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Should I change doctors?
Athenor
Battle Hardened OptimistThe Skies of HiigaraRegistered User regular
Battle Hardened OptimistThe Skies of HiigaraRegistered User regular
I've been tossing around the idea of changing my primary care physician for a while now, but I'm not sure if it is fear, annoyance, or something else.
About 2 years ago I finally visited the doctor for the first time in a long time. I was recommended to a general practitioner that was part of one of the bigger regional hospital networks around here, and that I knew my insurance would cover. I did this because at the time I was starting to walk/get more healthy, and I wanted to do that whole "consult a doctor" thing. Plus I wanted to get some things looked at.
The doctor is an extremely nice guy, and has stuck it out with me, even when I haven't been following his recommendations. However, he seems singularly focused on my weight. He keeps wanting to check in on me on a monthly basis, and has put me on a few different drugs to try and help get my weight down, including a water pill that I think has messed with me a bit.
Any time I bring up something that I think is wrong, he kind of does a quick "okay, I'll refer you to X." the net results of that are finally getting to see a counselor (which has led to me going on antidepressants as of about a week and a half ago), getting treatment and therapy for a self-inflicted case of lymphedema in my legs (wearing too tight socks for too long and hurting my lymph nodes), getting through a series of sleep studies and getting a CPAP, and getting my blood pressure down to more reasonable levels.
However, I still kind of dread seeing him, and as a result put off going if I can find any excuse to, which usually amounts to working more. I do like the hospital network as a whole, and the specialists I've seen.. But I'm just not sure about the doctor himself.
The thing is, he always brings up how we're going to beat this, and stick it out, and constantly repeats himself on advice. The last couple of visits he's been pushing a pre-set meal plan that's fairly aggressive, but I'm not ready to invest in yet. I know I need to make changes, eat healthier, and so on, but I'm trying to get my own house in order yet. So having a doctor see me for 15 minutes to go over stuff I already know and check my weight, and then charge me X amount, just.. it gets to me.
It's especially annoying when the doc says that other than my weight and the above-mentioned things, I'm in extremely good shape, health wise. Cholesterol and all those other risk factors are normal. I haven't done some of the normal screenings I figured I'd get as a 30-year old man, but when I first visited him he said he wanted to take care of my weight before doing any of that testing.
So I'm just kind of unsure about where to go. I don't mind visiting the doctor, but I want there to be some kind of worth to it. And it feels like his goals don't line up to mine, at least where I am now. I have a goal to be around 300lbs (I'm currently 425 or so), but that's like 2-3 years off. And monthly checkups just seem to bug me. But then there's the whole thing about finding a new doc and all that...
I know I'm an adult, and I can just pick another doctor. But I feel like that would be insulting him, or giving up, or all that.
Sooo.. does anyone have any advice on finding doctors, or should I stick with my current one?
About 2 years ago I finally visited the doctor for the first time in a long time. I was recommended to a general practitioner that was part of one of the bigger regional hospital networks around here, and that I knew my insurance would cover. I did this because at the time I was starting to walk/get more healthy, and I wanted to do that whole "consult a doctor" thing. Plus I wanted to get some things looked at.
The doctor is an extremely nice guy, and has stuck it out with me, even when I haven't been following his recommendations. However, he seems singularly focused on my weight. He keeps wanting to check in on me on a monthly basis, and has put me on a few different drugs to try and help get my weight down, including a water pill that I think has messed with me a bit.
Any time I bring up something that I think is wrong, he kind of does a quick "okay, I'll refer you to X." the net results of that are finally getting to see a counselor (which has led to me going on antidepressants as of about a week and a half ago), getting treatment and therapy for a self-inflicted case of lymphedema in my legs (wearing too tight socks for too long and hurting my lymph nodes), getting through a series of sleep studies and getting a CPAP, and getting my blood pressure down to more reasonable levels.
However, I still kind of dread seeing him, and as a result put off going if I can find any excuse to, which usually amounts to working more. I do like the hospital network as a whole, and the specialists I've seen.. But I'm just not sure about the doctor himself.
The thing is, he always brings up how we're going to beat this, and stick it out, and constantly repeats himself on advice. The last couple of visits he's been pushing a pre-set meal plan that's fairly aggressive, but I'm not ready to invest in yet. I know I need to make changes, eat healthier, and so on, but I'm trying to get my own house in order yet. So having a doctor see me for 15 minutes to go over stuff I already know and check my weight, and then charge me X amount, just.. it gets to me.
It's especially annoying when the doc says that other than my weight and the above-mentioned things, I'm in extremely good shape, health wise. Cholesterol and all those other risk factors are normal. I haven't done some of the normal screenings I figured I'd get as a 30-year old man, but when I first visited him he said he wanted to take care of my weight before doing any of that testing.
So I'm just kind of unsure about where to go. I don't mind visiting the doctor, but I want there to be some kind of worth to it. And it feels like his goals don't line up to mine, at least where I am now. I have a goal to be around 300lbs (I'm currently 425 or so), but that's like 2-3 years off. And monthly checkups just seem to bug me. But then there's the whole thing about finding a new doc and all that...
I know I'm an adult, and I can just pick another doctor. But I feel like that would be insulting him, or giving up, or all that.
Sooo.. does anyone have any advice on finding doctors, or should I stick with my current one?
He/Him | "We who believe in freedom cannot rest." - Dr. Johnetta Cole, 7/22/2024
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From what you've said he's addressed your specific problems promptly and effectively (lymphedema and sleep apnea) and is now working on the remaining problem. That your remaining problem isn't a quick fix and is something that involves a major lifestyle adjustment is pretty much why he has to constantly raise the issue, constantly provide positive support and in general be a pain in the ass about it.
If you don't want to address it then don't. You can tell your current doctor this and see how things go from there. He is pretty much professionally bound to tell you it's a bad idea.
If you want a doctor to tell you it's okay to ignore a major risk factor then you're looking for a doctor who will give you bad medical advice which seems like a horrible idea.
i know I'm at high risk. I also know I'm not producing results, because I keep falling back into bad habits easily, especially with my current living condition. And I know that another doctor would say the same thing to me. I just wonder if the visits are excessive.
He keeps on repeating his advice because you’re ignoring it. I’ve been where you’ve been with some other poor health choices and unfortunately I ignored everyone’s advice for pretty much ever until my health kicked me in the ass and let me know if I didn’t change things I was looking at a pretty crappy future. Don’t be me make your needed changes sooner.
Just don't use that as a means to slow down on your progress! Keep with it, whatever happens.
I am only guessing but frequent visits as often as that seem to be trying to build up the support, the desire and the strength needed to make the changes he thinks you need to. Do you think you will be more or less likely to break those bad habits if you have a visit each other month instead of each month?
Right now, to me, it seems like what he is doing all stems from trying to help you make difficult changes. It is completely natural to resist change and look for a way to avoid those who are trying to make us change. It's annoying to be reminded each month that you haven't changed and you're still endangering yourself. You know damn well you didn't do it. You also know that there is a large difference between knowing what you need to do and being able to do it. The first step to breaking those bad habits is to stop ignoring them...like with monthly reminder sessions.
If you're really serious about this being annoying then talk to him about reducing your visit frequency. Most physicians are realists and know that harping on this stuff drives patients away but they're professionally obliged to try. I strongly suggest before you do this you be absolutely brutally honest with yourself about what this will do to the likelihood of you being healthier.
I'm sorry to be harsh about this but you're too nice a person for me to tell you otherwise.
Yeah... I think I'm just scared of bringing up my desire for 2 month checkups. And I may be projecting my frustration. I think I've just been focusing on other things.
...It's hard to say.
How much do you weigh, and how much weight do you intend to lose over what period of time? Are you meeting your weight loss goals, and are you more or less likely to obtain your ultimate weight goal without a monthly check-up schedule?
You can say "it's just a little longer till I can deal with this" when you're talking about 20-30lbs. You are not. At your weight you are a ticking time bomb of concern and you will be as long as you find reasons to put off dealing with it directly. I know you know that. This isn't something that you can say is a goal to be completed 2-3 years down the road and so you don't have to worry about it until you get other things in order, and just cram it all in at the last minute like a book report or doctoral thesis. That 2-3 years takes into account that you are starting to do something about it NOW.
Do the preset meals he's talking about, at least until you can "get your house in order," as you say. And keep seeing him. He has already done so much to help you, even making a plan that he's willing to follow up on with you that often; I don't think you understand how rare and wonderful that is. I don't think going to see him every month is meant to give you a bunch of new information; it's to help keep you on track, because seeing where you're at, restating goals, and reassessing frequently, as well as monitoring your body's condition are all important and helpful things. I don't think you should see him less, and I DEFINITELY don't think you should see someone else. Hang onto this one with your life because he sounds AMAZING. He's not repeating himself a bunch for his own health, he is helping you take this huge goal on month-by-month and giving you a clean slate to work from each and every time you see him. Each visit marks a new month and a new leaf you can turn over.
At your current weight (especially if you're a male), losing 5-10 pounds a month is very much doable; I only say this as encouragement. He wants to meet monthly so that he can chart out your progress and help motivate you. He can't be there weekly or daily to encourage or track your progress so he has to settle for the next best thing. In a two month period, without encouragement or support you could easily gain back or simply go no where with your weight. The longer you push the meetings apart the more likely it is that no progress or retrograde will occur. Once he sees positive progress in the right direction he'll be willing to extend the time between check ups - because at that point he will trust you to make positive choices in the weight loss department.
That's (likely) his logic.
If he has a plan structured that you don't agree with, then tell him. Ask to slow it down. Understand though, that he's trying to help you help yourself. Cutting off your nose to spite your face by finding a new doctor isn't going to help you - especially because the next one is going to tell you exactly the same things and will hope to motivate you to see the exact same progress that he is trying to produce in you. My advice would be to try and follow exactly what he advises - for your current health and for your hopeful future. The vast majority of doctors who care about your health will probably do exactly what he is doing.
Edit: a healthy lifestyle can change a lot of things for a person - especially their perspective. You can achieve your goals man! It just takes adamant persistence, and a real desire. Don't give up, and don't let fear get in your way.
I'll look into the meal plan. Maybe I'll get over my fear of not getting to eat what I want.
If you'd be happier only going every other month, then bring it up to him and see if there's some way you'd both be comfortable with fewer checkups, maybe all he really wants is to check your cholesterol level every month (for example) and you could do that without meeting with him.
Nobody, and I mean nobody, has that fear worse than me. I could write you a book about my emotional attachment to food, and how it's built throughout my life, and the different things I do to try to combat it which work sometimes better than others.
Seriously.. a doctor willing to design a plan for you to help you take things month-by-month.. and then willing to actually follow up with you? Marry him if you have to.
No part of me wants surgery or anything like that, but they offer structured meal plans and such.
http://osfweightmanagement.com/
One example (and not, by a long shot, the only study of this nature that exists):
http://junkfoodscience.blogspot.com/2006/11/obesity-paradox-1.html*
If doctor is bringing up something every month, and repeating himself a lot, he's not being helpful.
My advice would be either to tell him to tone it down, or to go ahead and find another doctor.
*
But fuck you — no, fuck y'all, that's as blunt as it gets"
- Kendrick Lamar, "The Blacker the Berry"
I don't want to really get into this or at all come off as aggressive or judgmental, because thats really not how I mean it, but health science... especially related to food and weight, is changing constantly. Just this past year there have been a bunch of studies about health and weight that say the opposite of your source.
Like this one:
http://annals.org/article.aspx?articleid=1784291
Since this is a health question I would feel remiss if I didn't mention it since I only saw this the other day.
Alright; that's a pretty severe problem, and more than likely why the doctor has been insistent on the schedule - if you don't get a handle on it and start meeting goals to get the weight down, you're at extraordinary risk for problems like type 2 diabetes, joint complications & heart disease.
I agree with Ceres 100% - that doctor is a keeper. Keep holding to that schedule and keep yourself involved in improving your body.
Not making excuses, as I know I'm fat, and I understand the language, but it'll be unlikely that I drop dead tomorrow.
I won't change docs though.
Your body can handle a lot of things while you're young that it will handle less and less as you age.
Island Name: Felinefine
Yeah, just keep working on it and you'll get to a healthy weight sooner than you think. It will alleviate a number of your other problems too (as you've complained about your back and your mattress not being up to the task, both of which can be directly improved via weight loss).
The good news is that you're gigantic (I mean height-wise), so compared to others, you actually have less to lose.
Forget the weight and how serious it may or may not be, because that's a debate which won't be solved here.
The quoted part is the most important section from your post.
Talk to the doctor. Tell him how his attitude is making you not want to go see him.
If he says that's irrelevant, find a new doctor.
That just means that you are lucky and tough and have not hurt your health *yet* with your weight. My ex was healthy as a horse (despite being overweight) until he hit 35 and got diabetes. So being healthy *now* doesn't mean you will be healthy at 40. When you are young, your body can deal with pretty much anything. It's as you get older that bad things start to happen.
The doctor keeps repeating himself because he is not superhuman and sees a lot of patients a week. It's OK to say "You told me this last month, and I'm working on it." If he's as nice as you say, he won't mind.
Mention all the drug side effects. He needs to know this so he can try new options. If you just suffer them, he'll think they are working fine.
Honestly you probably just dread him because he is telling you stuff you already know and feel bad about. No-one likes that stuff. That's why people call it "nagging." But if you don't go, you could just end up putting these issues off and off until you have serious health problems. Better to tackle them now when you are young and resilient.
when I was 30 I was 365lbs. Felt good, had great cholesterol and BP and everything. Was able to move around and be nimble and all the other excuses I would tell myself to avoid the truth that I was really unhealthy and fat.
So fast forward to today, I am 38 and have actually lost 90 lbs over the last 8 years through diets, exercise and meal plans and stuff. Mostly in chunks, 40 here, 40 there with long pauses in the middle. because eating like that sucks.
So here is the truth for you. if you are 400+ lbs when you get to be 35 or 40, you will not be health any more. At 30 you are at the end of the stage of life where your weight and your general health are not a big deal.
what else have I done in the last 8 years? Cholesterol is up, BP is up, Reflux is worse, had to have my Gall bladder removed, most recently I slipped a disk in my back. Why? cause I am not 30 anymore. If I was still 365, I shudder to think what else would have gone wrong.
Now is your window. Take 1 year of your life, heck take 3 months and hit it. just suck it up and do the meal plan and don't cheat. If you fall off the wagon, get back on don't give up. your 40 year old self will thank you.
My father is a physician, and is pretty old school. If you kept ignoring HIS advice, my father would dump YOU as a patient. I for one, would be really happy that you have a primary care physician that is so committed to developing a real relationship with you and is committed to your long-term health. The vast majority of primary care/GP's don't give a shit.
With regard to the "get my house in order", sometimes it's better to let EVERYTHING change at once, rather than going about it gradually. A clean break from the lifestyle you're trying to move away from is often easier to maintain than a gradual change. Also, with eating, remember that everyone has good and bad days. Don't beat yourself up about the bad days, it's the "well I already ruined it" mentality that causes people to relapse. Accept your mistakes and move on.
The biggest part of this is being active. Fret about the food and stuff (I know it suuuuucks), but make sure you are being ACTIVE. Its the easiest way to diminish complications from obesity. No one actually judges the fat dude going for walks in the neighborhood. In fact, most people root him/her on (if they aren't, I never ever want to know!). Obesity is somewhat reversible and the best risk-reducer is ACTIVITY. Be active and you are far less likely to develop the complications. FYI, you won't drop dead tomorrow. You're totally right about that. However, you're going to have a significantly lower quality of life in your 40's and 50's and have a significantly shorter lifespan if you don't change something.
That being said, don't be ashamed. The medical system is really good at telling you what to do but no one truly understands the mechanisms of obesity yet. There are psychological and physiological components. You aren't a bad person and you aren't weak or less than anyone else.
Of course the doc didn't worry about it for a year of that time...
But yeah. As I said, I'm gonna go on the meal plan, and now that the weather's nicer I'm going to look into walks again.
After reviewing your posts I didn't see where you said how tall you were, only how much you weigh. I thought this was an oversight at first, but after reading the entire thread, it definitely wasn't an oversight.
You didn't want anyone to calculate your BMI.
To be honest, I had a lot of responses planned here. You were fat, you were unmotivated, you just didn't "get it". Instead, I think you're incredibly smart and you're looking for something to tell you otherwise.
Well, I think you are wrong. From what i can tell, your primary physician has dictated an aggressive, probably effective, method to lose weight and keep it off.
Normally this is where we all say "No, man, you can do this on your own" - but clearly you can't. Do what your doctor tells you and hate him or her every step of the way.
Funny thing is that since getting on Prozac, I've been feeling like I've got a lot more energy during the day. My current plan is to not even wait until my next checkup, but to just email the doc and see if we can get things set up.
Yesterday all I had to eat was some pieces of chocolate in the morning and a few slices of deli meat during the day.
I think that my appetite suppressant and the fact that I just bumped up my anti-depressants is making me go a little overboard on the not caring about eating thing -- today, my body is trembling a bit, I'm light headed, and a few other things, which I think are signs of starvation, but my stomach isn't exactly doing anything.
Right after I make this post I'm going to go force myself to eat, which is something I've had to do before on occasion with this appetite suppressant. Is this normal when taking that combination of drugs? The pharmacist said there weren't any known interactions, but I've seen this happen before with this appetite suppressant, and that's kind of why I didn't want to take it anymore, as well as a main reason I want to get on the pre-set mealplan.
There is nothing with having a cupcake once in a while: you just can't be like me and devour twelve in one sitting.
I promise I'm working on getting over those blocks (as my counselor puts it, "being selfish"), but it's just not that easy to tell people I interact with on a daily basis to wait to accommodate me, so instead I do the opposite, and my health suffers as a result.
Today I had my appointment with my doctor. Down 10 pounds, blood pressure is 136/80.
We're continuing with the appetite supressant.
Also, I am scheduled to interview with the weight loss guys of the hospital. The doctor mentioned that it's very aggressive - 900-1000 calories or so a day, and they recently had a case of someone losing 60 lbs in 6 weeks. It's all doctor supervised, with lots of blood tests and things like that.
I'm nervous/scared, but as the doctor put it, the idea is to get the weight off, then work on keeping it off.
So.. yeah.