Catholic Info
Traditional Catholic Faith => Anσnymσus Posts Allowed => Topic started by: Änσnymσus on December 09, 2023, 11:47:58 AM
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Does anyone have experience in getting a second opinion on a diagnosis?
I recently went to a new eye doctor, and he diagnosed me with "anatomically narrow angles" which can lead to Acute Angle Closure Glaucoma (and I can lose my sight if a quick onset of symptoms from this are not addressed immediately).
Although it is my understanding that this doctor has a good reputation, I do find it strange that my previous, now retired doctor of 15 years never mentioned I had this issue. I guess it could just be coincidental and that I just started having the problem, but I'm left wondering.
Anyway, it just so happens that when I made this appointment with this new doctor, I also made an appointment with another eye doctor in case the former cancelled on me (they had cancelled me a few months earlier due to temporary insufficient staff and the fact that I was a newbie, so I made sure I had a Plan B in case it happened again).
I plan on going to this other doctor in a couple of weeks to see what she says. However, I'm not sure whether I should keep quiet or let her know that I would like a second opinion. I'm concerned that if I tell her the diagnosis, she may not want to say different than her "colleague". If I don't tell her and she doesn't bring it up, then I'm still left wondering what to think. Do I have this or don't I?
Anyone have a similar experience? What did you do? Any other ideas even if you have not? Any doctors out there who have been on the other side of a similar situation?
Thank you.
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A narrow irido-corneal angle is a common variant. When the iris is dilated it bunches up at the narrow angle and can impede the outflow of fluid at the angle, thereby increasing intra-ocular pressure. Because it is a normal variant, it is unsurprising that an eye doctor who sees the variant every work day might not mention it. That second eye doctor mentioned it just as a matter of style, not an indication of some extraordinary mis-diagnosis on the first doctor's part.
In training we are taught "informed consent," to vomit forth every possible ramification of everything we do, the "lawyer's list." Early in my career I did exactly that and would provide patients with a lengthy discourse on all the possible side effects of every medicine I prescribed ("When you take this baby aspirin, you might die from anaphylaxis"). It was overwhelming how many patients would report "side effects" the very next day: "tired," "headache," "nausea," "dizzy." etc.
As an experiment, I started to provide only the serious potential problems. Lo and behold, the number of patients experiencing "side effects" dropped to near zero. I concluded that the lengthy discourses on side effects had a tremendous power of suggestion that was doing more harm than good. It's a judgment call.
I'm guessing that the first eye doctor read (correctly?) that you are a "worry wart," so he decided that he didn't want to worry you with a lengthy discourse on a normal anatomic variant. When the second doctor mentioned this normal variant, the outcome was exactly as the first doctor likely predicted—you worried yourself into a tizzy to the point of doubting the good care you received.
In my experience it is so rare for patients to miss reporting serious side effects that the incidence of such missed reporting is near zero. Should we unnecessarily worry 999,999 patients because 1-in-a-million might not report, for example, eye pain in the dark??? In the case of acute narrow angle glaucoma, eye pain in the dark (= dilated pupil) highly motivates patients to bring attention to the problem in plenty of time for the doctor to fix the problem (laser trabeculotomy = laser zap a couple of tiny holes in the iris to aid drainage). Period end of story.
If you experience eye pain in the dark (ooops… there's that power of suggestion at work) get your eye pressures checked. Otherwise… fuhgeddaboudit.
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I do not know if this will help your condition or not, but I'm linking what I started taking (Lutein 40) (https://www.puritan.com/lutein-158/lutein-40-mg-044251) about 5 or 6 years ago. For 30 years prior to that, at my every 2 year eye exam I always needed slightly stronger prescriptions. After taking those gelcaps my vision has stayed pretty much the same, I think maybe even improved very slightly, but so far since taking them I have not needed new glasses.
I hope they work for your condition, might at least be worth trying?
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I do not know if this will help your condition or not, but I'm linking what I started taking (Lutein 40) (https://www.puritan.com/lutein-158/lutein-40-mg-044251) about 5 or 6 years ago. For 30 years prior to that, at my every 2 year eye exam I always needed slightly stronger prescriptions. After taking those gelcaps my vision has stayed pretty much the same, I think maybe even improved very slightly, but so far since taking them I have not needed new glasses.
I hope they work for your condition, might at least be worth trying?
I've used this product (https://www.puritan.com/eye-health-003/ppherba-vision-gold60sfg-055691) from the same company with impressive results. Though it seems that they have a hard time keeping it in stock.
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Why not just leave it to the end of the consultation, and if it is not mentioned say "by the way, another doctor told me..." and see what the response is.
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A risk factor is only a risk factor, not a disease. Ask your doctor how high the risk is - not very high from what the poster above suggests. Be aware of the symptoms in case something does develop - who wants to lose their eyesight - but don't become obsessed. If it is nothing to do with the reason you presented to the doctor in the first place then there is no need to be overly concerned. Being alive is a risk factor for dying - apparently in 100% of cases. Your risk of glaucoma would be lower than your risk of dying :-)
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I do not know if this will help your condition or not, but I'm linking what I started taking (Lutein 40) (https://www.puritan.com/lutein-158/lutein-40-mg-044251) about 5 or 6 years ago. For 30 years prior to that, at my every 2 year eye exam I always needed slightly stronger prescriptions. After taking those gelcaps my vision has stayed pretty much the same, I think maybe even improved very slightly, but so far since taking them I have not needed new glasses.
I hope they work for your condition, might at least be worth trying?
Lutein helps the retina, not the lens, iris, cornea, or eye pressure.
By the time your reach middle-age, you eye stops changing in size, the major reason that your refractive correction changes.faster in youth.
Your age, not the lutein decreased the frequency of your refractive prescription change.
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A risk factor is only a risk factor, not a disease. Ask your doctor how high the risk is - not very high from what the poster above suggests. Be aware of the symptoms in case something does develop - who wants to lose their eyesight - but don't become obsessed. If it is nothing to do with the reason you presented to the doctor in the first place then there is no need to be overly concerned. Being alive is a risk factor for dying - apparently in 100% of cases. Your risk of glaucoma would be lower than your risk of dying :-)
Bravo!!! Well stated.
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A narrow irido-corneal angle is a common variant. When the iris is dilated it bunches up at the narrow angle and can impede the outflow of fluid at the angle, thereby increasing intra-ocular pressure. Because it is a normal variant, it is unsurprising that an eye doctor who sees the variant every work day might not mention it. That second eye doctor mentioned it just as a matter of style, not an indication of some extraordinary mis-diagnosis on the first doctor's part.
In training we are taught "informed consent," to vomit forth every possible ramification of everything we do, the "lawyer's list." Early in my career I did exactly that and would provide patients with a lengthy discourse on all the possible side effects of every medicine I prescribed ("When you take this baby aspirin, you might die from anaphylaxis"). It was overwhelming how many patients would report "side effects" the very next day: "tired," "headache," "nausea," "dizzy." etc.
As an experiment, I started to provide only the serious potential problems. Lo and behold, the number of patients experiencing "side effects" dropped to near zero. I concluded that the lengthy discourses on side effects had a tremendous power of suggestion that was doing more harm than good. It's a judgment call.
I'm guessing that the first eye doctor read (correctly?) that you are a "worry wart," so he decided that he didn't want to worry you with a lengthy discourse on a normal anatomic variant. When the second doctor mentioned this normal variant, the outcome was exactly as the first doctor likely predicted—you worried yourself into a tizzy to the point of doubting the good care you received.
In my experience it is so rare for patients to miss reporting serious side effects that the incidence of such missed reporting is near zero. Should we unnecessarily worry 999,999 patients because 1-in-a-million might not report, for example, eye pain in the dark??? In the case of acute narrow angle glaucoma, eye pain in the dark (= dilated pupil) highly motivates patients to bring attention to the problem in plenty of time for the doctor to fix the problem (laser trabeculotomy = laser zap a couple of tiny holes in the iris to aid drainage). Period end of story.
If you experience eye pain in the dark (ooops… there's that power of suggestion at work) get your eye pressures checked. Otherwise… fuhgeddaboudit.
Thank you. You sound like you know what you're talking about. :laugh1:'
It might be true about the first doctor not wanting to worry me, but he had already informed that I was a risk for a retinal detachment. So, I think he would have talked to me about this as well.
This idea about eye pain in the dark was not mentioned to me by the second doctor. Good to know.
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Why not just leave it to the end of the consultation, and if it is not mentioned say "by the way, another doctor told me..." and see what the response is.
This seems like a good, middle-of-the-road plan.
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A risk factor is only a risk factor, not a disease. Ask your doctor how high the risk is - not very high from what the poster above suggests. Be aware of the symptoms in case something does develop - who wants to lose their eyesight - but don't become obsessed. If it is nothing to do with the reason you presented to the doctor in the first place then there is no need to be overly concerned. Being alive is a risk factor for dying - apparently in 100% of cases. Your risk of glaucoma would be lower than your risk of dying :-)
I didn't present anything to the doctor. This finding was part of his regular (new patient?) exam.
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I didn't present anything to the doctor. This finding was part of his regular (new patient?) exam.
Very good. Then you have little to be concerned about. No need for you to lose any sleep at all! This is a Google quote: "for every 100 persons with smaller eyes and narrow angles, only one or two will actually develop glaucoma". Ask your eye doctor if there is any reason to think that you would be at increased risk. It may be prudent to be aware of the symptoms and discuss with your specialist a plan to ensure you have prompt access to an eye assessment should symptoms develop.
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Thank you. You sound like you know what you're talking about. :laugh1:'
It might be true about the first doctor not wanting to worry me, but he had already informed that I was a risk for a retinal detachment. So, I think he would have talked to me about this as well.
This idea about eye pain in the dark was not mentioned to me by the second doctor. Good to know.
Was your predisposition to retinal detachment due to being a "high myope"? (=VERY near-sighted) If so, those retinal detachments are sufficiently common that (in my judgment) a warning about the signs of impending retinal detachment (flashing lights, "curtain" floating in the perceived visual field) are perfectly in order. In 44 years I've seen DOZENS of retinal detachments in high myopes. How many missed acute narrow angle glaucoma cases have I seen? ZERO. Seen many thousands of narrow angles, seen many hundreds of prophylactically lasered acute angles, but not one missed acute narrow angle glaucoma.
As I said, these are judgement calls, not matters of right/wrong absolutes.
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Was your predisposition to retinal detachment due to being a "high myope"? (=VERY near-sighted) If so, those retinal detachments are sufficiently common that (in my judgment) a warning about the signs of impending retinal detachment (flashing lights, "curtain" floating in the perceived visual field) are perfectly in order. In 44 years I've seen DOZENS of retinal detachments in high myopes. How many missed acute narrow angle glaucoma cases have I seen? ZERO. Seen many thousands of narrow angles, seen many hundreds of prophylactically lasered acute angles, but not one missed acute narrow angle glaucoma.
As I said, these are judgement calls, not matters of right/wrong absolutes.
Yes.
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Very good. Then you have little to be concerned about. No need for you to lose any sleep at all! This is a Google quote: "for every 100 persons with smaller eyes and narrow angles, only one or two will actually develop glaucoma". Ask your eye doctor if there is any reason to think that you would be at increased risk. It may be prudent to be aware of the symptoms and discuss with your specialist a plan to ensure you have prompt access to an eye assessment should symptoms develop.
With this post and the optometrist's/ophthalmologist's posts, I feel much batter about things. I will still go to the other doctor and see what she says.
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With this post and the optometrist's/ophthalmologist's posts, I feel much batter about things. I will still go to the other doctor and see what she says.
This post is for the anonymous eye doctor posting in this thread (thank you so much):
You say mentioning the acute angle issue is a judgment call by the doctor.
How do you think I should address my concern with the second doctor next week?
Should I just let her do the exam without saying anything at first and see what she says?
If she doesn't mention acute angles after the exam, should I then tell her that another doctor did and see what she says in response to that?
Or should I tell her at the beginning of the appointment about the first doctor's findings?
Anything else?
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Ophthalmology is not my specialty, but those posts were mine.
I would be frank: "I was worried because one doctor mentioned the possibility of 'acute narrow angle glaucoma,' so wondered if there is any reason for serious concern." With that presentation, the doctor is cued that your worries need to be addressed as well as any existent risk factors, if any.
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Why not just leave it to the end of the consultation, and if it is not mentioned say "by the way, another doctor told me..." and see what the response is.
I always think it's a good idea, when going for a second opinion, to do what this poster says: Don't say anything at all about a previous doctor's findings. Not sure I would even mention it at the end, but if I did, only at the very end, after Dr. #2 has given his full findings.
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Ophthalmology is not my specialty, but those posts were mine.
I would be frank: "I was worried because one doctor mentioned the possibility of 'acute narrow angle glaucoma,' so wondered if there is any reason for serious concern." With that presentation, the doctor is cued that your worries need to be addressed as well as any existent risk factors, if any.
Hmm. Not sure how you know so much about eye conditions if it's not your specialty.
Anyway, it seems I'm getting two kinds of advice. You're saying to tell the second doctor what the first doctor said before the examination, and others are saying to wait until after the examination.
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Hmm. Not sure how you know so much about eye conditions if it's not your specialty.
Anyway, it seems I'm getting two kinds of advice. You're saying to tell the second doctor what the first doctor said before the examination, and others are saying to wait until after the examination.
Good doctors know about medicine in general.
It is really pathetic to go to an eye doctor, for instance, who cannot give you a medicine for the common cold.
I would wait until the end and see if the doctor mentions the same problem as the previous one. If he doesn't, I would mention it.
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Hmm. Not sure how you know so much about eye conditions if it's not your specialty.
Anyway, it seems I'm getting two kinds of advice. You're saying to tell the second doctor what the first doctor said before the examination, and others are saying to wait until after the examination.
See how you feel on the day and LIVE IN THE PRESENT. It is all you have.
Are you so naïve as to expect unanimity on your dilemma?
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A risk factor is only a risk factor, not a disease. Ask your doctor how high the risk is - not very high from what the poster above suggests. Be aware of the symptoms in case something does develop - who wants to lose their eyesight - but don't become obsessed. If it is nothing to do with the reason you presented to the doctor in the first place then there is no need to be overly concerned. Being alive is a risk factor for dying - apparently in 100% of cases. Your risk of glaucoma would be lower than your risk of dying :-)
This!
I know I have this variant only because when I was an inquisitive teenager, I told the eye doctor on a routine checkup that I noticed my left and right eyes reacted ever so slightly differently in the dark. He sent me to a specialist who diagnosed it and said not to worry about it. In the many years since, no other eye doctor has ever mentioned it.
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Good doctors know about medicine in general.
It is really pathetic to go to an eye doctor, for instance, who cannot give you a medicine for the common cold.
Are you kidding me? Medicine for the common cold??? That does not need medicine! We are a soft, over-medicalised society that has lost sight of what is the purpose of our existence.
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Are you kidding me? Medicine for the common cold??? That does not need medicine! We are a soft, over-medicalised society that has lost sight of what is the purpose of our existence.
Common cold was just an example of a very common disease that expert doctors refuse to treat because it is not their area of expertise.
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Common cold was just an example of a very common disease that expert doctors refuse to treat because it is not their area of expertise.
In my neck of the woods it is a long wait (maybe a month or so) to see a GP, and maybe a year or more to see a specialist.
So a specialist is unlikely to waste time on the common cold or any other triviality for that matter. He’s flat out already with his specialty.
It is true they we have become a soft over-medicalised society.
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Hmm. Not sure how you know so much about eye conditions if it's not your specialty.
Anyway, it seems I'm getting two kinds of advice. You're saying to tell the second doctor what the first doctor said before the examination, and others are saying to wait until after the examination.
Some of us studied hard in all our classes and clinical rotations, keep up to date, weigh "research" skeptically in light of what we see in practice, don't fall for fads, and there are many specialties that expose us to a wide spectrum and considerable depth of problems in many areas. It is possible that I am one of those doctors. Maybe not. I have given you good advice.
You want your doctor to be honest. You should reciprocate that expectation by being honest yourself. You are now seeing a doctor for the third time because you are worried. As best I can tell from your postings, your worry (not an active medical problem) is your concern, so put it up front. Being coy serves no purpose. Being abrasive serves no purpose. Re-read the Golden Rule.
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Are you kidding me? Medicine for the common cold??? That does not need medicine! We are a soft, over-medicalised society that has lost sight of what is the purpose of our existence.
"Common cold" is a waste basket non-diagnosis that covers a wide spectrum of mild-to-potentially-deadly disease. Certainly a viral rhinitis does not need prescriptive antibiotics. On the other hand, acute bacterial sinusitis or otitis, often called "common cold," can lead to more serious problems, such as bacterial meningitis.
An anecdote—In my first month working the Emergency Room I saw a 26-year-old man with exactly such an acute bacterial sinusitis/otitis. It was so severe that I called the Otorhinolaryngologist ("Ear-Nose-Throat") specialist on call asking that he see the patient immediately. The specialist was abusive: "What medical school did you go to? Didn't you learn how to treat a common cold?" He raged on viciously, but I persisted. The specialist relented and saw the patient at midnight in his office. After he evaluated the patient he called me back and apologized for being abusive, agreeing that this was an unusually severe case.
Three nights later the 26-year-old returned to our E.R. by ambulance—DEAD! I wasn't on duty that night, but my best friend from internship was on that night. He saw my medical notes from the earlier visit and discovered that the 26-year-old never filled the prescription to continue the antibiotic that the specialist had given him at the initial care. The young man died because his "common cold" progressed to a fatal meningitis.
So, you can pontificate all you want about over-medicalization (it is true), but it may shock you to learn that there actually are cases where we doctors really do save lives. It's unclear to me if over-the-top skeptics dispensing vague snarky platitudes ever save anyone's life.
And the last time I checked my catechism, we are tenants in our Temples of the Holy Ghost and we have a duty to be diligent in self-care. That is indeed an essential part of our "purpose of our existence." It is a chosen "purpose of my existence" to help people as best I can. On my way to work I pray a Rosary with the special intention of doing good and begging the Holy Ghost to guide my mind and my hands.
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"Common cold" is a waste basket non-diagnosis that covers a wide spectrum of mild-to-potentially-deadly disease. Certainly a viral rhinitis does not need prescriptive antibiotics. On the other hand, acute bacterial sinusitis or otitis, often called "common cold," can lead to more serious problems, such as bacterial meningitis.
An anecdote—In my first month working the Emergency Room I saw a 26-year-old man with exactly such an acute bacterial sinusitis/otitis. It was so severe that I called the Otorhinolaryngologist ("Ear-Nose-Throat") specialist on call asking that he see the patient immediately. The specialist was abusive: "What medical school did you go to? Didn't you learn how to treat a common cold?" He raged on viciously, but I persisted. The specialist relented and saw the patient at midnight in his office. After he evaluated the patient he called me back and apologized for being abusive, agreeing that this was an unusually severe case.
Three nights later the 26-year-old returned to our E.R. by ambulance—DEAD! I wasn't on duty that night, but my best friend from internship was on that night. He saw my medical notes from the earlier visit and discovered that the 26-year-old never filled the prescription to continue the antibiotic that the specialist had given him at the initial care. The young man died because his "common cold" progressed to a fatal meningitis.
So, you can pontificate all you want about over-medicalization (it is true), but it may shock you to learn that there actually are cases where we doctors really do save lives. It's unclear to me if over-the-top skeptics dispensing vague snarky platitudes ever save anyone's life.
And the last time I checked my catechism, we are tenants in our Temples of the Holy Ghost and we have a duty to be diligent in self-care. That is indeed an essential part of our "purpose of our existence." It is a chosen "purpose of my existence" to help people as best I can. On my way to work I pray a Rosary with the special intention of doing good and begging the Holy Ghost to guide my mind and my hands.
Ha ha! Nice try. That presentation was not the common cold, regardless of what your haughty specialist said. Exceptions only prove the rule. No treatment is without its risks either. There is a long standing debate in the fraternity, as you would know, whether or not to even treat otitis media with antibiotics, in spite of the rare but serious complications, for this very reason. Another snarky platitude from an over the top skeptic??? Who is being snarky?
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I used quotes because those were his exact words. I don't recall verbatim the entire several minutes long phone call, but I do remember those quoted words well. So both lay and professionals will use the same waste-basket "common cold" when it suits their purposes to describe a spectrum of disease.
//snark on
Yes, risk/benefit analysis is part and parcel of everyone's life, not just for physicians. When we get in the car to buy groceries we have decided at some point that the benefit of having dinner outweighs the risk of getting killed in a car wreck on the way to and from the grocery.
Thanks for your pithy analysis of "serious complications."
//snark off
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Like I said, no one should be going to the doctor for a common cold, except in exceptional circuмstances such as the immunocompromised, those on chemotherapy, for example, where what is usually an insignificant malady could be life threatening, and such patients should certainly not expect their eye specialist to deal with it! Similarly, those who develop more worrying symptoms like your ED case. But as Giovanni said, he was only using the cold to make a point. No snarking or platitudes intended.
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Some of us studied hard in all our classes and clinical rotations, keep up to date, weigh "research" skeptically in light of what we see in practice, don't fall for fads, and there are many specialties that expose us to a wide spectrum and considerable depth of problems in many areas. It is possible that I am one of those doctors. Maybe not. I have given you good advice.
You want your doctor to be honest. You should reciprocate that expectation by being honest yourself. You are now seeing a doctor for the third time because you are worried. As best I can tell from your postings, your worry (not an active medical problem) is your concern, so put it up front. Being coy serves no purpose. Being abrasive serves no purpose. Re-read the Golden Rule.
If I wasn't clear, do know that I really appreciate and respect your posts for various reasons. Thank you.
You are wrong about a "third" doctor, however. This would be a visit to a second doctor. My original doctor retired over a year and a half ago (which is why I went to the first doctor). I mentioned him only because he never brought up the acute angle issue. So, there is the first doctor I saw in August, and I will be seeing the second one next week (the second visit was set up before the August visit as a back-up plan in case the first doctor office cancelled me a second time. They had cancelled my original appointment in June. I thought I mentioned those details in the OP but maybe not). Although your impression of the number of doctors I have seen was wrong, you are correct about the worry. I'm not a crazy worry wart, but I do worry.
I'm still stuck on whether to tell the doctor first or wait until the end of the visit. I don't see the latter as being dishonest.
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It will work out either way. Your life, your call. I hope my advice helped. If you have any questions after your repeat visit, I'll keep my eye out for this thread next week. I'll help if I can.
In these days where the medical profession has been rapidly swirling down the toilet, a healthy (pun intended) dose of skepticism is warranted, even life-saving. That said, too often here on CI unhealthy, life-threatening cases of excessive skepticism erupt, arguably life-threatening because they descend into antagonistic throw-the-baby-out-with-the bathwater quackery.
I try to keep my balance by reminding myself of the analogy that practicing Catholics ("trads") are hated because of the misdeeds of nominal Catholics. Analogously, good doctors are hated because of the misdeeds of bad doctors. Neither good Catholics nor good doctors deserve the opprobrium; but we deal with it. It's just a part of life.
Be well and be good. In this morning's on-the-way-to work Rosary, I will ask the patron saints of physicians to guide your doctor at your appointment next week, so that he gives you what you need.
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Like I said, no one should be going to the doctor for a common cold, except in exceptional circuмstances such as the immunocompromised, those on chemotherapy, for example, where what is usually an insignificant malady could be life threatening, and such patients should certainly not expect their eye specialist to deal with it! Similarly, those who develop more worrying symptoms like your ED case. But as Giovanni said, he was only using the cold to make a point. No snarking or platitudes intended.
Appreciate the explanation. //no snark.
That said, "common cold" is misused by laity and physicians. The short-hand can easily be replaced by "viral U.R.I." for clarity, even better, "self-limited viral U.R.I." It strengthens your case.
Perhaps you'd be surprised at the thousands of times my polite and detailed explanations that antibiotics are not needed for a "self-limited viral U.R.I." have fallen on deaf ears. That spectrum of skeptics will rage that they "just want to be sure" and insist on antibiotic prescriptions, will even complain to hospital administrators if they don't get their demand. They are in the same patient demographic that brings little Johnny into the ER at 3am "just to be sure that Johnny is OK." Johnny barely bonked his head yesterday morning and has been and still is happy running around like a normal kid. It is readily apparent that Johnny is OK, but his parents are nuts and near-universal coverage gives no financial disincentive or skin-in-the-game to make a rational choice. That is not a small demographic. //still no snark.
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Appreciate the explanation. //no snark.
That said, "common cold" is misused by laity and physicians. The short-hand can easily be replaced by "viral U.R.I." for clarity, even better, "self-limited viral U.R.I." It strengthens your case.
Perhaps you'd be surprised at the thousands of times my polite and detailed explanations that antibiotics are not needed for a "self-limited viral U.R.I." have fallen on deaf ears. That spectrum of skeptics will rage that they "just want to be sure" and insist on antibiotic prescriptions, will even complain to hospital administrators if they don't get their demand. They are in the same patient demographic that brings little Johnny into the ER at 3am "just to be sure that Johnny is OK." Johnny barely bonked his head yesterday morning and has been and still is happy running around like a normal kid. It is readily apparent that Johnny is OK, but his parents are nuts and near-universal coverage gives no financial disincentive or skin-in-the-game to make a rational choice. That is not a small demographic. //still no snark.
I once read that a great number of medical visits are made for no good reason at all.
Most people are there just to have some attention and psychological comfort.
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Perhaps you'd be surprised at the thousands of times my polite and detailed explanations that antibiotics are not needed for a "self-limited viral U.R.I." have fallen on deaf ears.
No, I wouldn't, that is why I am trying to help you get the message across :-)
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I once read that a great number of medical visits are made for no good reason at all.
Most people are there just to have some attention and psychological comfort.
In "primary care" (ER and general/family practice) it is quite true. One phenomenon that has disappointed me is how feminized men have become in my decades of practice. When I first started my profession, men came with real problems: broken bones, other serious injuries, really sick. As the decades passed, like women, they began coming in for "issues" and "just want to be sure" emotional support. It seems that much blame goes to the destruction of the nuclear family. People are not having their normal needs met by having a normal family—and, of course, broken families amass broken communities and, in turn, a broken nation. It's pitiful. As a nation, we are goners.
It is a blessing for me that these days I see people with serious advanced problems and a blessing for them that I can help them. God has been good to me.
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My observation is that many ER visits are due to mental illness of one form or another.
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My observation is that many ER visits are due to mental illness of one form or another.
It would be a very short list of societal observations that are not due to mental (and spiritual) illness of one form or another.
:laugh2:
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It will work out either way. Your life, your call. I hope my advice helped. If you have any questions after your repeat visit, I'll keep my eye out for this thread next week. I'll help if I can.
In these days where the medical profession has been rapidly swirling down the toilet, a healthy (pun intended) dose of skepticism is warranted, even life-saving. That said, too often here on CI unhealthy, life-threatening cases of excessive skepticism erupt, arguably life-threatening because they descend into antagonistic throw-the-baby-out-with-the bathwater quackery.
I try to keep my balance by reminding myself of the analogy that practicing Catholics ("trads") are hated because of the misdeeds of nominal Catholics. Analogously, good doctors are hated because of the misdeeds of bad doctors. Neither good Catholics nor good doctors deserve the opprobrium; but we deal with it. It's just a part of life.
Be well and be good. In this morning's on-the-way-to work Rosary, I will ask the patron saints of physicians to guide your doctor at your appointment next week, so that he gives you what you need.
:laugh1:
Thank you. Yes, it has, and I will. I agree with you regarding the excessive skepticism when it comes to the medical profession.
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It will work out either way. Your life, your call. I hope my advice helped. If you have any questions after your repeat visit, I'll keep my eye out for this thread next week. I'll help if I can.
Be well and be good. In this morning's on-the-way-to work Rosary, I will ask the patron saints of physicians to guide your doctor at your appointment next week, so that he gives you what you need.
I wanted to post an update. Thank you.
I had my appointment yesterday, and it went very well. My original intention was to wait until the end of the appointment to tell her about the other doctor's findings. Before going in the office, it did occur to me that I may not have a choice (but I can’t remember why that thought came to me). It's good that I had that thought because it prepared me.
The doctor started by asking me when my last exam was AND who the doctor was. So, since I had to give her that information, I felt that I needed to tell her the whole thing. She was great about it all.... very professional. I made it very clear that I really liked the other doctor, but that I thought it odd that my retired doctor never said anything in 15 years about acute angles. She responded that they could change over time, but that it is less common for someone with such near-sightedness. She was actually quite interested to have a look-see.
Long story short, she did confirm that I do have acute angles; however, she did say that if it were her, she probably wouldn't have mentioned it to me. Apparently, I'm not at a point where this is an immediate concern. To be fair, the other doctor also said he didn't foresee me having an issue soon, but, outside of that, he seemed to make such a big deal of it, including providing me with a printed card with possible symptoms of Acute Angle Closure Glaucoma.
Anyway, I really liked her, so I am considering switching to her. But the other doctor is only 5 minutes away and she is about 30. And to be fair, he was not wrong. Of course, the local hospital is only 5 minutes away as well, so if I were to have symptoms in the future, the hospital ER is always right around the corner.
Some other differences I noticed between the doctors was that she seemed to do what is needed rather than doing anything "extra". The other doctor had me in the office for about an hour and a half. I honestly have never had an eye examination take that long. I think because of the acute angle finding, he also billed for a "special eye evaluation". Is he just very thorough? Conservative? Or is there more to it? Unfortunately, my suspicious nature has me wondering.
Knowing all of this, if you or anyone else has any advice on which doctor I should go with, that would be great.
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I wanted to post an update. Thank you.
I had my appointment yesterday, and it went very well. My original intention was to wait until the end of the appointment to tell her about the other doctor's findings. Before going in the office, it did occur to me that I may not have a choice (but I can’t remember why that thought came to me). It's good that I had that thought because it prepared me.
The doctor started by asking me when my last exam was AND who the doctor was. So, since I had to give her that information, I felt that I needed to tell her the whole thing. She was great about it all.... very professional. I made it very clear that I really liked the other doctor, but that I thought it odd that my retired doctor never said anything in 15 years about acute angles. She responded that they could change over time, but that it is less common for someone with such near-sightedness. She was actually quite interested to have a look-see.
Long story short, she did confirm that I do have acute angles; however, she did say that if it were her, she probably wouldn't have mentioned it to me. Apparently, I'm not at a point where this is an immediate concern. To be fair, the other doctor also said he didn't foresee me having an issue soon, but, outside of that, he seemed to make such a big deal of it, including providing me with a printed card with possible symptoms of Acute Angle Closure Glaucoma.
Anyway, I really liked her, so I am considering switching to her. But the other doctor is only 5 minutes away and she is about 30. And to be fair, he was not wrong. Of course, the local hospital is only 5 minutes away as well, so if I were to have symptoms in the future, the hospital ER is always right around the corner.
Some other differences I noticed between the doctors was that she seemed to do what is needed rather than doing anything "extra". The other doctor had me in the office for about an hour and a half. I honestly have never had an eye examination take that long. I think because of the acute angle finding, he also billed for a "special eye evaluation". Is he just very thorough? Conservative? Or is there more to it? Unfortunately, my suspicious nature has me wondering.
Knowing all of this, if you or anyone else has any advice on which doctor I should go with, that would be great.
Good to hear! I would stick with the second doctor.
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Sounds to me like you are spoilt with too much choice. It's a problem! Be thankful for even one doctor.
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Good to hear! I would stick with the second doctor.
Thank you for the charitable comment!
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I wanted to post an update. Thank you.
I had my appointment yesterday, and it went very well. My original intention was to wait until the end of the appointment to tell her about the other doctor's findings. Before going in the office, it did occur to me that I may not have a choice (but I can’t remember why that thought came to me). It's good that I had that thought because it prepared me.
The doctor started by asking me when my last exam was AND who the doctor was. So, since I had to give her that information, I felt that I needed to tell her the whole thing. She was great about it all.... very professional. I made it very clear that I really liked the other doctor, but that I thought it odd that my retired doctor never said anything in 15 years about acute angles. She responded that they could change over time, but that it is less common for someone with such near-sightedness. She was actually quite interested to have a look-see.
Long story short, she did confirm that I do have acute angles; however, she did say that if it were her, she probably wouldn't have mentioned it to me. Apparently, I'm not at a point where this is an immediate concern. To be fair, the other doctor also said he didn't foresee me having an issue soon, but, outside of that, he seemed to make such a big deal of it, including providing me with a printed card with possible symptoms of Acute Angle Closure Glaucoma.
Anyway, I really liked her, so I am considering switching to her. But the other doctor is only 5 minutes away and she is about 30. And to be fair, he was not wrong. Of course, the local hospital is only 5 minutes away as well, so if I were to have symptoms in the future, the hospital ER is always right around the corner.
Some other differences I noticed between the doctors was that she seemed to do what is needed rather than doing anything "extra". The other doctor had me in the office for about an hour and a half. I honestly have never had an eye examination take that long. I think because of the acute angle finding, he also billed insurance for a "special eye evaluation". Is he just very thorough? Conservative? Or is there more to it? Unfortunately, my suspicious nature has me wondering.
Knowing all of this, if you or anyone else has any advice on which doctor I should go with, that would be great.
Wanted to add some information about insurance:
The first doctor takes my medical insurance (and never took my secondary vision insurance VSP which only charges a $10 copay). The second doctor currently takes both my medical insurance AND the VSP, but she told me at the appointment last week that as of this May she will no longer be accepting VSP either. I appreciated her candor.
So, regardless of who I choose for my next annual appointment, they are both the same when considering $/insurance. Unfortunately, using my medical insurance means I'm paying anyway (until I reach our deductible).
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It's worth understanding what "taking" insurance entails for those of us on the other side of the counter.
(1) Having to pay at least 1 full-time salary to submit and birddog claims.
(2) Wait for 90 days to get a payment, EOB [Explanation of Benefit], or rejection of the claim.
(3) No communication or payment received.
(4) 1-hour on the phone, mostly on hold, "Never received your claim, please submit the claim."
(5) Re-submit the claim with extra docuмentation.
(6) Wait for 90 days to get a payment, EOB [Explanation of Benefit], or rejection of the claim.
(7) After 6 months, possibly get a fraction of the "billable" amount.
So, 6 months to maybe get partial payment. "Taking" insurance is more accurately "getting" the shaft.
"Taking" insurance means that to pay the overhead, most doctors must churn huge numbers of patients = long waits, poor care, doctor not "taking" the time to hear everything you have to say, shifting "care" to less skilled "providers," etc.
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Sounds to me like you are spoilt with too much choice. It's a problem! Be thankful for even one doctor.
It amazes me how two people could downvote this. First the lack of gratitude. Second the complete ignorance of what it's like to live without easily accessible healthcare. I know older people who were among the half of their many siblings to survive to adulthood. I know older people who grew up with stepparents since their own parents died young. All of the above has consequences for a person's worldview. As for myself, I have very good free and comprehensive insurance that I haven't used in many, many years except for the dentist every six months. I'm thankful not only for that safety net but also for the perspective gained from being raised with that sort of awareness.
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It amazes me how two people could downvote this. First the lack of gratitude. Second the complete ignorance of what it's like to live without easily accessible healthcare. I know older people who were among the half of their many siblings to survive to adulthood. I know older people who grew up with stepparents since their own parents died young. All of the above has consequences for a person's worldview. As for myself, I have very good free and comprehensive insurance that I haven't used in many, many years except for the dentist every six months. I'm thankful not only for that safety net but also for the perspective gained from being raised with that sort of awareness.
Well, let's use an analogy (which isn't perfect, but might help).
Say the OP was upset that her child has grown up and left the house and the OP was having trouble on how to deal with it, etc. Now someone comes in and says "Sounds like you're spoilt! It's a problem! Be thankful you even have a child."
Is that post helpful to the OP?
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Well, let's use an analogy (which isn't perfect, but might help).
Say the OP was upset that her child has grown up and left the house and the OP was having trouble on how to deal with it, etc. Now someone comes in and says "Sounds like you're spoilt! It's a problem! Be thankful you even have a child."
Is that post helpful to the OP?
Selective reading comprehension. "Sounds to me like you are spoilt with too much choice." Instead I read it as: "Sounds to me like you are spoilt with too much choice." Two different statements.