Your Relationship With Your Doctor?

I had a doctor I loved. Saw the guy for over 25 years.

He was a nephrologist. I started seeing him when I first had kidney stones.

When I moved 100 miles away in 2010, I still drove to his office for annual physicals. Sadly, he retired.

I've yet to find any doctors here that I like. The University of Virginia health care system has taken over every local practice. They bought the practice that my local GP works out of. I went to the guy last year for a physical, and had to make a separate appointment with a nurse to come back and have blood drawn for the physical!!! So UVA Health System gets to bill for 2 appointments. As it is, my GP has turned into nothing more than a referral machine.

My last doctor would give my a physical, look at the moles on my back, tell me the specific type each was, and assure me that they are normal (not skin cancer.) This guy has me take off my shirt, says "You have a lot of moles. I'll set you up with a dermatologist for skin cancer screening."

Most doctors in this system look at their computers more than they look at the patient. I have the cliché issues men of my age get, and have seen 2 urologists for them. Both were just horrible bastards. They hate people. To call them arrogant and condescending would be a major understatement. I left the appointments knowing that I might likely exit any procedure worse off than I started, and would get no relief or help. So for now I'm just living with it.

I had a colonoscopy and an endoscopy done a year or two ago. The G.I. was the same way. Just condescending as all get-out. I'm used to being engaged about my health, these people look at the patient as a necessary evil standing between them and an insurance payment.

I've never encountered anything like it. I swear it's a regional thing.

*sigh*

 

I've noticed that ever since Obamacare. The practice of medicine now consists of checking boxes off on a computer screen. They rarely look up from the screen, and they seem dependent on the computer to do their thinking for them.

 

Sure, I understand that. But the screen gets more attention than I do. I honestly believe that data entry takes precedence over patient care in many (some?) cases.

Now, I do like the fact that the doctors in the UVA system all have immediate access to what's going on with me and the results of the tests that others have prescribed. There is an upside.

 

Part of my problem is the relationship I had with my prior doctor. It was rather unique.

He was part of the MDVIP program (nationwide outfit, HQ in Florida), which is sort of a concierge service. When he went to this model around 2000 or so, my research showed it to have been common in California for some time, with people paying annual retainers of $25k and up.

You become an MDVIP member and pay a "retainer" to be the guy's patient. At the time, the retainer was $100/month. In return, the doctor contractually limits himself to a maximum number of patients. My doctor went from a 2,400 patient workload to having no more than 600 or 900 patients...I forget which He was a happy camper. He was back to practicing medicine the way it should be practiced. In addition to having more face time with the guy during appointments, that $1,200 annual expenditure got me an Executive Physical...several hours of exams & tests, plus extensive blood workup.

I'm cheap by nature, and I'm not the type to have a doctor on retainer, but I have always stayed with my doctors even if they have been "out of plan." So I thought I would try this for a year, since it was the only way to keep seeing this guy. I loved it! He was always available. Appointments were casual and not rushed. And for the first few years, I negotiated insurance reimbursement for the fees (although that eventually went away.)

As I said, I moved 100 miles away in 2010 but stayed in the plan and drove back for my annual physicals (really the only time I would need to see a doctor.) Then he retired (had been my doctor for over 25 years.) Then I got thrown back into the crowded system, sitting in crowded waiting rooms hoping I got in to see the guy within an hour of the scheduled appointment. Then my doctor's practice got bought out by the UVA conglomerate and his priorities were driven by Corporate. But he gets to work flex time (3-4 days a week.)

 

You're very fortunate. I've enjoyed a close relationship like that, and really miss it now that I'm approaching 70. I swear this is a regional thing, infected by the UVA conglomerate owning everything.

When my brother was in the hospital up north 80 miles away and I went to visit him, I was shocked to see the "UVA Hospital" sign at the entrance!!! The only thing that's kept them from encroaching further north is they've hit the southern boundary of another conglomerate (INOVA)...but there's plenty of territory west and south of here for UVA.

I could travel to the next city over and try that market, but who wants to drive 40 miles for a doctor appointment? And any tests or procedures will be done in that doctor's sphere.

 

I have never really had a long-term regular doctor, and my cardiologists come about as close to that as anything. When i was growing up, I didn’t go to a doctor (never needed to), and as a younger adult , I didn’t go to a doctor either, except seeing one during pregnancy.
After I got old enough for Medicare, is when I really started seeing a doctor, because they want to do annual checkups, blood tests, and send you for all kinds of other checkups that I was not interested in, but was supposed to do.

The one doctor that I had the longest was an Indian lady , and I really liked her; but we moved and then she was a long ways to drive to see. The last few years, we went to a clinic and only saw the doctor one time, and the nurses took care of patients otherwise .

When we first moved here, and my heart was really awful, but I had no insurance and no money to see a doctor, my friend, Evelyn, told me about a community free clinic that saw patients on a walk-in basis.
We had to be there around 3 PM, and then sit and wait to see the doctors, who came in and volunteered their time after their regular job. It was usually after 7 that night before I went back home.
A long time just sitting and waiting.
My cardiologist volunteered there, which is how I first met him, and he helped me to get medicine for my heart failure and afib.
After I was old enough to have Medicare/medicaid , then I was actually able to see him as a regular patient, and not just occasionally at the free clinic.
I really appreciate that man for helping me, and for caring enough about his community to volunteer at the free clinic after he finished a long day’s work at the Heart Center.

 

So I just had another stupid issue with my GP.

I had a supposed small stroke in early January. Medicare requires follow-up visits with your GP when this happens. I was supposed to have my second follow-up in March, but COVID caused it to get deferred to this Wednesday. Knowing how things are there, I called this morning to verify that this was just a check-the-box visit without labs being done, and the receptionist said "That's right." Then she says "No, wait. I see the doctor went in this morning and ordered labs." Me: "So I have to fast?" She: "Yes." But my appointment is at 2:30PM.

I've had this issue before with a physical. I go in, get my physical, the doctor says "We need to draw blood for your physical. On your way out, make an appointment with a nurse to come back and have blood drawn." He made no arrangement for blood to be drawn along with my physical, even though I had known to fast for it. It's as though nurses are their own Profit Center (heck, maybe they are.)

So here I am again. These people don't call when there's a change like this. Had I not called (or had I called a day sooner), I would have had to come back solely to have blood drawn after I fasted. I still might. I'm not gonna fast all day. I won't get out of there until 4PM.

Time to find a new GP. The problem is that they are all in this University of Virginia Hospital system. All the local guys got absorbed into The Beast. I never had this issue with my doctor before the takeover.

I guess I could look in Richmond, but that's almost an hour up the road to get away from The Beast. If I need a ride for some procedure, it's awfully inconvenient for friends to take me there, and a big pain in the butt for me.

I've never encountered anything like this before. It's just so basic...