Anyone ever fire their physician? page

[MikeB]

I'm real close to firing mine but frankly know of no good way to identify one who will be any better.

I'm located east of NYC in Long Island so anyone with a physician they use and are happy with that would care to offer up their dr's name would be greatly appreciated - either in NYC or Nassau County would be the preferred location.

I just had some blood work done and my Dr's immediate reaction was to state "you MUST start taking your medications again - then come back in 30 days for more blood work." This after telling him I had ceased taking a statin and another drug for high uric acid in conjunction with requesting to be taken off of some blood pressure medications.

By way of background - I'm a 43 yrs old, male, 6'2 and currently 250lbs - down from 275lbs since I began eating Primally and to a lesser extent exercising Primally. About 7 years ago my cholesterol was "high" and he prescribed a statin which I took because -well he's the dr and knows better right?

About 5 years ago I ended up in the ER thinking I was having a heart attack - I felt "unwell" and had stiffness/numbness in my left arm. Tests - including stress tests turned up okay - basically I had some residual PTSD from 9/11 (I worked close enough to the WTC that the office windows blew out when the towers collapsed) and that coupled with a high stress environment at work ( sizable downsizing where I had to help decide who should stay or who should go) manifested itself in some anxiety attacks. Not surprisingly my blood pressure taken in the dr's office while trying to figure out what was wrong with me was a little on the high side - maybe 140 over 80 at worst. He declared I was prehypertensive and prescribed a bp med (diovan hct) which contained a diuretic or water pill.

Again I took the medication since he as the dr must know what was best. Somewhere along the way I gave up cigarettes about 4 years ago and gained a few pounds - growing from 245lbs to 260lbs or so. Around the same time I started to experience gout attacks - a few attacks were manageable by taking some NSAID's but about 2 years ago I had a really debilitating attack that resulted in him prescribing allopurinol to get what he described as high uric acid under control.

It was around 3 or 4 years ago that I began exercising after leading a largely sedentary life since leaving college when I played rugby. In my teens I was very active in sports and played football - the American version - for quite a few years all through high school. Anyway I began cycling and going to the gym but was frankly stymied in terms of losing weight as I was "eating healthy" which included lots of grains, low fat, etc.

The chronic cardio wasn't sustainable and I fell off the wagon and ballooned to about 275lbs this time last year. I heard of paleo via another forum and after some googling ended up here. I began eating somewhat primally about 10 months ago and treated myself to Marks books (2 cookbooks and Primal Living) for my birthday in April. Stuff started to click in my mind and by eating primally I saw a fairly rapid improvement in how I felt overall - I suspect that while I'm not gluten intolerant I do better when I avoid any substantial quantities of if. I had been lifting weights 3 x a week - that got cut back to 2x a week for full body workouts and while I lost weight I saw some nice strength gains - again coupled with a major improvement in energy levels, reduction in stress and an overall improvement in how I felt.

Anyway - about 6 months ago the allopurinol prescription ran out and I couldn't be bothered to refill it. I stopped taking it and since then zero gout flare ups.

About 3 months ago the same with the statin - so I stopped taking it.

During this time my weight has slowly come down to around 250lbs - ideally I'd like to get down to 225 so at 1 or 2 lbs a week 6 months is my goal.

Needless to say when I was scheduled for a visit I was excited about my "gains" and general improvement in how I felt. During the visit I asked to be taken off of the blood pressure meds and he basically said not until you lose enough weight to not be considered obese based on BMI - which is around 180lbs. Frankly given my build I don't think anything below 200 is even realistic but I didn't put up too much of a fight at the time because it became clear to me that in his eye's if BMI said I was obese - well then I was obese.

Fast forward to today - the results of the blood work came back and as stated in the beginning he's ordering me to resume the statin and uric acid medication. I asked what were the numbers that were causing him to recommend resumption of the meds and they were:

Uric acid was 8.6 which is a bit high but I think it's attributable to the diovan with hct which as I've found online can cause high uric acid due to the diuretic/water pill embedded in it! Again, I've not had any gout flares since eating primally and quitting the allopourinol.

Total cholesterol was 236 - this was the reason for his insistence I resume the statin. I asked for the other numbers and they were:
HDL - 57
LDL - 169
Trig - 52

Total/HDL ratio = 4.14
Trig/HDL ratio = .9
LDL/HDL ratio = 2.96 if you use the iranian LDL calc it is 2.38

So he seems to be ignoring my ratios completely! This is why I am wanting to fire my physician and the reason for my long winded/worded rant/plea for help in finding another dr.

Am I off base here?

Thanks.

[jojohaligo]

I don't think you are off base in trying to find a physician who is open minded. The Dr you have is just doing what he has been trained to do.

There is a web site that allows you to search for paleo friendly Dr's in your area:

Physicians Archives - Primal Docs

Hope that helps.

[JoanieL]

Ask friends and coworkers. People you respect. Ask anyone you know/like in the medical profession; EMT, NP, PA - people who come into contact with doctors and know who the buttheads are. Ask them things that are important to you: does the doctor listen? does he get offended if you offer other solutions? (I don't know what's important to you, so your list of questions would be different). See if there are patient advocate groups in your area and ask them where to start.

Once you have recommendations, call the NYS Medical Association (you might be able to find this online now) and ask them if the doctor has ever been sued, what the outcomes were, etc. This will weed out the worst of the worst.

I fired a doctor (and more than one dentist) for merely keeping me waiting too long, and another for suggesting surgery before any other alternative.

It may take some trial and error, but there's a doctor out there who will be an ally in your journey to attain health.

Good luck.

[MikeB]

Thanks for that link. This looks very promising. I will have to see if any of them are in my healthcare providers "network".

[MikeB]

Ask friends and coworkers. People you respect. Ask anyone you know/like in the medical profession; EMT, NP, PA - people who come into contact with doctors and know who the buttheads are. Ask them things that are important to you: does the doctor listen? does he get offended if you offer other solutions? (I don't know what's important to you, so your list of questions would be different). See if there are patient advocate groups in your area and ask them where to start.

Once you have recommendations, call the NYS Medical Association (you might be able to find this online now) and ask them if the doctor has ever been sued, what the outcomes were, etc. This will weed out the worst of the worst.

I fired a doctor (and more than one dentist) for merely keeping me waiting too long, and another for suggesting surgery before any other alternative.

It may take some trial and error, but there's a doctor out there who will be an ally in your journey to attain health.

Good luck.

Thanks - I will do that.

[jojohaligo]

Oh and congratulations on ditching 25 pounds!

[magicmerl]

I would totally fire my doctor if he insisted that I take statins. Just remember this: Statins increase all cause mortality.

And the focus on BMI as a health metric? smh

It sounds like you are doing everything right. Keep it up.

[peril]

I fired one. My wife has always used them (two GPs sharing a practice) and I'd never been happy with them but only had rare reason to use them so did so out of intertia. Found them totally unhelpful when trying a nutritional approach to managing CVD so went elsewhere. Lucked up an elderly chinese doctor willing to discuss how I was managing my disease, even though he didn't agree with me much of the time. He provided useful counterpoint. Since he retired I haven't has sufficient incentive to try find another. Wife badgers me about it but it is frankly not worth the effort given the likely return. Only reason for me to have a GP is to order blood tests (mandatory here to get Govt subsidy)

[janie]

I went for my once-a-year Medicare physical several months ago and was royally scolded for not having been seen in their office for over a year. "But I haven't been sick" I replied.

I was told I should be coming in "at least every three months" which in my view is ridiculous. He implied that if I didn't want to do as he advises, perhaps I didn't want him as my doc. He got that right. So I'm searching too.

Doctors work for us although they all too frequently forget it. Sounds as though you are doing great and your cholesterol numbers are fantastic. Yep, get a doc who will be respectful and give you the support you need.

[Dragonfly]

Haven't seen a doc for over 5 years ( I'm 50.)

Have been so amazingly healthy since going Primal & getting my D3 blood level dialed in that I see no point in having a GP. I will go to an Urgent Care facility or ER if needed.