My Orwellian Doctor's Visit

[exskibum]

It is quite possible that your medical provider simply had health promotion at the heart of the questioning. The information obtained can be further explored with a plan for education to help reduce your risk for adverse health events. If a healthcare provider didn't ask me those questions, I'd be worried that they're only concerned about illness and not health.
My 2 cents.

Sorry. I do not see how a question about whether I ride a motorcycle is in my best health interest. That is ludicrous at best, but more likely insidious.

The direct question is not, but the follow-up education which reinforces the importance of safety equipment may have a direct impact on injury reduction when you decide to hop off of that motorcycle at speed.

Same with gun ownership... it's not about whether you own a gun. It's about whether you have a trigger lock or not, children in the home, etc... that impacts your health and/or the health of your family. The medical home is expanding and SHOULD NOT be focused on active illness. I do understand the conspiracy theory side of things though. I can see the information potentially being used maliciously by some third party payers if they actually discovered the information. I'm trying SO HARD to not make this turn political, but politics/regulation plays a huge role in your fears.

I respectfully disagree. And I don't see the need for this to become political. Indeed, I suspect that based solely upon my

views about guns and privacy rights, you would never be able to predict my considered views on other political issues.

I don't begrudge a medical professional ASKING such questions, so long as he or she is fully and immediately willing to understand that I don't have to answer them, and is willing to accept that decision, especially since my problem with it is that he is making a permanent record of those answers. I have a doctorate degree too, and I can make my own decisions just fine. Having said that, I've never had any problem with a doctor in that vein -- fact is that I probably know more about insurance, insurance underwriting and insurance claims procedures than they do.

More to the point, I get it that gun locks, safes, training and motorcycle safety precautions all bear upon incidence of injury. But I'm neither a child nor a neophyte in any of those things. I can manage all those things just fine without being babysat by someone or a system who is more than likely less well informed than I am about those issues and the prevention of injuries related to participation in those activities. I try to maintain "beginner's mind" about everything, including guns and motorcycles -- I just might learn something if I'm open. But the doctor's office is not where I'm going to seek education about them. So, where the context involves writing down my answers on these subjects when *I* chose to come in for an unrelated medical condition, I'll decline to enhance the growing computer data base on every detail about me, my preferences and my activities that can be used against me by others with access to that data base.

As an example, I will simply point to these records as a common basis for declining to provide medical insurance based upon a preexisting condition or participation in a "dangerous" legal activity. An even better example is the CLUE system, which can make it nearly impossible to get homeowners insurance on a house if you show up in the insurance industry's CLUE database as ever having made a claim for water damage on any house you owned or rented. I've seen cases where the homeowner seeking new insurance only inquired about water damage on a previous house, got into the CLUE data base as a result, and had an escrow blow up in a subsequent attempted home purchase because the lender wouldn't fund without HO insurance that couldn't be obtained in time to close escrow due to a BS CLUE entry. More? Ever try to straighten out an erroneous credit report that traces to an erroneously reported purported failure to pay a bill?

So, thank you, but NO to being babysat with those potential ramifications -- I don't quite trust a system that has such powerful consequences once information gets into it, and from which bad, irrelevant and improperly considered information is so difficult to remove. IMO, if you want to avoid those consequences, you have to take responsibility for managing the data that goes into it to the extent possible. Not a much different concept than trying to prevent identity theft.

That does not mean that I support taking it out on the doc or other health care providers doing their jobs -- I'll just decide what I answer and what I don't.

 

[Fred W]

The direct question is not, but the follow-up education which reinforces the importance of safety equipment may have a direct impact on injury reduction when you decide to hop off of that motorcycle at speed.
Same with gun ownership... it's not about whether you own a gun. It's about whether you have a trigger lock or not, children in the home, etc... that impacts your health and/or the health of your family. The medical home is expanding and SHOULD NOT be focused on active illness. I do understand the conspiracy theory side of things though. I can see the information potentially being used maliciously by some third party payers if they actually discovered the information. I'm trying SO HARD to not make this turn political, but politics/regulation plays a huge role in your fears.

worldbound4now

I can see how one might come to those conclusions if as example there had been any subsequent discussion about motorcycle safety as result of my answering "yes" to the motorcycle riding question. I would then have assumed that the doctor and her office had only my best interest at heart, albeit misguided and misplaced IMO. But there were none.

My conclusion therefore is that this was recorded so it could be handed over to the same insurance data-banks that are cross-reporting and recording my eye exams, visits to the dentist, etc (not that those are in the same class). Hence the title of this thread.

There is a big difference between health and safety. I do not (and would not) visit a medical provider seeking advice on how I can most safely lead my life. They are not qualified to provide that, if I wanted it, except in those specific areas that are directly medically (ie health) related.

I mean, what's next? Are they going to insist that we always wear hard toe shoes and safety glasses when ever we get out of bed ? After all, we might get hurt... What does an MD know about how safe or unsafe a motorcycle is to ride? Did they study that in school? No, a physician is trained in the detection, treatment and prevention of disease. That is where they should apply their practice, not safe living. While accidents may result in subsequent health problems, they are not disease.

The group that WOULD be quite concerned about both one's health and safety would be the insurance company, since they would potentially be responsible for medical bills incurred as a result of an accident.

So, the bottom line question is: Does my doctor work for me or for the insurance company?

 

[puppychow]

So, the bottom line question is: Does my doctor work for me or for the insurance company?

Who pays his bills, you or the insurance company?

 

[Fred W]

So, the bottom line question is: Does my doctor work for me or for the insurance company?

Who pays his bills, you or the insurance company?

Who walks in his door and has the right to leave at any time? Me or the insurance company?

Seriously, I am the one that "hires" him (or her). Where that money actually comes from should be of no importance in the relationship.

 

[puppychow]

So, the bottom line question is: Does my doctor work for me or for the insurance company?

Who pays his bills, you or the insurance company?

Who walks in his door and has the right to leave at any time? Me or the insurance company?

Just pointing out the fact, that since insurance pays 80% or more of their bills, they sometimes succumb to strong arming by the insurance companies. Not all of them do, which is very honorable considering that they might lose a lot of business if an insurance company decides to drop them from the approved or preferred providers list. Not many would go to a doctor and pay all or 50% of his costs out of pocket if their insurance company suddenly decides the doctor is out of network.

Having said all that, I agree that doctor-patient confidentiality should be held in the highest regard, I also do not like my doctor sharing ANY information about me unless it is with my express consent. I agree that finding a good doctor who really cares is turning out to be difficult these days, I have had a doctor before, who treated his patients like an assembly line, you get 10 minutes with him, if you are not satisfied or there is something which will take more time, you had to make ANOTHER 10 minute appointment and pay another co-pay etc. Needless to say he only did this to me one time before I booted his ***. I am lucky to say that I have finally found a good doctor who is not stingy about spending time with his patients, of course this sometimes means that he is running a little late in his appointments, but I will take that anyday over a doctor who is always running on time, but kicks you out of the room after the 10 minutes are over.

 

[Fred W]

Just pointing out the fact, that since insurance pays 80% or more of their bills, they sometimes succumb to strong arming by the insurance industries.

Bingo. That sometimes happens. :glare:

I think we already agree that it never should.

 

[DE OPPRESSO LIBER]

My little primary care dilemma is compounded by having just completed my annual physical with the wicked witch of the west. I assume that any new PCP would want to do a complete physical on me before subscribing anything.

Yes, they might want to do one, but often times your first visit to a new doc is just informational gathering and discussion... different docs do different things and you could always ask the office their practice before signing up/making an appointment.

Here is my short term plan:
I can take my own BP no problem, so I'm going to try and exercise (and diet) my way off the HCTZ over the next 90 days, which is when my existing prescription expires. It's a pretty lame-*** drug anyway if you think about it, lowering your BP by making you pee a lot. That part of the plan I am fully comfortable with since if I see that the BP isn't responding enough I can just go to a new doctor with that complaint at that point.

Yep, taking a BP is easy enough. Diet and exercise, it goes without saying, is of course good advice whether you're on medications or not and whether you have a medical condition or not. Yes, HCTZ is a lame *** drug, but, it has the least risk with the least amount of side effects and is often effective, save pissing all the time, which is why it is so popular. Aside from eating less salt and increased exercise, perhaps you could spend some quality time with the bike meditating as you assume the perfect Zen Yoda riding position!

But, if (when) I go off the statin I will not know what's happening to the cholesterols unless/until I fork over some big lab fees. It was never all that bad before she drugged me, and (correct me if I'm wrong) cholesterol is more of a chronic threat, so I think that I'll be OK at least until my next annual physical.

Since your cholesterol profile isn't horrendous, then yes, it could wait to be checked until your next physical. In the meantime, aerobic exercise will help to lower your LDL, a good quality fish oil supplement will raise your HDL, and eating a reasonable diet trying to avoid trans and saturated fats will help keep the triglycerides in check. Niacin is commonly used to treat high cholesterol with good effect, but in the non-prescription form, it causes flushing (much like your girlfriend's 'personal summer') which sometimes people don't tolerate well.

There are some ways to help play the insurance game provided your doctor is amenable to your plan. I will have my labs drawn BEFORE the appointment so that when I go, they don't say "Ok, lets check X, Y, and Z" and then bring you back for another visit to discuss the findings and create a treatment plan, thereby necessitating another co-pay. I like one stop shopping when I have to go to the doctors- cheaper and more efficient .

 

[old&slow]

A few years ago ,,, My Auto / Bike insurance company called and wanted to know ,, If there was anybody living

at my house that was of driving age??

I told them , it was None of their business ,,, and what did that have to do with my auto insurance ??

My wife and I are covered to drive my cars ,,Right ?

Any legal licensed driver on a temporary / emergency basis is covered to drive my cars ,, Right ?

" Yes" , but we need to know If any one lives at your house that is of driving age" ..

To which I replied , " It was none of their Damn Business !"

Which they then said they Could cancel my insurance if I didn't answer.. Which I said , Or I could

just look for another insurance company !!

( it was only me and my wife ,,, but it still wasn't any of their Business)

Would be the same thing with the Doctor office / Medical insurance company ,,,

Do I ride a motorcycle ?? Do I have firearms ?? etc...

:angry2: Ain'T None of their Damn Business !!!!! Tell them,,, to go pound sand,!! :angry:

( My doctor usually ask me what I'm riding / driving ,, how the kids / grandkids are doing ,, etc...

I've been going to him for 35 + years,,, After a few mins. of small talk ,, he then ask, Why I'm there ??)