My PCP "doesn't care about me"

[111 118]

I've been stewing over this since June and I need some advice. In June, I had my yearly physical with my PCP. He was going over my numbers and decided to finally be honest to me about my weight and where I will be in 10 years if something isn't done. Okay. That's cool. He then proceeds to tell me, "I should have had this conversation with you years ago, but I didn't because I just don't ca-" he pauses and tries to restructure is sentence but goes off on an entirely different tangent instead. Honestly, I didn't hear a word of what he said after the pause because all I was thinking is that my doctor doesn't care about my health - the very thing I pay him to care about!

Now, I feel as if I'm in a sticky situation because he approved me for WLS and I am waiting for clearance from my cardiologist (I have to take a stress test first). I've been hearing from many forums that you shouldn't change doctors when you are going through surgery. Considering my situation, my instinct is to ditch him and find a new PCP shortly after my surgery.

What is your opinion on my situation?

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[KristenLe 5,980]

@ Once you don't have a good relationship with your PCP - it's time to change! I wouldn't change before just in case there was an issue with your referral/approval.

[OutsideMatchInside 10,166]

Your BMI is high enough that is doesn't even matter. You count as suber morbidly obese so if your insurance covers WLS switching Drs is not going to stop you.

I started this process with a brand new primary Dr. He and my other Dr never ordered my records from my previous Drs or endo.

Switch doctors, make sure you find one that is supportive of WLS and don't look back. Don't give this Dr another co-pay.

Yeah once you get started switching Surgeons can be a problem, but Primary care Drs matter very little. They just sign off that you are okay for surgery, but there are ways around that too.

Edited August 18, 2016 by OutsideMatchInside

[WLSResources/ClothingExch 3,444]

1. You may be correct, the "ca..." may have been the start of "care," but you didn't ask so you'll never know for sure.

2. Even if you were to find out that he was not about to say that he didn't care, would you ever again be comfortable and have confidence in him? I doubt that I would. There are other PCP's. The present one has served his purpose in signing on the dotted line in favor of WLS.

3. Any time I needed to see my PCP after and since WLS, the visit had no connection to WLS. I had routine physicals, which meant some duplicated bloodwork. The PCP weigh-in's and BP measurement and the like are part of standard medical practice that a new PCP will continue.. I don't see a reason not to shop around for a new PCP. Whomever you choose will have access to your past records.

Edited August 18, 2016 by WLSResources/ClothingExch

[Dub 10,070]

The fact that your PCP is an ass is reason enough to move on to a better doctor.

The fact that he is an ass doesn't mean what he said isn't true, though.

I am pleasantly amazed every few weeks at the health improvements I've seen since losing some of the weight I am working towards losing.

[Djmohr 6,965]

@

I would not be afraid to change as long as you have your pre op physical done. Otherwise it could delay you.

If you have not, then I would suggest very quickly after surgery getting a new PCP, in fact, I would share your story with your Bariatric team and ask for a recommendation on a PCP that supports WLS.

Even though you don't know for sure what he was going to say, you know he should have talked to you long before now. I had the same situation with my old PCP. In fact she let me go 3 years before saying anything about my rapidly deteriorating kidneys. When she finally did, the damage was done and I had no idea it was even a problem. She recommended I see a nephrologist and he is the one who showed me all the results and how long it was going on for. He is also the one who suggested WLS to stop the disease in its tracks.

I never trusted her again and actually called her out on it as well as asking why my nephrologist was the one who had to recommend WLS. She admitted she was not good at having those conversations because she herself is obese.

Of course I thought "what the heck, then don't be a PCP" - I immediately went on the hunt for a new PCP. Now I have a great one.

Change as soon as you can.

[theantichick 2,204]

I would wait until after the surgery, but then I would get a new PCP ASAP. Ditto to what someone else suggested about asking for referrals from people in your support group. Having a doc that's a butt about weight issues just adds to the shame and struggle, and there's no excuse for it. Good luck!!

[111 118]

Thank you all for your advice! I truely appreciate it. :-)

[AvaFern 3,516]

I'm not sure if this makes you feel better or not, but most of your doctors don't care about you. Your PCP, of any of them, should have an established relationship with you that allows them to care a bit more, but for the doctors that rarely see you, you're just another piece of meat for them to fix. It seems highly personal, but it really isn't. When I was working in healthcare, which was in the emergency setting, not primary care, I do not specifically remember more than a few cases and those were significant to me for some reason (the first baby I delivered, the first person I did CPR on, the first person I almost killed- but didn't she wasn't even hurt, thank goodness).

I'd be more concerned that your doctor after all these years has such craptastic bedside manner. Past not killing you, doctors, nurses, medics...they don't care about you, but good God, they shouldn't say it. Are you sure he was going to say "care"? Although I can't really think of anything else, a lot of doctors struggle with talking to patients about their weight because the logic is that you have a scale and you're educated- why harp on the obvious? If your PCP is older, this is a far more common perspective than younger doctors, particularly since now we know that obesity is a disease with genetic links and there are so many ways to help people combat it.

So...not saying your doctor wasn't wrong, because I also can't really think of a word other than "care", but if it helps at all, it has absolutely nothing to do with who you are as a person and everything to do with how he was likely trained to maintain a degree of distance from patients. I would have called him out, and once all of your paperwork is in place and you no longer need him for everything...I suggest you do the same. It's ok for a doctor to not care, but it is not ok for them to be an unprofessional jack*ss.

[Clarevoyant 347]

I got a new pCP just before I started the process. I absolutely love her. She even called the day after I got home from hospital to check in on me. I have never had a dr like that before and did not know what I was missing. Get a new dr asap

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[James Marusek 5,244]

Your PCP is only a minor part of the weight loss surgery process. He/she is only the initial gatekeeper that refers you to a specialist, the surgeon that will perform the surgery. Since he made the referral, then he is out of the equation.

The weight loss surgery can be a long process involving many individuals. Within many states, there are Bariatric Surgery Centers of Excellence. These are like a full meal deal. These center of excellence puts these specialist under one umbrella. These include the hospital, the surgeon, the nutritionist, pre-op testing, training, psychologist and sponsors of bariatric surgery support group meetings, and specialist that deal with the insurance companies. So I would recommend that you find a center of excellence and work the process through them.

[Djmohr 6,965]

@@AvaFern

I have to say that can be true as I have seen it with a few over the years myself.

However that being said, I feel like I have been very lucky in this respect. Maybe it is because I have had a lot of health issues and nothing is ever textbook with me so they have to work extra hard at helping me with my health issues.

I will also say that I have learned to dump very quickly the doctors that I feel don't care enough to even listen. I have been known to ask the question, "are you going to listen to and pay attention to my lengthy history or will I find someone who can"

Seriously, I have done it more than once until I find a doctor and then I stick with them.

I searched high and low for an excellent dermotologist when I was in MN. I had very severe psoriasis with arthritis. Was finally diagnosed with psoriatic arthritis. It took many years and several doctors.....All of them want to go by the text book. Well, my psoriasis is on the palms of my hands and the bottoms of my feet. It got so bad that all of my skin would slough off and I would have open hands and feet. Can you imagine how embarrassing that was to even shake someone's hand. (I didn't of course)

Well after years of suffering with this to the point I literally could not walk, I got an infection that was moving up my leg and up my right arm. I called my new idiot doctor that refused to listen to all the things we tried and didn't work. She told me to go to the ER immediately and gave me a number for the ER doc to call her. Well, guess what? She never answered the calls. I was in there 5 days and my loser dermotologist doesn't do hospital visits....so they sent in a new dermotologist and it thought here we go again. Well, it turned out that this guy was exactly who I needed to see.

He is older, now in his early 60s but this was nearly 10 years ago now.

Anyway, he immediately was alarmed with what had been happening and said, "with you my dear, we need to throw the textbook out the window, you have a life threatening infection that should never have happened"

Light therapy, creams and the biologics I was on we're not working. He made a suggestion that he would call my dermotologist and talk her through his opinion. I said don't bother, as soon as they let me out of here I will be seeing you in your office.

A year later he told me my case of psoriasis was the worst he had ever seen. We developed an excellent relationship to the point where I now travel 6 hours from wi to MN to see him every 10 weeks for my Stelara injections. He used me as a testimonial on his website, I have done radio for him and I will continue to see him and pay out of pocket probably until he retires.

I have a lot of arthritis issues that impact my spine and my shoulder joints. I have been searching for the last year in my new home state to replace my docs in MN and every relationship I have built, has been based on how things have worked with my dermotologist. I make it a point for them to get to know me very well and to treat me with respect.

My health care is too important to leave it to a doctor that doesn't care. I now have a PCP, a Orthopedic spine specialist, dermotologist and recently even a plastic surgeon who likely won't forget me or give me mediocre care. They know I am outspoken and demand the best care possible.

I tell you all this because it is very possible to have an excellent relationship with your doctors at least the ones you see regularly which should include your PCP. Don't stand for anything less unless you don't care either.

As for nurses, it's much harder because they change them out so frequently, but there are a few special ones I have been dealing with for years. One of them is Dorothy my Bariatric nurse who herself had bypass 12 years ago. By far she is my favorite and has a pretty outstanding bedside manner.

Don't settle for less than the best care you can get. We pay a lot of money for health care in this country.

[knowmydestiny 13]

@evenya. My primary care did not address my weight problem until too many problems popped up to ignore it. My annual was in June and I got the stern talk too, along with an insistent recommendation to at least go hear what the bariatric surgeons have to say. In fact a GI dr recommended it 2 years ago and I was so angry I returned to my primary care to report him, lol, look where I am now! Preparing for the very surgery I could have had long ago if I wasn't so stubborn!

WLSresources is right. You don't know if he was going to say he doesn't "care" .... About you ..... Or about the lifestyle you wish to live ....... ? But he does think you need to discuss surgical options, so in the end he was doing right by you. That being said, if you have any doubt about how he cares for you, you should consider a new Dr after your surgery.

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[4MRB4PHOTO 3,900]

Your doctor sounds like a real Di- (I'll pause and try to restructure this sentence. )

If he truly was about to say the "...don't care", it is time to find a different doctor who really cares.

[ShelterDog64 2,364]

Good doctors DO care about the health of their patients. I'm married to a Family Medicine doctor who carries the weight of his patients' care on his heart every single day. He still remembers the names of patients who have long moved on, who have died, whose lives he's saved and ones he hasn't been able to save. He gets to meet the college kids whose births he attended and he goes to funerals when his elderly patients die.

There is NO reason to entrust your care to a primary care practitioner who doesn't care about you...find a new one. And make sure, when you call to have your records transferred, you let your old PCP know EXACTLY why you're leaving his/her practice.