I read and see this advice often. Such as “if you experience any of these side effects, talk to your doctor.” Or, “ask your doctor before you …”
Which makes me wonder, am I the only one without ready access to a physician I can call to discuss my questions?
No. I also know people who have ready access and get dismissed. My best friend who is in the navy was diagnosed with fibromyalgia. Treatment didn’t work, another doctor said they didn’t think that it was fibromyalgia so further testing required. The latest doctor said it was depression. WTAF.
We get what we pay for.
My PCP is a revolving door of NPs in a very large practice. I mean, I can submit a question through the portal or ask them at an appointment, but I’m not going to get a very personalized answer. They don’t know anything about me.
Same. It’s the corporatization of medicine. The doctors have quite strict quotas for how many patients they need to see each day–which means they have a time limit per patient.
I know a couple doctors who have gotten fed up with the system and quit to start concierge practices. But they don’t take insurance, so they only deal with more well-to-do patients.
After a 10 year period of having no doctor I finally went and got myself a PCP. So yes I do have a doctor I could ask a question or get a referral for a specialist if I needed it.
It’s usually a legal CYA. So if you do a particular diet or exercise regime, and you didn’t consult with your doctor first, the company can use it as a defense to avoid being sued.
Sometimes, with a drug, it means that if you get a side effect you should discontinue use until speaking with a doctor to ensure the benefits outweigh the risks.
Socialized medicine in Canada. For 25 years, the GP I stumbled onto right after he had become a Doctor (he was a pharmacist first) was bloody brilliant. Cared. Smart. Would phone me at home, at night, if he was worried about me. When we moved away, we travelled to get to this guy, as did many of his patients who had moved 8 hours away from him. Later was rated on the website that “rated doctors” as #1 in Canada. Then he retired, and I was cut loose.
Since then, I have been nothing but disappointed and dismayed. We have a small clinic that is fairly local to us. They were taking patients about 5 years ago, so we felt that it would be best to sign up with them, as we were lucky that it was a possibility to have a doctor locally rather than just the “walk in” situation. It has been very depressing in dealing with this situation. Our doctor is now from Iraq. Doesn’t appear to have a clue about most things, or care. Pill pusher without ever asking “why”. Announced that “In Iraq, the patient takes whatever drugs the doctor says they should take, and questions nothing”. OK, isn’t that lovely, in Iraq. I currently have several growing moles on my back, and sore. I had to make a special appointment for these to be looked at (it took 2 minutes to do that) but she could not look at or DO anything else on that visit. OK. Spent 4 months waiting for an appointment with a dermatologist to have moles removed, heard nothing. Phoned again re moles and dermatologist appointment. There was no appointment made yet. Hadn’t done anything about it. Do I want to go to Vancouver for this appointment (5 hour drive). No. OK, it will be a year to wait. I still don’t actually HAVE an appointment. Am considering phoning a dermatologist myself. In the old days, my previous doctor just took them off himself, in his office. It’s my BACK… I don’t care if it leaves a scar. Just cut them out, and put a couple stitches in. A good vet could do the job in 15 minutes.
Your experience sounds like 99% of the experiences in the United States, too.
I asked my PCP about a mole that was changing. She said I would have to go the dermatologist. Dermatologist told me appointments were booked 9-12 months out. I said I’d try someone else. Surprise, there is no one else that takes my insurance. I still haven’t called the first dermatologist back.
I would change PCPs but I had to call ELEVEN different offices before I was able to get in with this one. No one was accepting new clients.
I’ve had a doctor in Vancouver all my adult life who has shepherded me through one major health crisis but she’s older than me and must be retiring at some point. My impression is that health care in rural BC has been downsized and underfunded with regional hospitals closing.
There are some clinic chains that are really not very good for care. They are really useful to get semi urgent care like an x-ray request when you fall off your horse or a suspected strep throat or bladder infection but the doctors are rushed and I expect have awful working conditions.
What treatment was given for fibromyalgia? I have it, and I know of a few things that help, but they don’t help a whole lot.
Rebecca
When I lived in Orange County, Calif., there were so many doctors and specialists that they were clamoring for patients. If I had a health issue, wham bam, I saw my GP and then was handed off to the appropriate specialist in a week or two at most.
I’ve lived in this fairly rural part of Arizona for almost 8 years now. My GP is good enough, but she is extremely overworked. I’ve tried calling her to ask simple questions about medications or symptoms; don’t get a response for days. I’ve used the email portal, and that takes her a full week to respond. I’d consider switching to a different GP, but I was lucky to get into her practice, because most GPs are not taking any new patients. Plus, the devil you know is better than the devil you don’t know, right?
For the last year I’ve been dealing with pain and occasional blood in my urine. Sometimes there’s an infection component; sometimes not. I’m forced to go months between appts., scans and tests. Until recently, there wasn’t even a single urologist for me to see, unless I drove over 2 hours down to Phoenix. Not having an answer and living in pain is terribly frustrating. It feels like I’m living in the era of frontier medicine, not 2023.
That’s the “way it used to be.” I know an orthopedist (RIP) who used to make house calls on complicated surgical patients when he was worried about their post-op progress.
It used to be that when docs became doctors, they entered a special “society” focused on patient care. No more. I don’t know the reason or why things have changed. I do know that recently when I wanted an appointment with a cardiologist, they are scheduling 12 months out…yes…one year out.
The best thing the government can do to improve access to health care is to pay for the medical school education of anyone who qualifies to get in, then require a10-year commitment to practice in underserved areas as pay back. This would add doctors to the supply chain and provide docs to underserved areas.
I don’t know the exact details and I’m not exactly comfortable saying without her permission. Can I get back to you? She’s all but given up and I’m begging her to let give her a Hail Mary.
The person who can help her is an Orthodox Jew so it will be a minute.
Of course. I appreciate that you’re willing to ask. I agree you shouldn’t tell me without her permission.
Rebecca
I just want to help her but I also respect she’s willing to just live with pain.
I’m the one not wanting that. I haven’t spoken to her husband yet, but I’m sure he will be on my side.
I do want to rage on her behalf. Being isolated to military doctors is shitty if they do t think you need a specialist.
I agree. When the question of single payer or socialized medicine would come up, people would always object, “We have the best healthcare system in the world!” and “Do you know how long people in Canada wait for surgery?”
I’m not sure anyone makes those arguments anymore with a straight face.
But the big problem with fibromyalgia is that there just aren’t very effective treatments. So we live with pain.
Rebecca
Could you explain it to me? Through PM if that’s better. Her current doctor is saying she’s just depressed. This woman is always happy. Always has a smile. Even when she is mad as hell and cussing you out she has a smile.
She doesn’t have that smile. It’s not depression. I’ve seen that with her.
Fibromyalgia is not well understood. It’s applied to chronic body pain with no obvious cause and therefore no obvious treatment.
If you’ve read your Freud you know there is a whole panoply of things that can manifest as psychosomatic illness. This is where a person is repressing emotions and they erupt in real bodily symptoms. They are not “imaginary.”
Much later than Freud we’ve come to understand a bit about the complex role of cortisol in causing inflammation and various symptoms and illness. Of course cortisol spikes when we are under stress or trauma, so that’s one of the connections between stress and illness.
Depression is also complex. Some depressed people go through phases, many recover or go into remission for years, or only experience depression under certain types of stress. And you also can’t tell by public behavior. Many depressed people learn to keep up a brave face.
I would say that some who feels the need to smile even when they are furious and yelling in anger may have some emotional repression going on. I mean I don’t feel any need to smile unless Im in front of a camera, but on the other hand I can’t remember the last time I got mad enough to yell at a friend.
Anyhow, fibromyalgia is a blanket term used to refer to chronic body pain when all known causes have been ruled out. So because the cause is unknown, there’s no obvious treatment other than topical or symptomatic.
If someone had the resources, energy, and focus, my suggestion would be to do a total lifestyle overhaul including introducing gentle exercise, doing an elimination diet to look for wierd triggers and food sensitivity, and getting into counseling to talk about responding to stress and anxiety. Also getting a super healthy diet and good vitamin mineral supplement going, after you’ve looked for clear food sensitivity. But all that is hard if you feel like crap already. And it’s not guaranteed to help, because there may in fact be an actual disease process or even a retrovirus that no one has identified yet.
Thank you for that but I don’t think that quite fits my friend. She doesn’t feel the need to smile. I’m not sure how to describe it without getting personal about her but I do thank you for that post.
I just know it’s not depression and she knows that too.
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