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Physicals - What a crock

Discussion in 'Off Topic' started by big_z, Dec 30, 2013.

  1. big_z

    big_z Android Enthusiast
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    My wife finally convinced me to get a physcial; I hadn't had one since I was in high school (about 15 years ago). Pee in a cup, blood pressure, stethoscope, turn and cough, quick grope for T-cancer, draw blood and we're done. Other than the lab work, I can't really figure out what was remotely worthwhile here. And it seems to me that the doctor just acts as a middleman for the lab work. I wonder how much my insurance company paid for this "you're healthy, go away" treatment.

    Now I'm just waiting to hear him recommend that I be on a statin, which I will immediately reject.

    I used to think rather highly of doctors. More and more I'm beginning to think of them as lawyers that went to school for 10 years instead of 7.
     

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  2. Rukbat

    Rukbat Extreme Android User
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    During one yearly physical (I was a bit older then than you are now), when I was feeling fine, my blood sugar was over 400 (way over). We watched it for a few days and it didn't come down. If the physical hadn't caught that, the latest improvement in cellphones I would have known about was using digital technology. Today I'm still here, and keeping my sugar at the low end of the range for a non-diabetic.

    It's like insurance - sometimes a routine physical is a waste of effort, sometimes it catches something that, left untreated, will cause you a lot more suffering to treat, or even kill you.

    If you use small rubber bands to bungee jump, skip physicals from now on - you're not afraid of risk.
     
  3. unnamedny

    unnamedny Android Expert
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    Well, do you take your car for a check up when you think something is wrong with it? You pay mechanic to tell you if anything is wrong. If everything is fine then you just go.

    Insurances do not pay that much. If you think blood test cost $200 that's not true. They get about $30 for you to come and insurance pays $25 for a blood test. That's the agreement with insurance companies and doctors. If you do not have insurance and willing to pay cash, I would recommend you to negotiate the procedure price. There is a really big chance that you can get a big discount.
     
  4. shmn

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    An annual physical is preventative in nature and usually free or very inexpensive under most insurance plans.

    If you think it's a 'crock' then don't do it. It's not mandatory (usually). But it can 'save' your life by spotting the early symptoms of a serious problem. And it's usually the blood-work that finds it.

    Do you run virus or malware checks on your computer? Do they always find something? Nope. But you do it so you can deal with a problem before it gets worse.

    Your short-sighted rant on physicals is perplexing. There are much larger problems with the health industry and annual physicals is, in my opinion, not one of them.

    Now, as for your comment about doctors...it's like any other profession...there are good doctors and bad doctors. Just being an MD does not preclude you from being an idiot or an a-hole.
     
  5. big_z

    big_z Android Enthusiast
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    I understand the bloodwork. It seems the most concrete of anything I did today. Diabetes is a big problem in my family. I get it. What I don't get is why the law insists that someone who has $250k and 10 years (meaning, 10 years of no income that they're trying to amortize on top of their already amortizing school loans) of school to read a couple of numbers and say "yep, you're fine". Well, I understand how the law got to be that way, but I don't agree with it. Sure, if the numbers are bad, then bring in the doctor to discuss options, but there's no reason to bring in (or pay) big guns for normal readings.

    I also don't get society telling me that I did the right thing today. As far as I'm concerned (subject to change if bad lab results come in), nothing was learned today. All that happened was that the doctor skimmed some money from my insurance company for looking at me for 5 minutes.

    On a positive note, he was more gentle than the TSA.

    And there's nothing that was done today, other than the lab stuff, that would catch something that will kill me. The doc said I'm 10 years away from having fingers and scopes in...unfriendly places. I can (and do) check for testicular cancer myself.

    Prostate and colon cancer scare me (because they tend to be asymptomatic until they're a problem), and he said that a 32 year old doesn't need those tests. Diabetes scares me but we've covered that. Full disclosure, I had a colonoscopy last year for non cancer reasons.

    Only when I think something's wrong with it. Which is to say, only when someone changed lanes into me and destroyed my driver's door 5 years ago, and only last month when it wouldn't stay in 3rd gear and I knew that the problem was related to old/bad manual transmission fluid. I never take my car in to just "have it checked out". I always have a specific reason. I change my own oil and air filters, too.


    Great, then let's set up labs next to my dry cleaners so I can drop off my suit and a couple of vials of blood on the way to work, and pick up the results at the end of the week. No doctor needed unless things are amiss.

    TANSTAAFL. I may not pay for it, but someone pays. And if I pay someone to pay someone to pay the doc, is the system not just a little crazy for encouraging me to do it that way?

    Nope.

    There are larger problems, but I bet a lot of them stem from having to have the most educated and expensive people on the planet bless things, whether it's lab work or stitches or "yep you have the flu, stay the f home" that shouldn't need their blessing.

    Look, I'm not begrudging doctors for charging lots of money for surgeries, emergency traumas, or opinions on treatment plans for serious or chronic diseases. I guess my rant boils down to this: I do object to doctors acting as skimmers and gatekeepers for routine yet definitive tests (tests that aren't even completed by doctors), and for society cheering them on.

    Oh, one last thing:
    Did you see the part where this was my wife's idea? It's not mandatory, but it's, well, mandatory. :D
     
  6. MoodyBlues

    MoodyBlues Choose compassion over cruelty
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    With all due respect, big_z, you're speaking like a person who's never had anything seriously wrong. I'm glad for you that that's the case, but it has not been my reality by a long shot. I can't say enough about the doctors who are or were part of my life along the way, and the 'routine' physicals that discovered various problems.
     
  7. lunatic59

    lunatic59 Moderati ergo sum
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    I'm with you Moody. big_z is still young enough to not appreciate catching things early through regular checkups, but one day the doctor will find something (better the doctor than the mortician) and he'll be singing their praises to the heavens (or to Galaxy A237 if "heavens" is too religious in nature ;) )

    Now mind you, for someone under 40, unless you have a pre-existing condition or something is bothering you, annual full physicals might be a bit much.
     
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  8. Rxpert83

    Rxpert83 Dr. Feelgood
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    I'm convinced the healthcare/insurance system would be in much better shape if more people got a yearly checkup.

    Prevention is they key
     
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  9. Xyro

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    You could well have a nurse for some steps (collecting blood/urine, or measuring blood pressure being obvious examples), and I'm sure some hospitals do that. If that was all a medical exam involved they would likely save money and have the nurse do it instead, but that isn't the case.

    With regards to lab tests, they don't just pop out a diagnosis/all clear signal. In reality, neither you nor the technicians carrying them out are qualified to interpret the results or make recommendations based upon them. The doctors aren't qualified to carry out the tests themselves either.
     
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  10. MoodyBlues

    MoodyBlues Choose compassion over cruelty
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    The thing is, age isn't necessarily a factor. I was a good deal younger than big_z (21) when I dealt with my first--and almost fatal--big health problem. There isn't enough praise I can heap on the doctor who saved my life. She was an amazing physician and human being. :)

    Indeed! :D

    I'd add "family history" to that list, such as diabetes, heart problems, cancer, etc. Better safe than sorry.
     
  11. Rukbat

    Rukbat Extreme Android User
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    The law doesn't say anything. You can read the results yourself and trust that you didn't miss anything. (Your doctor, unless he's a moron, goes to another doctor for his checkup.)

    My niece has had medical training, years of it. So when her mom was dying last spring and summer, and when my wife, her aunt, had a stroke before Christmas, she wanted to see all the results and consult with all the doctors. Since she understood everything they said, and didn't ask "layman" questions, none of them objected. But she has the training. I understood most of it, having had to learn a lot to write medical software, but after a doctor left, in many cases, I still had to ask her to explain what significance something had.

    Me? I had cold sweats back in 97. The head of HR insisted on calling an ambulance and sending me to the hospital. They took blood and read some enzyme levels. My doctor can't read computer code in split octal and I can't read enzyme levels. But I can write a program in machine code, and he could tell from my enzyme levels that I had suffered a silent myocardial infarc - a piece of my heart muscle had died.

    That's why he has an MD and I have an EE. (They didn't teach programming when I was in school - we were still on vacuum tubes.)

    I don't care whether the government insists on the man looking at my lab results has that level of training, *I* insist on it. I don't want overlooked bugs killing my cellphone and I don't want one killing me.

    But do you know what combination of readings is "normal"? Jim Fixx (this may be urban legend, but It's what I've heard) had an abnormally low blood pressure - but abnormally large veins and arteries, so it didn't take a lot of pressure to push a large volume of blood through his body.

    My blood sugar is abnormally low for a diabetic.

    If you have the training to understand how all the numbers affect each other, pay $25 for a lab test and diagnose yourself, but even most internists won't do that. "An attorney who represents himself has a fool for a client." So does a doctor who diagnoses himself.

    But that's the same kind of thing you just had - they looked at you. That's all a colonoscopy is. (Sure doesn't feel like it, but that's all it is, unless they snipped off a few polyps.)

    You're qualified to. Are you qualified to determine whether a hemoglobin A1C of 7 is normal for you?

    Yep. The insurance company pays - so that instead of paying for part of a heart transplant operation when your heart is 80% fat, they pay a few bucks for a cholesterol test now, and can tell you to change your diet if your LDL is over 200.

    Why pay for fire insurance on your house? So few houses burn down that it's pretty much money thrown away, isn't it?

    More of the same, really. The reason a doctor can look at the lab results for 2 minutes and know how you're feeling better than you know yourself is that he went to school for 10 years (and spent years of training in a hospital, and still goes to seminars and ... keeps up with things is what it is). You'd have to spend 3 hours going over the web, finding out how this affects that, and if it's bad if the other is that value and ...

    I have high cholesterol (generated internally - it stays high if I'm on a pure vegetable diet) and gout. The best meds for those conditions are contraindicated together. The gout medication (don't get me started on what a ripoff it is to allow a company to do a meta-study on a generic and get the right to have it not be a generic any longer) interacts with any statin and can cause major problems. So either a heart attack or pain so bad that I lay in bed all night screaming?

    That guy who's so overpaid (my doctor at the time) researched the situation, including with some very good pharmacologists, and came up with a course of medication that continues, years later, to keep the gout just about non-existent, while I'm still on a statin.

    When my spinal arthritis had me wondering if living was worth the effort any more (about 2 months ago), one of those overpaid doctors spent half an hour working with a pharmacist to find some way to relieve the pain. Opiates have only one effect on me - if I take them with water I get a bit of hydration. I could have taken codeine until it stopped my breathing, and I would have died, still in agony. Can't take most other meds that would have worked, for other reasons.

    But - I don't know where she got this one - many people who get no effect from codeine and opiates (some kind of northern European genetic heritage) get great relief from a combination of a very mild pain killer (the kind that would slightly take the edge off a mild headache) and a very low dosage of Valium. Works like a shot of pure morphine for me.

    Are there doctors not worth the paper their degree is printed on? Sure. Just ask anyone who uses the VA for medical care. But there are doctors who are worth all the money they can carry in a large truck. The one who sees something in your blood test when you're 35 that causes you to be above ground on your 36th birthday is one of those. And that's why the insurance company pays doctors what Cisco pays good programmers - because "change your diet and take this prescription" saves the insurance company hundreds of millions of dollars every year. (And it would save them more if more people DID what the doctor recommended.) And it keeps your rates lower too. If they had to pay millions more, you'd be paying hundreds or thousands more.

    They're in the business for only ONE thing - to make a profit. And they have people they pay good salaries to, to figure out how to do that. So if they're paying for an annual physical you can be sure that your taking an annual physical is saving them money, statistically. And if it can't hurt your health, what's bad about it? They win, you win or break even.
     
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  12. MoodyBlues

    MoodyBlues Choose compassion over cruelty
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    Great post, Rukbat, and I give you a big :thumb:. :D

    I disagree with only one point:
    In my experience, most VA doctors [and nurses and other staff] are very good and very caring. They also know when they're in over their heads, as when my best friend [who has a multi-decade, very complicated health history] needed a new pacemaker last year, but was very high risk because of sepsis. The VA facility she was going to [in NC] made the extremely good decision to send her to Duke for surgery and treatment, and the VA picked up the tab. My husband has also received stellar care through the VA.

    Like everything else, I'm sure different people have different experiences, and I don't doubt that there are some VA doctors who are incompetent, but that kind of doctor exists in the private sector, too.
     
  13. mikedt

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    Now I don't think annual physicals are a "crock". If my mother had them she might have still been around :( The labwork could have found the cancer early enough to be treatable. I have them now, really because my job requires them as I'm over 50, and one never knows what they might find.
     
  14. big_z

    big_z Android Enthusiast
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    Look, I get that if you have a problem or are over a certain age then yearly physicals are necessary. I'm healthy. Society tells me that I should have annual physicals even though I'm under 40 and healthy. I think, given my experience here, that it's a crock, and just a way for a doctor to skim some money from my insurance company. I used to work for a Beltway Bandit; I know how the skim game works. I don't think I'm qualified to read lab results, but I also don't think that it takes an MD to be qualified for normal results.
     
  15. big_z

    big_z Android Enthusiast
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    And my labs came back normal; even my cholesterol was under 170. I like meat and some close family members have levels high enough that their doctors harp on them, so that was pretty surprising.
     
  16. jhawkkw

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    Age shouldn't make a difference because even though some conditions can appear at any age. During a physical a couple years ago during a test that you seem to have dismissed (throat compression), that my doctor found a growth in my throat. It turned out to only be a goiter due to the eventual diagnoses of hyperthyroidism after blood tests on my TSH and T4 levels, but could have very well been a tumor on my thyroid. I'm only in my 20s.
     
  17. big_z

    big_z Android Enthusiast
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    But that's the thing, it doesn't take an MD to know that cholesterol over 200 likely is a problem, and it doesn't take an MD to know that it's time to bring in an MD in that situation to discuss treatments, particularly with the competing goal of managing gout.
     
  18. lunatic59

    lunatic59 Moderati ergo sum
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    The medical community recommends it, but I don't think society as a whole cares about an individuals checkup schedule. I don't recall any peer pressure for medical treatment other than "dude, you're bleeding ... you should see a doctor." I know there's a lot of general recommendations floating through the media for things like 40+ breast exams and 50+ colonoscopies, but for general physical exams i don't recall every feeling any societal pressure.

    I think you should take a hard look at lawyers the insurance industry for that. All those malpractice suits generate oppressive premiums for dedicated medical personnel to the point of making certain things that seem ridiculous necessary for them to protect themselves.

    I'd also point out that what is "normal" for one person is not for another. You can't really plug in a set of numbers into a spreadsheet and come up with a health rating. You see a combination of readings or conditions that individually would be fine but together indicate a problem. It takes loads of training and experience to sort some of that out. Heck, one of the most prevalent diseases in my area is Lyme, but its symptoms present differently in a lot of folks and in many cases, unless you look specifically for it, it could be taken as something else. The only other option to qualified medical review is to have every person periodically take every test for every disease, which isn't really practical.
     
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  19. Elmers26

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    I know that it passed quie a long period since this thread was active, but I just wanted to add that I'm also dissapointed with the service of physicals nowadays. A few years ago, I had the symptoms of gout, similarly as Rukbat. I had such symptoms as pain in the toe, stiffness in the joint itchy skin and etc. as described in, for example, this article http://goutsigns.org/symptoms/gout-symptoms Thereby, I had several consultations with different doctors and almost neither of them could provide me with a proper treatment. Eventually, I found a good doctor who presribed me an effective therapy, but isn't strange that I didn't get it from any of the previous doctors?
     
  20. rootabaga

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    The resurrection of this thread prompts me to add this...

    [SIDEBAR]
    Many years ago I was applying for a job with a municipality in the bay area of California; at the time I lived in Colorado. One of the requirements was passing a physical. Initially I thought that strange, and then I figured it made sense because the workup would reveal if the applicant were taking illegal drugs. That's really the only thing that made sense to me about it (the medical coverage groups are required to cover the employees regardless of pre-existing conditions). The municipality arranged it with a doctor local to me and paid for the exam as well.

    No problem passing the exam, of course, but it was a while later that I found out they don't even check for illicit drug usage.

    Which really puzzled me. I mean, why then the waste of time and money for the exam? To my knowledge they still have that policy, but it sure seems like a joke to me, at least in this discrete context.
    [/SIDEBAR]

    Please continue your ordinarily scheduled discussions. ;)
     
  21. dan330

    dan330 Extreme Android User
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    ^^^

    they might not want to hire someone that has a big health issue.
    lost of work days... and higher cost to company ins cost.
     
  22. bjacks12

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    I have become distrustful of doctors lately, although my own physician that I've known since I was a child is great.

    My mom's side of the family has a history of cancer. I expect that's what will take me from this earth at some point.

    She is the only person in her family who has not had cancer. All of her siblings have, one did not make it. Her parents both suffered from it at some point. Needless to say, my mother is on top of getting regular screenings. She's had doctors that will call and say "We think we've found something and you need to come in for further testing" only to find out it was a false alarm every time. Now...maybe the science is just that unprecise at this point in time...I'm no expert. But the cynic in me sees this as a money-making tool. Find nothing, tell the patient that there are 'concerns'. They come in, clear. No harm done right? But you can now bill them or the insurance company for the time. And you know they're not just going to stop coming in because they don't want to take the risk that it was cancer and they didn't have it treated in time.

    Anybody else have observations like this?
     
  23. lunatic59

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    Actually yes.

    A girl I work with has MS. She goes for regular blood screenings as prescribed by her doctor. Following her last test, the doctor's office called her and said the doctor wanted her to come in as soon as possible. Of course it put the fear of Dog in her so she asked if anything was wrong and the office staff would not tell her. Needless to say, she was a wreck until the appointment. When she finally got there, her doctor sat her down and said there was no change and that she should continue her medication. WTF is that about if not for the sole purpose of billing for an office visit?

    My personal experience is worse. Several years ago I was having random symptoms. Mild fevers, muscle aches, ears ringing, headaches and a few others. The "doctors" sent me for a plethora of tests including complete ENT, cardio-pulmonary, arthritis and osteo and even performed a CAT scan. They put me on pain meds, anti inflammatory drugs and antidepressants. When none of that worked I, me, myself suggested being tested for Lyme. Came back positive and they put me on the proscribed antibiotics. Said I was "cured". 2 months later the symptoms returned. They put me on an extended course of the antibiotics with lesser effect. To this day, I don't feel "right". Now, I know Lyme is hard to diagnose by the symptoms since it tends to present differently in each case, but considering I live in Lyme country and i was having these seemingly unrelated symptoms you'd think the prudent thing would be to test for it.

    Had they done the prudent thing, it would have been ~$200 in bloodwork and ~$20 in antibiotics rather than tens of thousands of dollars in useless diagnostics.

    And ... Last year I had an appointment for a routine physical. The office called prior to the appointment and asked if it would be okay if i saw a PA (physician assistant) instead of an MD. I said sure, since it was only routine. The PA said he heard something when listening to my carotid pulse and insisted an ultrasound was necessary. Since my family has a history of heart disease, I naturally said yes.

    During the test, the technician said as a matter of routine, when performing a carotid ultrasound, he always listens to the brachial arteries as well. Didn't ask, just moved the device to my collar/shoulder area, recorded a few seconds and called it a day.

    When I got the bill, i was charged for a Physician's visit with a doctor I've never heard of and was charged for two separate ultrasound tests. Oh, and the test results were negative across the board. In fact the technician said I had no plaque at all, which aint too shabby.

    So I paid a partial amount, in good faith and asked for clarification. No response except a statement the next month for the balance. Called again and again no call back. After three months of this dance, I got a letter saying they were sending it to collections and if I didn't pay they could no longer treat me as a patient. At that point, I called the billing office, didn't care who I talked to, read them the riot act and threatened to involve my attorney. They waived the remaining balance.

    So, I found a new doctor. When the previous practice transferred my medical records they were woefully incomplete. Is it any wonder why i don't trust the medical profession any more?
     
  24. FishenFool

    FishenFool Well-Known Member
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    Try saying good things about VA Doctors & VA Hospitals in AZ.
     
  25. no one

    no one Android Expert
    Rank:
     #61
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    Dec 8, 2010

    Dec 8, 2010
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    I agree, doctors and their voodoo magic mind control only make you think you are sick so they can do unspeakable things to a certain orifice and siphon money from your wallet.
     

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