My Orwellian Doctor's Visit

[Fred W]

So it was that time again. Time to subject myself to the indignity of another annual physical at my primary care physician's. Always a great time, especially if you like being prodded and probed, having your genitals fondled and asked to cough and your *** reamed to check if your prostate is oversized. :glare:

I'm an employee loosely associated with the healthcare industry so I understand the importance of preventive medicine, so (if not gleefully) I willingly subject myself to this annual ritual of ridiculousness. I mean, please... doesn't the doctor think I might have a teensie clue if I had a hernia big enough to bulge when coughing? Or does she just want a goo peek at my junk? I'm also pretty sure I'd notice if it took me 5 minutes to take a leak and had to make 3 trips a night to the toilet. But I digress...

So I'm sitting in (one of the many) doctor's exam rooms and one of the unidentified worker bees is going through my medical history that they have captured on their computer system. We discuss all the stuff they should already know since I tell them the same stuff every year, and then...

"So," he says, "you haven't been to the dentist since such and such a date?"

"Umm, yeah I guess."

"And your last eye exam was over two years ago?"

"Uh huh." (Huh? How the heck did they know that stuff?)

"I need to ask you some questions about your lifestyle.

Do you own or keep any any firearms at home?"

"No."

"How about any high risk activities?"

"No."

"...like sky diving or motorcycle riding?"

"High risk? Who says? I ride motorcycles all the time!"

What the F***? What freeking business is it to my primary care physician whether I own guns (I really don't) or ride motorcycles (I obviously do). Thinking about this whole scene after the fact I have come to realize that the dentist, eye doctor and primary care doctor have been trading my files somehow. And the only reason that I can think of the doctor's wanting to know about guns and bikes is so they can share that info with the insurance company!!

In this age of supposed "Patient Information Privacy", there is some scary **** going on behind the scenes. I was not prepared for these intrusive ******** questions or I would have either refused to answer or lied. I've decided for a number of reasons (this is only a small part of) to find a new doctor.

Be wary...

 

[Geezer]

I get an annual physical that sounds similar to yours, but they do not ask about dentists or eye exams, and no questions about my activities except those that directly affect my health, like drink, smoking, and exercise. I would refuse to answer questions about firearms, motorcycles, skydiving, etc. Whether they are risky or not, they have absolutely nothing to do with your physical health.

 

[Auburn]

Be careful, big brother is watching... :assassin:

 

[ShinyPartsUp]

I am required as a federal health care provider, to assess suicidality on every patient at least yearly (like nothing can change in between? But that's bureaucratic logic...). One of the pieces of information I am required to obtain is whether or not there is access to guns in the home (increases risk). I see the logic of asking if somebody says they are suicidal, but it (and other questions) are not part of a decision tree of lethality of means after increased risk is determined. Rather, you gather all kinds of info THEN determine overall risk of suicide.

You wouldn't believe how many things happen in health care because of one incident out of many thousands (to minimize political or legal risk), or because of one small flawed study some ***** or committee takes as hard indisputable science. Wanna keep your job? Do as you're told.

 

[BobbyBlue]

I hear ya Fred ! However, just to show ya that the line they cross is a crooked one...they just replaced my pacer/defib, an outpatient procedure..but a hairy one, and all anyone asked me is if I am on coumadin and did I eat and/or make a doo-doo recently...thankfully that killer bud and Glenlivet for breakfast didnt come up...goes good with Versed...anyway, I'm convinced nobody cared cuz I am "self-pay"...the politically correct analog to " uninsured "...and thus not under insurance advice, care, threat or malfeasance...and strangely enough instead of 120k, like they charged my previous insurance company, this new bad boy in my chest will only cost me 25K...what a difference, no? Glad you are well though, and good luck on your doctor search !

Blessings,

Bobby

 

[exskibum]

Once upon a time, I used to handle insurance bad faith and coverage matters -- plaintiff and defendant. Getting asked the questions you were asked wouldn't have been the first time I refused to answer a doctor's questions, and on the very few occasions in the past when I've done that, the Docs took it just fine. I explained that I was maybe a bit too knowledgeable about insurance policies and practices, and that as a result, without knowing where that info would be taken down, who would use it for what and receiving assurances about limiting its use and dissemination, I wouldn't provide certain answers. It is possible for a doc to get answers to questions he poses upon a promise not to write it down, BTW.

But some of that "lifestyle" stuff you were asked? As far as I'm concerned, unless there's some nexus to the reason *I* decided to come to his office, I would never answer his questions about guns or what legal sports activities I do or do not engage in. Damn big brother stuff pisses me off. No offense meant to the Doc, and I'd tell him that, while inviting him to simply write down that I refused to answer.

 

[Bounce]

I am required as a federal health care provider, to assess suicidality on every patient at least yearly (like nothing can change in between? But that's bureaucratic logic...). One of the pieces of information I am required to obtain is whether or not there is access to guns in the home (increases risk). I see the logic of asking if somebody says they are suicidal, but it (and other questions) are not part of a decision tree of lethality of means after increased risk is determined. Rather, you gather all kinds of info THEN determine overall risk of suicide.
You wouldn't believe how many things happen in health care because of one incident out of many thousands (to minimize political or legal risk), or because of one small flawed study some ***** or committee takes as hard indisputable science. Wanna keep your job? Do as you're told.

i disagree (with the perception of required/requested). someone may have told you that you ought to get that info but they are misleading you if you have been made to believe that you are REQUIRED to get the info. you can ask but that doesn't obligate the patient to answer. as a provider you can choose not to ask those types of questions as being overly intrusive.

i think i remember being asked those questions once and politely declining to answer such questions as inappropriate and intrusive. they were left blank and never asked again.

i see them as part of the CDC (under various administrations) to attempt to classify gun ownership as some sort of disease of health issue. but that's just me.

 

[Aasland]

Orwellian indeed ...

The NIH considers has a history of publishing studies on gun violence and lobbying for gun control until congress pulled the funding for that in the early 90's. Since then some funding has been restored but with the caveat that it cannot be used to lobby for gun control - they can only use it to fund the studies.

In addition, the CDC and National Center for Injury Prevention and Control considers firearms to be a public health threat - I'm sure that eventually filters down to our medical origanisations.

 

[ShinyPartsUp]

I am required as a federal health care provider, to assess suicidality on every patient at least yearly (like nothing can change in between? But that's bureaucratic logic...). One of the pieces of information I am required to obtain is whether or not there is access to guns in the home (increases risk). I see the logic of asking if somebody says they are suicidal, but it (and other questions) are not part of a decision tree of lethality of means after increased risk is determined. Rather, you gather all kinds of info THEN determine overall risk of suicide.
You wouldn't believe how many things happen in health care because of one incident out of many thousands (to minimize political or legal risk), or because of one small flawed study some ***** or committee takes as hard indisputable science. Wanna keep your job? Do as you're told.

i disagree (with the perception of required/requested). someone may have told you that you ought to get that info but they are misleading you if you have been made to believe that you are REQUIRED to get the info. you can ask but that doesn't obligate the patient to answer. as a provider you can choose not to ask those types of questions as being overly intrusive.

i think i remember being asked those questions once and politely declining to answer such questions as inappropriate and intrusive. they were left blank and never asked again.

i see them as part of the CDC (under various administrations) to attempt to classify gun ownership as some sort of disease of health issue. but that's just me.

You missed my point entirely or I didn't explain it well.

I am required to ask certain questions. Guns were raised as an issue and I explained why at my employer the question is required to be asked -- and if you have been determined to be a high risk you will be asked multiple times. It is required to ask every caller to the Mental Health Clinic whether the caller is suicidal, without exception. Inefficient, intrusive and annoying since there may be absolutely no reason whatsoever to suspect it -- but it will be done.

I am given statistics regularly of how many certain "reminders" have been done, whether a risk assessment has been done in enough percentage of patients, and I am required to use a particular template of questions without exception.

Do some people say they refuse to answer, or don't tell the exact truth? Of course. You missed my point. The point I was trying to make is that if those things aren't done by a provider in my system, sanctions happen. If there is a poor outcome (such as a suicide) and the policies of asking these types of questions (in this case gun ownership) are not asked (whether some make sense or not) the fingers are pointed and the individual provider is blamed and sanctions happen, whether the information would or would not have made a difference.

So if you are asked questions you don't like (in my system) multiple times, don't blame the worker bee.

 

[juniorfjr]

I would worry more about the sharing of info between all of the different practices. Just how did they find out when you saw the dentist or the eye doc. I'm betting if it's the same insurance company that is the common thread.

And as shiny said, just don't answer questions you find objectionable, and let them know you find them objectionable.

 

[Checkswrecks]

I'm in a Fed position that can occasionally be hazardous. We get questionaires now & then that are clearly CYA for big brother. One that I refuse to answer has questions like:

Have you EVER been exposed to chemicals, including gasoline or gasoline fumes?

WTF???

But they didn't ask about my week in the parasite-infected swamps of Cameroon.

I bought a new gun a couple of months ago and the Maryland permit application asked if I bought it with the intention of committing suicide.

Errmm....

 

[worldbound4now]

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.

 

[johnny80s]

Thanks Fred. Now I can be ready with my answer.

 

[08FJR4ME]

I stopped going to doctors. Everything is virus anyway according them. All they do is perscribe antibiotics for every known desease to mankind.

My doctor is now the internet. Search and ye shall find answers. JMO

 

[Solo]

I'm also pretty sure I'd notice if it took me 5 minutes to take a leak and had to make 3 trips a night to the toilet.

Is this a problem? Gee, I thought it was the normal state of things at this age.... :dribble:

 

[Crash Cash]

I'm not a fan of CNN, but they have an area in the Health tab called "Empowered Patient" about crap like this and other stupid stunts doctors try to pull. It's interesting reading and a good head's up so you don't get caught flatfooted by it.

 

[exskibum]

I bought a new gun a couple of months ago and the Maryland permit application asked if I bought it with the intention of committing suicide. Errmm....

:lol:

I wouldn't answer if asked by a doctor, but here I'll cop to liking guns and buying *more* of them on occasion (the ones the PRK allows us to buy, that is. )

The transfer app. form we have to fill out here doesn't have the suicide question you mention, but it's got 2 or 3 questions that I've joked about to my regular FFL: "If I answered 'yes' to a couple of those, at best you'd roll your eyes and chase me out of here, and at worst you'd be calling the cops as I leave. Do you get anyone in here dumb enough to answer 'yes' to those and then hand you the completed form?" When I pick up a gun from them after the wait period, they usually say something like "it looks like you've been a good boy", probably meaning that so far as it's in any official records, I don't have an addiction to illegal drugs, an alcohol problem, a psychological disorder, any restraining orders, felonies or gun crimes, and I don't beat my domestic cohabitant.

 

[FJRay]

Didn't see any wierd questions on the form for my latest purchase here in OR. Just fill out the form and give them your OR drivers license and you have you new toy in about ten minutes.

 

[Fred W]

I would worry more about the sharing of info between all of the different practices. Just how did they find out when you saw the dentist or the eye doc. I'm betting if it's the same insurance company that is the common thread.
And as shiny said, just don't answer questions you find objectionable, and let them know you find them objectionable.

Ding-ding-ding!!

Exactly right. I may very well have told my primary who my dentist was, and vice versa. But for my eye exams, there has never been a "pre-exam" debrief or any other nonsense about who my primary physician is. This was the one that set-off the red flag for me.

~~~~~~~~~

Well, I wasn't going to go into all of the gruesome details, but it seems it is germane to this discussion, and I am hopefully it will help some other folks see they may be in similar situations (earlier than I did) so here goes:

For the last few years I have been "mildly hypertensive", according to modern definitions.

This year, no doubt as a response to the perceived dilemma of Obamacare, the company that I work for (largest corp. in the US - you figure it out) has decided to radically modify the health insurance plans of all it's non-exempt employees. The new plan is that preventive care is covered at 100%. But you will have to satisfy a (big) deductible for anything else. After the deductible is satisfied you are covered at 80/20. The idea is they want us to "Take charge" of our own health care. I interpret that to mean that they want to save money.

So I go in for my annual check-up as previously reported (100% covered).

An hour or so before hand I had taken my own blood pressure as I often do. Looked OK. 126/84.

I show up for my anal probing and other inconveniences and the (previously mention) medical minion who collected the non-medical statistical information takes my BP.

Later, Mizz doctor comes in. After being anally abused, she reveals that the minion recorded my BP (on the computer) at 150/109. What??? I'm not THAT nervous. I laughed out loud because this was not the first time that one of her minions wasn't able to take an accurate BP.

She retook my BP and told me that she got 130/92. (pretty close huh?) I am still (according to her) hypertensive, so she wants me to add more anti-hypertension drugs. I refuse and tell her that I will try to be more diligent about exercise. Then she tells me she wants me to return in 4 weeks to recheck my BP. I explain my new insurance and tell her that I will phone in my BP in 4 weeks.

Oh no... that isn't any good. And I will also need another appointment in 4 months to recheck my cholesterol levels even though they are excellent.

No, I tell her, I will not be coming back for those revisits because these will be coming out of my pocket and I cannot afford to pay $4-500 for labs beforehand and a BP check.

"What? That's crazy! You're setting yourself up for a heart attack!!"

"Well, that's what it is..."

So later when I'm attempting to check-out from the office, the front desk minion attempts to schedule the 4 month visit that she recorded in my chart and I say no, and explain (again, to her) why.

Then, a few hours after I leave, a (maybe the same) minion calls my cell phone and tells me the doctor really wants me to schedule that appointment as "you have been diagnosed with high blood pressure". I calmly explain the insurance situation again and decline to schedule.

The following day, in the middle of a business meeting, I take a call on my cell which turns out to be another (possible the same) minion telling me that the doctor wants to inform me that if I will not schedule the 4 month re-visit that she will not renew my currently standing prescriptions for HCTZ (a diuretic for BP) and Simvistatin (a Cholesterol med).

That was the last straw. I think they call that coercion, don't they?

******* *****. I will never darken her office door again. Did she really think I would go back after that crap?

...and then I started thinking about all the questions they had asked.