailed estimate with specifications and a commitment schedule. And what about guarantees? There should be something assurable in the medical profession. Perhaps the first easiest step would be humility, (as others mentioned) ask...then listen admit to lack of knowledge and perhaps this is where the guarantee should be.........if a doc even accepts the appointment after having read a description of the service needed............ he had better go find the answer... better even before the patient arrives, when possible. Nothing more irritating than explaining your situation very clearly (to any professional) then arriving to explain it yet again to hear.........I'll have to research that. A waste of time for everyone. Very good question by the way........yes time to revolutionize medicine. Of course all would depend on the kind of patient you want. Many I am sure want 'hand holding' not answers or solutions. Personally I think many problems lie with the patient's lack of assuming responsibility for their own health, which in turn feeds the frenzy of incompetent physicians willing to hand out crumbs (service). And isn't this a big part of the population. Government agencies have been telling us how to eat, tell us how to educate our kids, tell us how to drive........now the irresponsible want someone to tell them how to fix themselves. I would appreciate and trust a doctor much more who did not pretend that he can assume responsibility for my health, but will help me do so. Can you really trust another person with your life...your children's lives? Again as someone else mentioned.........advise on where to educate ourselves in regards to our problems..reading matter.

1
77877f762c40637911396daa19b53094

(78467)

on April 25, 2011
at 02:52 PM

Dr.K do you have a picture of your paleo results. Or some link to some writings of you. I get interesting who you are.

sorry for the crosspost..

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on April 25, 2011
at 10:19 PM

yes.....you can go to Jimmy Moore's site and I believe he has a picture of me in his network of docs.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on April 25, 2011
at 10:24 PM

http://i574.photobucket.com/albums/ss187/livinlowcarbman/DSC_0023.jpg?t=1298846164

F6ea948ab43dc51d72509c0989e670fe

(1639)

on May 15, 2011
at 06:05 AM

Holy cow. The pictures speak for themselves... :)

0
E0250b1e6dc5ec1539ffb745042b4d80

(3651)

on March 02, 2012
at 11:35 AM

Great topic.

I want a dr that is under fire from government food police and CW profesional associations. The ability to see through the mass of nonsense in health care is top priority.

Bad experiences: Many! "Try this pill for 2 months and see if those trigs go down." "Take this pill and do weight watchers for 6 months, and then maybe we will order the cortisol test too." "High triglycerides have nothing to do with it." "WHAT are you eating!"

Best experience: "We will find it and we will fix it." -Dr Wayne Wightman (my dr at the Holtorf Clinic in Tortance, Ca.)

0
452b4d079e0c39d4ca923e712f64239f

on March 30, 2011
at 01:41 PM

I'd like a doctor who doesn't blindly follow FDA/NIH guidelines--medicine and health should be an INDIVIDUALIZED thing. I'd like one who actually READS and understands, then incorporates the latest findings, testing methods, and ways of calculating health, such as assessing cholesterol values, knowing the value of dietary fat, and ignoring the useless BMI chart.

As it is, we ALREADY HAVE government-run medicine--docs won't do anything that isn't FDA or NIH-sanctioned, and insurers won't cover stuff unless it follows those guidelines. Why push for universal healthcare coverage? To capture the only missing ingredient: money.

I think it's totally ironic that patients can be ahead of doctors when it comes to medical and health knowledge, leaving doctors to be the "mechanics" of their profession--almost like hooking us up to computerized diagnostic machines (just like cars) that spit out what's supposedly wrong.

If you look at what's considered "healthy" by today's FDA/NIH standards, you'll find cholesterol levels spurred lower by omitting meat/eggs from the diet, thyroids spurred lower by the encouraged use of soy, and havoc wreaked by encouraging the use of vegetable oils high in Omega-6.

Is this REALLY the picture of health? If so, then I want a word with the artist!

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on April 25, 2011
at 10:17 PM

Evidence based medicine = this. The real problem with evidenced based medicine is who is collecting the evidence and is it helpful? See cholesterol and dietary recs are evidence one that they all have their heads up their asses.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on April 25, 2011
at 10:15 PM

well that is what medicine is becoming. cookbook medicine is what the government is advocating. That is what walgreens offers via its NP and nurses in their medi clinics.

0
F1b39d4f620876330312f4925bd51900

(4090)

on March 29, 2011
at 05:58 PM

I am horrified at the thought that a doctor might not do a treament or spend time the needed time with me based on my health insurance. Here's an idea. How about doc offices never assume anything about your finances. I have savings, I am willing to pay for anything to get better, up front. I want a doctor to plan out everything I need, then I go can go to work on the insurance and finances. I don't want my treatment limited,especially without running it by me. I just flat out want to know what needs to be done, and I will make it happen. (I might not be this uppity if I had cancer or something..). For example, if my situation required a two hour visit, just to get all the details, look over the tests, ect..but insurance would only pay one hour, then tell me, and I will pay for a second hour with cash. I know not everyone could do this, but its worth a try to be upfront with the patients. I am willing to pay for excellent care.
As a side note: I will never forget the look on the gastero docs face when I came in for a followup to a healthy endoscopy/colonscopy. 'Why are you here?' he asked me. I told him 'Because nothing has changed, I still feel like hell'. He was so confused!

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on April 25, 2011
at 10:14 PM

so you get gas when you have no money? How shall the doctor pay to keep the lights on and the malpractice paid? You do realize that if I were to see you for free and something bad happen to you, legally you could still sue me even though I was doing the service for nothing? I guess you dont get it. Many of us do many things for free. We no longer can. When you make 23 dollars to see a medicare patient for an hour.......1+1 does not equal zero in my world. You had better wake up to that reality. We care as a profession but you also have to be realistic.

0
B1fcaceba952861d0324bdb291edbbe0

(3159)

on March 29, 2011
at 03:09 AM

Well, I don't go to the doctor regularly but, I like it when clinics, doctors, etc have websites that provide a decent amount of information (e.g. credentials, specialties, prominent contact information, perhaps you could link things about paleo for your patients, maybe even free wellness calculators of some sort, or book suggestions- inform the patients ..., stuff like that).

0
Cc2a43461ec5b2b7ba5d55215ea0f068

on March 29, 2011
at 12:11 AM

Like some of the others, I'd like a doctor to take the time to explore what a problem may be before just prescribing drugs. The last time I took prescription drugs (allergies), the dosage was so high, it caused major side effects.

I would also like a physician to know some of the "non-medical" ways to treat ailments and conditions like arthritis (my grandfather's hand arthritis was finally controlled with a daily parafin wax treatment after all drugs were exhausted. He was in pain for months before they tried this). I realize this puts a burden on medical doctors to not only keep abreast of the latest developments, but to know and appreciate historic remedies and other health disciplines. At the same time, if the first part of being a doctor is to do no harm....

I also appreciate a doctor who thinks for his/herself rather than regurgitating whatever the AMA recommends, like my last internist did. BMI? I might by 4'11', but even when I was a size 8 and skin and bones for me I weighed over 110 lbs.

And I'd like an honest, decent answer on how much calcium a woman needs, especially once all the crappy grains and oils are out of the diet. I didn't even get that.

-1
319cdfcd8ec0467f34a3c5aeb2a5e045

on March 02, 2012
at 10:45 AM

I wish I'd found the one I had sooner! Not only is she a fellow cyclist and bike commuter with a a sweet Bianchi, but when I showed interest, she gave be a blood test in everything, even Vitmain D! It was really interesting to pore through all the results when they came.

-1
91487fa364848b52aad94002266aebc9

(76)

on March 29, 2011
at 06:53 PM

Well, for one thing, stop the BS about Canadians wanting their health care system to be more like the US's.

"40% of Canadians come to the US" ?????!!??? Now THERE is a lie that surpasses all the rest of the right-wing pro-big-insurance-company lies I have seen!

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on March 29, 2011
at 09:40 PM

I doubt you'd find any pro insurance company stances behind me. That number came from MNI neurosurgery clinics over the last 5 yrs. They cant get what they need because the money goes bye bye the last quarter. Once its gone you wait. Neurosurgery issues generally cant wait. Ask Liam Neeson or about that. (Natasha Richardson) Ironically this happened in Canada too.

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