What would you do?

This is another cardio question but not really, it's more of a doctor relationship question.....and sorry so long.

So, my Internist/PCP is also my Cardiologist, board certified and practicing in both. I have been seeing him for about 15 years and we have always had a good relationship. I appreciate that he knows me, knows my quirks (many) and fear level, and even recognized me when we meet at the driving range, early in in our relationship.

He is known as a great diagnostician, knows his limitations and for that reason knows when I need to be referred to a specialist. He even referred me, some years ago, to another cardiologist who specialized in hyperlipidemia for my crazy high triglycerides. He has a very pleasant personality.

BUT...
HES VERY BUSY. He sees so many patients every day. Even though he does not intend to rush my visits I sometimes feel rushed and always feel under pressure to get my questions out (maybe that's just me). I realize that part of it is, when he is in the exam room with me, he never sits down when he talks to me. Always standing up, sometimes pacing around the room. He doesn't mean to rush me, it's just his demeanor.

At my last visit he was happy with my Total cholesterol of 97. When I asked him if I should cut down the dosage of statin, he responded "no, your doing great, it's fine" I then mentioned the studies that I had seen (which I can't seem to find now with google) showing low cholesterol can lead to cancer, hormone imbalances and results in higher mortality, and he responded "I'm telling you, your fine, leave it as it is."

I felt like it was a question I deserved a better answer to

Sometimes I wonder if I should be seeing a dedicated cardiologist. I think PCPs today see 70-80 patients a day, they can't help but be rushed. I think Cardiologists get paid more and don't need to do that. The two dedicated cardiologists I saw for a second opinion on my angiogram, gave me a ton of time. I sat in their office with them and just talked and asked questions.

It would be very awkward to leave this guy. I am just thinking , not sure if it's time yet. But I'm not sure. Like most people here, I want to know what's going on and I want to be able to challenge the Drs if I feel it's warranted. I also feel like I owe this guy. He was the one who started doing PSA as soon as I started seeing him at age 50. And sent me to a urologist as soon as it started rising. And he's the one that got my triglycerides down from a dangerous level of 750 to 145, he's the one that sent me to a nutritionist who helped me lose 35 pounds to address the triglycerides, And he's the one that found my need for an angiogram, got me diagnosed and in for an angiogram within 24 hours.

I'm seeing him today for an echo stress test, I'm not going to say anything, but it's something I'm thinking about. Not sure what the right thing is. Sometimes I think it's me because I ask so many questions and am so nervous and maybe I'll have this issue with any Dr.

Post Edited (Pratoman) : 8/17/2015 4:41:04 PM (GMT-6)

Pratoman,
I refer you to your post on the Rock Star thread. If you hold your choice of a doctor for PCa to Rock Star status, I would think you would do the same for a cardiologist. You are much more likely to die of a heart attack than PCa.

Possibly the solution is to continue seeing this doc as your PCP and find another specialist for the cardio related issues.

Your whole situation reminds me a little of why we send our biopsy slides to Epstein -- he ONLY deals with prostate slides. While your PCP may be a board certified cardiologist, he's probably seeing a diverse array of illnesses and conditions every day and I think you want someone who ONLY deals with cardio issues. If nothing else, it's going to give you the peace of mind you need.

What would I do. Here's my honest answer: I don't quote studies to my doctor and I follow their advice.

Maybe I should become a more militant patient and question everything they do.

and any possibility that your doc was just having an off day or something bad had happened earlier?

One day I was sitting at the clinic waiting to see a surgeon when the place went nuts. An announcement came over the speaker, "CODE BLUE, ROOM 401, CODE BLUE" Doctor's, nurses, security guards, and equipment were flying everywhere. 20 minutes late for my appointment an obviously shaken nurse called me back, took my vitals and placed me in a room. about 10 minutes later the doc appeared, sweaty, breathing a little fast and clearly upset. Turns out it was his patient that had a heart attack while his was talking to him. The poor man could hardly focus on me, but he knew my case was important and was doing his best. He prescribed something for my condition, apologized for not being focused and asked if he could call me later in the day to answer my questions.

Andrew

Pratoman - your question brings up a couple of thoughts from my experience.

I had a formerly excellent GP take early retirement while still practicing. Over a pretty brief period he became less interested, more irritable & less current. I dropped him. Perhaps though your cardiologist/GP has a long positive track record with you, his attention to you is deteriorating?

I've had two "concierge" MDs. I pay the current one $1400/year. He takes a limited number of patients. He has time to research everything, advocate for anything, and respond to any informational query within hours. I have his cell number, could reach him any day at any hour (very unlikely to ever use that - but that's the level of accessibility). Can get same day appointments. Nothing is ever rushed. And he and his staff are very happy in their work. The annual physical is four hours in two sessions - far more comprehensive than I've had with other MDs

Wilderness

Post Edited (Wilderness) : 8/17/2015 12:00:20 PM (GMT-6)

Prato,
This situation is under your total control. You can either accept that he is busy, but has other attributes that you find good or you could find another doctor that better meets your needs.
One thing is for certain, he is not going to change.
One of the few great things about our medical system is that we the patient get to choose who we want treating us.

" I want to be able to challenge the Drs if I feel it's warranted." ....and that,my friends , is the operative phrase...learned here , do doiubt. LOL

said...
iving with Pca""]What other field but medical can we pay someone alot of money and than wonder if we can question the service we get? Carol[/quote

Actually Carol, ironically, the answer is, my field - investment advice.

So, at 8:15 this evening, the Dr called me, just to ask if I was doing ok. And gave me all the time in the world.
Who does that these days?
This is what keeps me with him.

We'll see what the angiogram tells me tomorrow. I need it to be negative, and I need them to tell me it's all in my head, or normal exertion under heavy exercise for a 64 year old

Lol, I thought about that.

Thanks Tim. And I agree it's good advice that I got from Mel
With that said, getting a call from the dr last night after 8Pm really threw me.he acyptually called just to check in, ask if I was doing ok mentally, and to answer any questions.

It seems like he does spend a lot of time on the cardiology part of his practice, he even has two rooms dedicated to echo stress testing. And his partner is a cardiologist too.

Honestly, I don't even understand the need for a PCP. I don't need referrals to a apecialist for insurance, and I know when I need a specialist and can figure that out for myself, including finding q good one in my area.

Anyway, leaving in 5 minutes for the hospital, so here we go, really hope I don't need another stent.

Medhelp (urgent care or walk in Centers.)
But I think I'm going to stay with him. Him calling me last night shows me he geniunely gives a SH!t about me, and o do think he's a good dr, and cardiologist.

He also gave me his cell number and told me to call him anytime.

PSA is much more fun to worry about.

Andrew