Doesn't anyone go into medicine anymore because they actually want to help people?

[Holly_Hobby]

Or do they just want a paycheck?

My husband is 57 and hasn't been able to do his job in heavy construction because of an old knee injury. He just can't climb 300 feet anymore, lift 70 lbs. or climb his way out of a 12 foot hole anymore. His knee is deformed. The lower leg bone is bowed and he walks like a penguin. That leg is really atrophied, it's much smaller than the other leg. He's been treating it with Ibuprofen for many years, and wearing a knee brace. His knee is shot. Period. The younger guys at work would help him out.

So his regular internist retired and he was given another doctor at the same practice. He went for the knee, but it was time for a PSA check, so she ordered blood work for that. It's time for a physical too, but she told him to come back in 4 months for that. Why? She could have at least drawn some more blood while she was at it. And listened to his chest. But she didn't.

He talked to her about his knee, he told her that he had an appt. with an orthopedist the next week (we don't need referrals). She didn't even look at the knee and left.

He went to the orthopedist, did not even see the doctor, an x=ray was taken and the nurse practitioner gave him a steroid shot in the knee and said that's all they could do, he's a bit young for a replacement. The nurse calls the next day, said bone cysts need a CT scan, so he had that test. They called and said, yes, the knee is very bad, but the bone cysts aren't that bad. My husband told them twice he can't do his job and those are his only skills. The nurse said to go back to his internist. Oh, the CT scan said his cruciate ligament is completely torn in half.

Back to the internist, she continues to ask my husband why she is seeing him and who is doctor is. His doctor retired! She's well aware of that, she replaced him.

So my husband goes over the CT scan report with her and tells her he is filing for Disability. She said she can't say whether he can work or not and to go back to the orthopedist.

So neither doctor will treat him. Why not??? We aren't getting an answer. He isn't there for heavy duty pain meds.

I filed his application for disability yesterday.

I have to leave shortly, but I'm going to post a picture of my husband's leg. It's horrifying. The x=ray tech wanted to know how he can even walk.

Should we find another internist and another orthopedist? Does anyone know what we should do? We have health care, which costs us $1,200/month, so we can find other doctors. I just can't believe that he has such a bad leg proven by tests and no one will even tell him to take his pants off and look at it.

Thanks for listening.

[spooky3]

1. Absolutely you should find a new doctor.

You are paying full costs for health care and you deserve to get what you have paid for.

GPs are under a lot of financial pressure these days like everyone else (especially since the Medicare reimbursement mess has STILL not been corrected and many are losing money on all the Medicare patients) but as in any field, there are good ones and bad ones.

I think you will find a much better one.

You could try asking for a different one in the same practice first, if you would prefer that.

[leftyohiolib]

2. they go into it wanting to help people but leave school with a 100k student loan debt

that changes their perspective

[Frances]

3. Where do you live?

My husband and I are VERY fortunate. We belong to Palo Alto Medical Foundation, a medical group with offices in several cities in northern CA. All of our information is computerized so that my husband's cardiologist can see the notes and tests performed by his urologist and other doctors. However, there is no eye doctor who specializes in Foch's dystrophy, which I have, in my immediate area so I go to a private doctor PAMF referred me to. I have the option of going to any other private doctor I want to. I have old-fashioned Medicare (not Medicare advantage) plus my own private insurance supplement, so my costs are usually covered.

In the past I belonged to Kaiser, which computerized their records a long time ago, but I could not go to a private doctor under that plan unless I wanted to pay the whole cost myself.

Back to your problem: I would see if there is another doctor in your current practice who would be more helpful as my first step. (I did that at Kaiser and was assigned to a really good internist. Note: I was very polite when I made specific complaints about the internist I did not like. I said I thought I would be more comfortable and compatible with a different internist.) If that doesn't work, I would investigate other doctors in other practices.

[grasswire]

4. second opinion time

It's a time-honored option.

I'd find another practice. A good way to find exceptional doctors is to ask nurses who they see.

[TexasProgresive]

6. Very good advice- ask nurses-cause they know. n/t

[spooky3]

8. I have to add a caveat to this.

I did that, years ago, but found that they recommended someone who seemed like a nice guy but who routinely kept me waiting HOURS past my appointment time. One time I decided to call ahead to see how close to being on schedule he was the day of my appointment, and the receptionist said she was glad I called because he probably wouldn't have time to see me that day because he was backed up. Yet she wasn't directed to call all of us to reschedule?

The dr. was making a ton of money and kept opening other offices, apparently by doing it as the airlines do--overbooking so he wouldn't lose money on no-shows or when appointments took less time than scheduled. Or, maybe he also just couldn't say no when people asked for more time, to squeeze in, etc. But this kind of time management was totally unacceptable me when it occurred over and over. I couldn't afford to lose that much time from work for routine appointments.

I chalked it up to the differences in perspectives for some nurses and some patients.

I switched to another doctor recommended by friends, and was very satisfied with the quality of care he provided for many years, until I took a new job in another city.

Also, in some places (such as several major metro areas), you can subscribe to checkbook.org or similar services where doctors are rated systematically.

My suggestion would be to use all the sources you can and see if recommendations converge.

[TexasProgresive]

5. In answer to the question in your subject line

I think most who enter med school want to help people but by the time they get their license and worst if they specialize they are saddled with huge debt. I think that causes many to shift their focus to making money.

I do think you need to think hard about getting new docs.

[jerseygal]

7. Have him see a rheumatologist.

I'd have your husband see a rheumatologist.
Internists are not particularly trained to evaluate knee osteoarthritis and clearly the one you got didn't even examine the knee. He would do much better with a rheumatologist as the person responsible for evaluating him and then helping with the disability forms.

That said, it sounds like he is a candidate for total knee replacement regardless of the orthopedist he saw. Many more replacements are being done on younger individuals especially if they are not obese. At his age, if he has a torn cruciate, he probably also has significant osteoarthritis and is unlikely to benefit from arthroscopic surgery.

So, I would find a rheumatologist you like and then let them find you an appropriate orthopedic surgeon.

He also might benefit from some physical therapy and will need to continue this after a knee replacement.

In terms of his other health issues, you might look for a new internist as well. And talk to them about the usefulness of PSA - in recent studies, it has been suggested that this test is overused and contributes to unnecessary urologic surgery.

[HuckleB]

9. Yes. I work with 16 MDs (8 pediatricians and 8 internists).

I've never met or worked with more caring people in my life.

[cbayer]

10. Medicine isn't what it used to be.

With crushing debt, reimbursement not keeping up with expenses, ridiculous rules and paperwork from insurance companies, medical malpractice claims, unreasonable demands from patients and families about what to do and all the bad information available on the internet, it's just not that much fun anymore (let alone rewarding).

Physicians and other health care professionals are being beat to death and it shows.

[Paper Roses]

11. Thank you for your reasonable assessment. I have 2 Doctors in my family.

Both have school loans up the wazoo. They are earnest in that they are trying to do. Paperwork, staff and office expenses, lousy Medicare reimbursements, malpractice insurance, etc.
Forever wait for insurance companies to pay for office visits and treatments. The list goes on. (not to mention 'call' every 3 weekends or so.

They love what they do but I think they find that it is more and more difficult to keep up their enthusiasm. It takes its toll. Sometimes I wonder how they manage have another life besides being a Doc.