Craig Meyer Loc: Sparks, NV

I agree with the hands and stethoscope on, but for the follow ups, a BP log, etc. emailed and a zoom call saves a few trips. And for the ice cream, a distant memory, for me. But I certainly treat every day as a cherished special occasion.

Frank Basile Loc: Hudson Valley NY

Stewart's ice cream is the best. I am also fond of their Apple fritters

DirtFarmer Loc: Escaped from the NYC area, back to MA

I rather like Shaw's ice cream (local to Dracut, MA)

Canisdirus

Haven't been to a doctor in 35 years.

DickC Loc: NE Washington state

Then you haven't had cancer!! If you do you will see 35 doctors in one year!!

sb Loc: Florida's East Coast

OK - this issue touches a nerve!

Medical training these days is not broad enough. Medical students decide to specialize even before they start their clinical rotations, and in many programs there are lots of elective clinical rotations, so a student who wants to be a nephrologist (kidney specialist) will do rotations in nephrology, immunology, rheumatology, transplantation, and all sorts of kidney-related things, then graduate and go directly into an internal medicine program then a nephrology residency. In all that time, they may have never delivered a baby (and counseled pregnant moms), done any general pediatrics, examined patients with back pain, etc. Most of the training is inpatient oriented in hospitals. It is sad. Doctors don't touch their patients anymore (a hand on the shoulder while listening to the heart and lungs is a simple reassuring gesture) - I had many patients over the years that told me that they felt their previous physician was afraid to touch them. I taught a lot of medical students when they were doing an outpatient primary care rotation in my office (from a school that required that of all students). I always encouraged them to TOUCH the patient. When examining skin lesions, for example, you may sometimes be able to determine what is going on with a distant look, but often it helps to actually feel the lesion. Sure, an elevated PSA blood test may be a sign of prostate cancer, but I diagnosed quite a few cases of prostate cancer in men with normal PSA values with just my finger. Part of the exam for low back pain in a man over 50 needs to be a prostate exam. You have to explain THAT to the patient, but it has to be done!

I don't even recall the last time I had a prostate exam. I went for the first-ever visit with a dermatologist because I had a few spots that were changing. He looked at the spots and offered reassurance that they were benign and that was that. Used to the dermatologists would do a full unclothed skin exam. I guess I should have requested that - a little disappointed that it was not offered or automatically done. Office visits are mostly very quick (and yet every office I go to charges a Level 4 (code 99214) visit, even if it is just a 5-minute "howdy" visit). When you first get Medicare your primary care doc is encouraged to do a "Welcome to Medicare" physical which includes a full history and exam, an EKG, and a depression screen. Although the appointment I requested was for that, I received the cursory exam (no prostate exam...). I had pain patients that would see their pain management docs every month. I asked if the pain docs ever did depression screens (ten quick questions). They did not - and yet 52% of suicides have "chronic pain" on their problem list. To me that is gross negligence.

The medical establishment has moved us towards quick visits that do not involve much. In private practice I was told that if I wanted to look at urine under a microscope or do other simple microscopic evaluations for which I was trained I would have to pay a biannual fee of $400. Reimbursement for those tests was $1.30, so I quit doing them. I was forbidden from doing gram stains to evaluate infections because I was not a "highly complex" laboratory. Those used to be a fun part of the detective work of medicine. For some reason we were discouraged from doing Hemoccult testing - the simple test of stool for blood which we did whenever we did a rectal exam. The newer send-home tests are a little more sensitive at showing intestinal bleeding (but NOT bleeding in the stomach) but cost $20 and half the patients do not return them. The hemoccult test could answer the question about GI bleeding immediately - and yet, at the large VA clinic where I worked until my recent retirement they had no hemoccult cards at all.

The state of medicine is sad. While technology is fantastic and allows so much more than ever before (in societies and for people that can afford it), the basic fundamentals are being neglected.

twowindsbear

Check out Schwan's, they only deliver and I think their ice cream is better than Baskin-Robbins. Not as many flavors though. You can order online, too.

TreborLow

Our son has a serious eye problem that started when he was about 7. After the stressful eye examinations, we would always stop and get him a Hot Wheels car. He is over 50 now, lives more than a 1,000 miles away, but still buys himself a Hot Wheel car after each eye appointment!! Bob

srg

Jerry, I'm your age and I avoid doctors until absolutely necessary. They like to prescribe medications. Have you ever read through the side effects list? I don't have that much time on my hands. They will also be happy to prescribe something to counteract the side effects of the previous medicine. It becomes like a hall of mirrors. I only take vitamins. Exercise is a cure for everything.

nervous2 Loc: Provo, Utah

I like the final step best. My favorite is Pralines & Cream.

clint f. Loc: Priest Lake Idaho, Spokane Wa

Sounds like everything is rationed by Medicare reimbursement.

PhotogHobbyist Loc: Bradford, PA

I've had cardiac bypass and lower back neurosurgery plus have a minor disability approval from the VA so I have three different practitioners that want to see me at least once a year. Having been a PA for several years I truly can say the VA doc does the best annual physical exam of them all. My primary care and cardiology practitioners are very cursory with the exam, listen to heart and lungs, check vitals and maybe look in my ears, but that's about the extent of it. The Doc at the VA also looked in my eyes, down my throat, listened to my belly, poked around on my belly, and checked my reflexes by hitting me with that little hammer. The only thing she didn't do was the fickle finger of fate exam. I blame the insurance companies for the private docs being so quick, they (insurance) tell the docs to limit the time spent with each patient. The faster medical people are seeing patients, the more they get reimbursed from the insurance company. And the insurance companies do not pay what the doctors charge for each visit.

Dannj

I guess I’m lucky to have a doctor that doesn’t fit the description of yours. As for side effects, you’re right about the amount, but that’s the FDA that requires the list, not the doctors.

DickC Loc: NE Washington state

I had good oncologists and a half a year in a cancer ward and then 33 radiation treatments, eating thru a feeding tube, diapers, never leaving the house, can't drive, but yeah, I'm alive!!

jerryc41 Loc: Catskill Mts of NY

I went for my annual physical yesterday, and the prostate exam was part of it. Since joining Medicare, I don't get the EKG, or the hearing and eye exams. The breathing test was eliminated, too. For the blood test, insurance no longer covers checking for Vitamin D. After waiting fifty-five minutes, the doctor was finished my exam fifteen minutes after he entered the little room. I can foresee a time when insurance companies run the medical schools.