bob_G

Over 65, on Medicare, quality health care?

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My old doctor  of 30 years retired almost two years ago.  Great guy, excellent doctor. Two annual physicals, two EKGs, examined my eyes, my ears, my skin. Prostate exam. Tested reflexes. Listened to my heart and lungs. 

Then, he sat down with me and went over my labs.  Carefully explaining the values and results of each test.

 

Ok, he retired. Referred me to a new doctor. Young gal, he said I'd work well with her.

So fast forward to my recent office visit. Haven't seen her since Sept 2019. Our other appointments were of the virtual variety. In other words, a phone call.  :rolleyes:

So, Dr walks into the examination room, say hello. Sits on a stool 10' away, and proceeds to tell me the results of my recent labs. Much to my surprise, my labs consisted of an A1c test only (I'm a type 2 diabetic).  No cholesterol, no urine test, no uric acid (gout). No EKG.

She was very happy with my significantly lower A1c, and was about to conclude the visit. However she must have seen me look at her stethoscope on the table, and decided to listen to my chest. But never asked me to remove my shirt.

 

She concluded by saying it was nice to see me, and walked out.  On the way out, she says our next office visit will be next Sept, 2021.  The rest will be virtual.

I'm sitting there thinking, what just happened here?   Am I being "moved along" because I'm a senior on Medicare?  I have excellent health insurance that we pay dearly for.  But I felt like I just got the bum's rush.  

Is this the new state of medicine?

Edited by bob_G

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COVID concerns. limited contact and only do lab work if there was an existing chronic care issue (Diabetes, Hypertension, etc)

I only went in for blood work and a tetanus shot, everything else is "virtual".

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Yes there's no old school doctors around anymore , last one i saw was 20 years ago. he would stitch you up right in his office. . Ask your doctor to do that nowadays . They will send you to the ER or a [ Specialist] .

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Medicare will only pay for only so many tests per year unless there's a history that something needs monitoring closely , You can thank Covid 19 for the distance thing and virtual visits , 

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You need to find a new doctor, or maybe a few. I'm on Medicare since 2006 and that has not been my experience at all, and I have been through prostate ca, polymyalgia rheumatica (look it up) and now cutaneous lupus successfully. My out of pocket costs have been nada with a combination of Medicare and a supplemental policy provided by my wife's former employer.

I see a PCP, a Rheumatologist, a Urologist, and a Dermatologist all of whom are willing to spend the time to listen and respond without pushing me out the door. 

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Not sure how much a physician receives for a annual checkup, it’s supposed to be no cost to patient but I have seen similar to you. I moved to florida made an appointment for myself and wife for our annual with a new doctor. We go there( separate appointments, back to back) and the nurse said do you want to go in together. We are like no, what? Never heard of that. I go in and it’s an introductory meeting, what? I scheduled a physical,  oh well we do an introductory visit first, charged me like $100 bucks and the wife as well. When I finally got a physical, no EKG, no prostate exam, no coughing exam. No pre blood test, Blood pressure, temperature, listened to my lungs, asked me a few questions and out you go. Do less and find a way to charge more, the state of healthcare in the US is a mess.

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5 mins ago, aneary said:

Not sure how much a physician receives for a annual checkup, it’s supposed to be no cost to patient but I have seen similar to you. I moved to florida made an appointment for myself and wife for our annual with a new doctor. We go there( separate appointments, back to back) and the nurse said do you want to go in together. We are like no, what? Never heard of that. I go in and it’s an introductory meeting, what? I scheduled a physical,  oh well we do an introductory visit first, charged me like $100 bucks and the wife as well. When I finally got a physical, no EKG, no prostate exam, no coughing exam. No pre blood test, Blood pressure, temperature, listened to my lungs, asked me a few questions and out you go. Do less and find a way to charge more, the state of healthcare in the US is a mess.

Sounds like we have the same Dr. :laugh: .  I'm laughing but it's not funny.

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I have a Medicare advantage plan and my historic Dr. is in network. Haven’t noticed any change since before I went on Medicare.

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6 hours ago, Ditchbag said:

Yes there's no old school doctors around anymore , last one i saw was 20 years ago. he would stitch you up right in his office. . Ask your doctor to do that nowadays . They will send you to the ER or a [ Specialist] .

Yup, it's hard to find the good ones anymore that really give a ****.  I had a great old school guy that was one of a kind and worked until he dropped dead at 96.  He loved his job and cared for his patients and did housecalls back in the day.  I haven't been able to find the same since.

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Posted (edited) · Report post

I think you need to find a new Dr. 

 

My mom's Dr (a cardiologist who we use as her primary) spends tons of time with her and does an EKG and blood every time she goes, among all the other things.  She is 96 with no previous heart condition.  Really no medical conditions at all.  She had been going every 3 months until COVID hit.

 

Edited by Suebert2

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Wife and I just returned to NC from Westbouough Mass for our annual physicals. Had blood work done down here and had results before appointments. My Dr is hands on and does check everything, like your old Dr. Anything else is an email.My neighbor down here was a surgeon and his Dr wanted to do a virtual visit and he said if you can't touch me how can you examine me. Ask around there are a few old school Drs left. 

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Posted (edited) · Report post

Certainly medicare has rules and limits but that should not change the visit with the provider.  Assuming you were both masked she is pretty safe sitting in the office with you for 10-15 minutes.  Being an older timer in our practice you can truly see a difference in the way younger docs and patients interact as well as the obligation of availability to patients. Walking out the door after 10 hours in the office I heard two of the younger docs tell the staff the sick kid can go to the ED, they were done for the day.  I came back in , turned on the computer and asked the kid to be placed in a room and I saw him.  Maybe it's me, but medicine ahs never been an 8-5 job.  Never.  Newer doc's/providers definitely have a cutoff on their availability.  

 

Oh, and good job with the A1c!

Edited by ScottO

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I'm on Medicare, but haven't had a checkup since CoVid showed up.  Last fall my doc left my family practice to head up a department at the medical center, so I had to get a new doc.  I set up an appointment and went in to meet Dr  Mukai.  I sat down and said I had heard online of this fisherman and guide on Cape Cod named Juro Mukai and had he heard of him.  The doc chucked and said Juro was his brother.  We talked about Juro and his exploits and his now being in the Pacific northwest now.  The doc doesn't fish, so we haven't become fishing buddies.  That's my curious story.  I don't know how the practice is handling in-person visits right now.  Hopefully we get through this plague by this time next year.

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