Doctors once you are over 70

[Pony Soldier]

Have any of you ancient folks found a change in your doctor once you are over 70? What I have noticed is an atitude change to (kind of ) " what the hell you are going to die anyway". Nothing seems to be of interest and the tests (colonoscopy, heart tests, etc) appear to be unimportant unless you have obvious symptoms. Is there a medicare pay schedule that has changed or am I over sensitive?

 

[mtnwrunner]

I'm 5 years away from the 70 mark but I have found that you need to find a doctor to fit your lifestyle and one who you can really communicate with. I had an incident several years back where I slipped on a snow covered slope in the backcountry and wrapped myself around a tree and screwed my ankle up.
When I went to my doctor and told him the story, he said and I quote "maybe it's time you start acting your age." I replied "I was."
He is no longer my doc and I now have a younger doc who is very sports oriented and is super willing to be proactive and LISTENS to me.
He does keep asking me for my honey holes though......

Randy

 

[philos]

The sad reality is today's medical field has created physicians that are businesses first and a health practitioners 2nd. At any age you need to take a proactive stance on health care and vet your Dr. like you would any other provider of service. Do your best to know what you need to do and not what the Dr.'s office wants you to do to pad their numbers. Too many people put blind faith in their Dr. and follow lockstep the medical advice provided.
As an example if your Dr. routinely prescribes you antibiotics for recurring issues you have perhaps that 4th round of a Z-pak in as many months is not what you need.

We shouldn't have to worry about such things but here we are. Interview the potential Dr. and let them know you appreciate their expertise but you plan on the relationship being more equal adults discussing treatments than Dr and slave patient with blinders on.

 

[FLATHEAD]

I've seen it with my Mom and Grandmother.
Once you hit a certain age they just dont give a rip.

 

[rayporter]

doc is almost my age which has 70 in the rear view mirror. he said "you did what"

my eye doc said 'you know what they told me my biggest complaint would be?"
me ="no"
"old men complaining they could not see the sights any more"

 

[go4thegusto]

I think you are experiencing "modern healthcare" About 5 years ago many of us started saying "did your GP even touch you during a physical?" They sit and ask a few questions while typing on the computer and maybe a cursory heart listen. Clothes stay on etc.
You need to come prepared, not be intimidated, and get the care you deserve or move on. I just switched primaries and told him out of the box this was an interview to see if we are a match.

 

[willfrye027]

Outpatient medicine is in rough shape these days. If you find a doctor you trust who can communicate well and makes the time for it, you’ve struck gold.

Insurance and Medicare payouts actually decreased recently despite minimum wage increases, inflation, etc. the end result is that offices need to pump more patients through to keep the same bottom line. Plus it is rare these days for a doctor to actually own the practice—they’re working for a corporation that has way too much control over how they practice. That’s not to mention the proliferation of NP and PAs who are thrust into essentially the same job with often very little experience and much fewer years of training and supervision.

Best advice I can give is to educate yourself on each of the medications you are taking and what they are for. If you have unanswered questions ask them at the next visit. Take control of your health as best you can.

In terms of the preventative medicine (colonoscopies etc) some of them get phased out the older you get. Jury is actually out on whether or not colonoscopies are even beneficial but that’s a long ongoing story.

 

[5MilesBack]

We have a sect of society that just doesn't really care much about "life" or "lives" in general (abortion, euthanasia). They consider older people and the unborn expendable. These are the same folks that want population controls and climate change initiatives.....the two agenda's are tied together. Unfortunately many of those are the same people that have a strong hand in academia these days, which are the ones influencing, training, and putting Dr's in the workplace. The "corporate" and "bottom line" structure is not set up to fix or cure anybody......it's to keep them medicated, scheduled with expensive "procedures", and continually coming back for more. It's not in their best interest to have a society of healthy self-sufficient people. That's a problem. And we're seeing the evidences of that from governments and all the way down.

 

[Bubblehide]

One of the things I do is use my doctors first names. I never call the doctor. In my experience, if a doctor insists on being called doctor, then they will try to make decisions of treatment, instead of discussing options with me and me making the decisions.

The standard is informed consent. The above type doctors often rob their patients of informed consent, and run their practice on consent alone. To me, that is simply unacceptable.

 

[mtwarden]

found this list of "routine" testing medicare covers

https://www.medicare.gov/coverage/preventive-screening-services

 

[Vedauvoo]

I've been a physician for over 40 years. I have seen the devolution of medicine from patient-centered, where the doctor was your advocate, to $$$ centered, where the patient is a financial opportunity. And I mean for Insurance companies and hospital organizations, not so much for the doctors.

It is rare to find a physician who is not owned and operated by some iteration of theses 2 organizations. The government is the other big doctor employer. As an employee, the physician has become a "double agent", incentivized to withhold care, rather than provide it.

Look long and hard to find that rare independent physician, and you likely have found a good one.

I was lucky enough to find a physician that is 1 year older than me, and very active. He sees my health as "opportunity", not a restriction.

You can check with the American Association on Physicians and Surgeons in Tucson, AZ. They are an active voice for the few remaining independent physicians. They can provide you with a list of independent doctors in your area. Members of this group of physicians were the ones that championed early outpatient treatment of COVID-19 (Peter McCullough, MD is one such physician). It was their contention that early intervention with repurposed existing antiviral medications would be effective in preventing hospitalization and death. Turns our they were right! They were instrumental in saving hundreds if to thousands of lives.

Finding such a doctor when you are still healthy will be a real plus as you ascend the age ladder and run into its inevitable challenges.

 

[gbflyer]

We use an independent doctor for my sons mental health care. One man show, does not bill insurance or have guard dogs at the gate. He has saved our lives. I wish everyone the same experience.

 

[long hunter]

Have any of you ancient folks found a change in your doctor once you are over 70? What I have noticed is an atitude change to (kind of ) " what the hell you are going to die anyway". Nothing seems to be of interest and the tests (colonoscopy, heart tests, etc) appear to be unimportant unless you have obvious symptoms. Is there a medicare pay schedule that has changed or am I over sensitive?

Here lately seems like every time I go to see the doc, I wind up at two or three so called specialists for tests, now my wife and I have very good insurance along with Medicare, I wonder if there is some reimbursement work going on between docs. So, makes me think if a person doesn't have decent medical insurance how proficient the initial care would be. It's a money game. Example had a cyst in the palm of my right hand, went to my doc at least three times all he wanted to do was prescribe meds and get a CT. The damn thing would not go away and just bled, got tired of that made a appointment with a hand specialist, An old navy cutter one look and she told me it's got to come out told her let's do it and in about two week healing time no more problems. My regular doc ask me what I done that for told him I wanted it fixed and he was not helping. Theory here is your doc strings you out as long as they can and then sends you to a specialist who fixes the problem first visit.

 

[Pony Soldier]

That was my experience with a cancerous lymph gland. I lead the issue found treatment and removed it but it wasn't led by my doctor.

 

[MNBill]

I have found that it is important to be your own best advocate. I had many tests run, and at best, I was told what the problem was and that was the end of the discussion no discussion about treatment, treatment plans, etc. do your own follow up with your physician.

 

[riversidejeep]

Gone are the days of the doctor in town that would give you a shot if sick, set your arm if broke, deliver your baby if pregnant. Now it's a P.A. with a I-PAD that looks up your problem on WEB-MD, Anything more than an ear infection your sent to a specialist. The little chick P.A. I see sent me to get a stress test, My insurance that I pay $1000 / month for told me to pound sand as I wasn't in the risk category. After you hit 65 your a burden to society.

 

[eddielasvegas]

Not sure how I missed this thread, but glad I found it.

I'm closer to 70 than 60 so happy to read the replies and learn.


Eddie

 

[mitchell]

At 62, I do feel sore and tired after I had just hung 2 treestands. When I was younger , I could hang 4 in a day and also have all the shooting lanes cleared without all the hurt. Now, the only thing I have to look out for is coming down sick or getting hurt. Our Canadian Health system sucks and it takes forever to even get an appointment. Grrrrrr!

 

[yfarm]

70% of US physicians are now employed rather than independent. Why You say? While hospitals and drug payments are paid at cost plus, physicians are paid by medicare on a fee schedule based on 1968 fees. Every year medicare cuts fees usually around 3-3.5% this has been going on for years. How many businesses are paid 1/3 less today than 10 yrs ago? As the physician said earlier, prices for everything in the office go up, your income goes down and you retire or go to work for someone else. Hospitals hire your doctor, have to pay prevailing rates for the specialty and pass thru the increased cost over revenue to medicare and private insurers. The employer dictates how many patients you see per hour, typically for primary care they allow 7 minutes/ patient. Not much time for personal care. They try to replace the docs with advanced providers as the cost of the employee is lower, downside is you replace knowlege with more tests. Recent study published from Pennsylvania showed significantly higher ordering of advanced imaging from non physician providers. Medicare has mandates that you have to follow or you don’t get paid. Have to ask questions and document the answers to the questions that have nothing to do with the care being provided. Sex life, smoking cessation, etc. All previously documented 6 months ago at your last visit. Don’t know where it ends. I used to think at some point physicians would just say no to medicare and become non participating but most just go to work for a hospital and slow down. Want personalized care like the old days, find a concierge practice if you can find one.

 

[MTGunner]

We see a young doctor that we call Doogie Houser. Nice you doc. He put us on heart pressure meds. Hate the crap. Says no need for colonoscopy any longer. Offered ED meds but declined. The good thing is he is young, not burned out and does have a sense of humor. Told him the ED meds make it difficult to roll over at night. So far good doc. No real issues with me. My bride recently went through breast cancer treatments. She’s good, for now. Anyhow, these golden years sure seem like Rust years. Oh well, good ‘nuff! We are still kicking and doing OK. MTG