Preventive Care

A recent comment from Doctor D:

If people are getting most of their care from a specialist it is always important to check in with their Family Doc to make sure they aren’t missing the essential preventative care.

One of the early things I learned in my research about this monster disease is that it is common for people with RA to skip preventive-care appointments with their PCP.  I found that puzzling, since it would seem that one would want to be extra vigilant in caring for oneself in this situation.

Now I understand.  I’ve crammed a lifetime of doctor’s visits into this past year and there is no way on God’s green earth that I’m looking to make any additional office visits.

I saw my rheumatologist in February, May, July, August, September, and October – with another follow-up scheduled in December.  Seven doctor’s appointments in twelve months.

Three times I’ve seen the podiatrist.  Helpful.  A very nice specialist.  Nice, too, that I don’t have to go back any time soon.

This year I also saw my PCP in January, February, March, May, June, July, September, and October.  I have another follow-up appointment with him next month (and hopefully not until June after that!).  Nine more doctor’s appointment in those same twelve months.

Ten times this year I’ve had a needle stuck in my arm to draw blood and there’s sure to be another b/w order next month, too.  These do not take place in my doctor’s offices, but in a separate lab.  Although sometimes the blood draws are immediately following a doctor’s appointment, there have been multiple days that I had to make a special trip into town just to have lab work done.

Tests:  this year I’ve had x-rays on three separate occasions, an ultrasound, a biopsy, an MRI, and an EMG.


This brings me to a grand total of nineteen doctor’s appointments, eleven blood draws, and seven extra tests (plus a car wreck at highway speeds with resultant EMS ride to the ER, CT scans, etc.) in a single calendar year.  No wonder people skip preventive care!

Extra appointments?  Not if I can help it!  Kidney stones?  Drink more water; they’ll pass.  Gallstones?  Drink an oj/oil concoction (nasty tasting, but effective).  Rotator cuff problems?  Hot packs and exercise are beneficial and can be done in the comfort of your own home.  I’ve set a record for doctor’s appointments this year.  While I am incredibly grateful for the care I have received, I am   D O N E !!!

One trick I recently learned is that I can schedule two appointments back-to-back.  Instead of follow-up for an ongoing issue, then a separate appointment for something else on a different day, I can schedule two appointments back-to-back, pay two co-pays, and get everything taken care of all at once.  This is one of those little tips I wish I’d known a couple years ago – definitely a time saver.

I do recognize the importance of preventive medicine, so (despite my reluctance) I’ll see my PCP for the appropriate preventive exam.  Next year.

How about you?  How often do you schedule a routine, preventive appointment?


5 thoughts on “Preventive Care

  1. Currently, my reason for almost never going to my PCP is that he is my UNCLE. Awkward. But that’s what happens growing up in a small town.

    I know I need to switch, but my region of Ontario is notorious for its family-doctor shortage. Need to get off my backside and start looking, though.

  2. I didn’t go in for an annual physical for years. Then, in 2008, I lost my job (and medical insurance) and applied for medical care through the Veterans Administration. I was approved and set up for a physical, which led to further appointments: Gyn/Rheumatologist/Dermatology, and the resulting blood tests, MRIs and biopsies. Except for the rheuma, I’m just fine, thank goodness, in spite of a couple of scares.

    Since then I’ve had my second yearly physical, during which my PCP discovered I was Vit. D deficient. So… more labs, an appointment with an endocrynologist, and more meds in the form of massive Vit. D supplements. Next month? Bone density scan… January 2010? Rheumatologist, more labs, endocrynologist…

    As I said, I went for years without setting a foot in my doc’s office. Today, I feel like I live there. I sure can empathise with your aggravation, but I can’t complain about the superb medical care I’ve received from the VA.

  3. Oh, and I’ve got 3 kidney stones too, so I can empathise with the frustration of having “more” that you might otherwise be inclined to do something about. So far mine have stayed put for 2 and a half years, and I’m just drinking lots of water and crossing my fingers they don’t decide to go anywhere.

    Nineteen appointments is more than anybody should have to sit through.

  4. One option when you have to see your primary doc often is to do the primary care in small parts during other visits rather than one big “preventive visit” each year.

    The model of one “check up” that covers all the preventive needs once a year works best for people that don’t have many other medical needs.

    When I worked at Crayzee Clinic I did a little preventive every time with my regulars who had chronic problems. There isn’t a rule that says you can’t check cholesterol, schedule a mammogram, or discuss exercise at a visit for something else. The clinic got mad about this because I was “losing income” by doing this. It was either lose income or lose patients by letting people miss the preventive care.

    • The clinic could be wrong. Probably. I don’t think it’s accurate to say you’re “losing income” in that situation. A patient who’s already seeing a doctor frequently isn’t looking for extra appointments. It’s not a choice between getting paid for one appointment versus two. It’s a choice of addressing routine things when the patient is there, or not addressing routine issues at all.

      The patients at Crayzee Clinic lost out when you took your break from family medicine.

      Many times my PCP has dealt with multiple problems at a single visit. He always acts like he has all the time in the world. It wasn’t until I started reading medblogs that I learned that’s not how it usually works.

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