Mumblegrumble doctor rant

[mominatrix]

So... My 69 year old mother was in the hospital with a nasty, nasty stomach virus. She came out weak and dehydrated.

When checking out, hospital staff told her to follow up with her primary care doctor if she wasn't feeling normal in a day or two.

She wasn't, so she made an appt with her PCP... Now, the doctor she has seen for years had left the practice to go work for an urgent care facility, so she was unavailable. Appt made with new doctor.

Background... as I said, my mom is 69. Fairly active for her age (she takes long walks pretty much every day, etc), she's like 5'2 or 3, 140-150 pounds. She was diagnosed with diabetes in the last year, but her numbers wouldn't have made her diabetic two years ago (like, her sugar is 105. ”diabetic” today =100+, while two years ago, it was 120, and before that, it was 140). So, probably fair to say ”borderline”.

So, she goes to see doc because, after leaving the hospital, she was still having stomach issues, and was weak and tired.


instead of taking about the issues that brought her in, he proceeded to tell her that if she didn't get down to 120 pounds, he wouldn't continue to be her doctor. That if she weighed less, she wouldn't be weak and tired.

That she needed to eat no red meat, only fish and chicken, nuts and eggs, veggies... And whole grains, but not in the form of bread and pasta. No bread or pasta ever, even whole grain. And no fruit, she quoted him as saying that nobody needed fruit to live.

oh, and she's supposed to exercise a half hour at a time, three times a day. Including once within an hour of waking up.

He gave her a ton of flack about her weight, add it related to the diabetes, and when she told him that her father and pretty much every one of his relatives were diabetic, he went on about how that didn't matter at all (which even I know is kind of bull, there's totally genetics involved). Also, even if she lost the weight, she'd still be on the diabetic meds.


Now, I'm all for doctors promoting health, but a lot of this advice sends like crap. Also, I'm not happy about him blowing off her concerns in a post hospital visit.

So, bad? Tough love? Asshole? Genius?

Sent from my HTC Glacier using ProBoards... So excuse any wonky autocorrect.

[UMaineTeach]

that sucks
time for a new practice - and if that urgent care is near by I would stop in with my symptoms and see the old dr.

[shadow]

I'm all about being a healthy weight and eating more healthfully but... I say asshole.

[penguingrrl]

Asshole, no question. Those concerns are for annual well visits, not post-inpatient care.

[emisi]

I say asshole, and agree with penguingrrl. That crap is for wellness visits, not sick visits. He should have made sure there wasn't something else wrong, instead of bitching about her weight.

[ttt]

May 26, 2012 10:02:05 GMT -5 emisi said:

I say asshole, and agree with penguingrrl. That crap is for wellness visits, not sick visits. He should have made sure there wasn't something else wrong, instead of bitching about her weight.

Absolutely. If he was that concerned that it just couldn't wait until her next well visit, a sentence or two about how losing weight was important and could help her feel better would have sufficed.

[pescalita]

Wow, what an ass. Does this guy intend to kick out anyone who is overweight?

[emilyj]

I'm going with asshole. If she has no established history with this doctor, she went for a sick visit, and he jumped all over her not knowing her history...then asshole.

I'd find a new doctor. I've watched my dad struggle with Type II diabetes, and in my (very humble) opinion, a primary care doctor shouldn't be the one giving advice about diabetes - that should be managed by an endocrinologist and a registered dietitian. Not that I think all of his advice was wrong/bad/sucked, but for diabetes management, it should be done by people that specialize in the disease. Diabetes isn't going to be the same from person to person, so what works for one may not work for another.

I hope your mom can get some answers and feel better soon.

[shadow]

May 26, 2012 10:53:55 GMT -5 mr+ms said:

Sorry you're mom isn't feeling well

On the doctor, I'd rate that 10% tough love and 90% asshole. The delivery sounds especially poor. And I have pretty low expectations of conventional docs to begin with.

Agreed that he should have spent the bulk of the visit addressing her primary concern. Even if there was nothing going on that needed treatment he could have just said that and to get rest. Duh, if a chronic health condition is well managed you can deal with acute problems more easily but it's not like you can snap your fingers and have it so. Also, focusing on weight is a cheap shot. The focus should be on getting to a reasonable body composition and shooting to minimize belly fat.

It's true that nobody needs fruit to survive. Nor do they need grains, whole or not, for that matter. People with impaired glucose tolerance might do better without either.

Genetics don't matter - yes and no. I don't think it's something to be upset about if a Dr. says it doesn't matter. They can say it in a way that's inspiring to take action on one's health rather than brushing someone off, though. People should feel good about the fact that DNA doesn't determine our fate. A family history gives us advanced warning to make changes before a disease state is detectable. It could be one of the best preventive tools we have.

Eyeroll at no red meat. Properly raised meat from ruminants is a far better source of nutrients than whole grain which is more like substandard filler, especially as it's commonly consumed in the US (not sprouted/soaked and/or fermented which increases nutrient availability). The fat profile from grass fed ruminants is much more favorable than poultry. If I were to lower any animal source of food it would be chicken/turkey (especially the fat). And add liver, nature's multivitamin!

I'm not an exercise expert, but I've read that HIIT is the best for normalizing insulin sensitivity. I'm pretty sure there are studies that support this. It definitely does not take 1.5 hrs/day, lol. An effective session is focused and takes less than 1/2 hour. Being active in general, like your mom is, is great in addition. I dunno, maybe he is used to couch potatoes and prodding them to peel off the couch a few times a day.

For all general health matters, I think it's important to address sleep quality, stress levels and sun exposure (or vit. D levels) in addition to diet and exercise. Those other factors could be the tipping point for some people having good health or less than good.

This is surprising. Dr. Oz (i know, I'm not a fan) recently mentioned on his show that you shouldn't eat livers b/c then you're eating all of the toxins that the animal had...I usually assume most of what he says is bs though, so I'd be happy to hear otherwise (not that I want to eat livers though).

[Deleted]

Super asshole, particularly given the illness she was just dealing with. A stomach virus? She's weak and dehydrated? The most important thing right now is to get her energy back. I'm not saying it's OK to subsist on a diet of potato chips and cake, but now probably isn't the right time to start a strict diet.

[Deleted]

May 26, 2012 8:45:12 GMT -5 mominatrix said:

instead of taking about the issues that brought her in, he proceeded to tell her that if she didn't get down to 120 pounds, he wouldn't continue to be her doctor. That if she weighed less, she wouldn't be weak and tired.

Or maybe she's weak and tired from a very recent nasty stomach virus.

Sounds like he didn't even know why your mother was in for a visit. Appalling, but I've seen it before.

Or, maybe he didn't care; maybe he's pissed off that he has to see some of the patients formerly seen by the doctor who left. Sadly, I've seen that before too.

In any case, no cardiologist I know would consider your mother obese. I vote asshole with either lazy or idiot on the side (or both). Also, everything mr+ms said.

I'm sorry about your mom. Hope she's better soon.

[ringstrue]

a-hole. I'm sorry.

You can maintain diabetes w/o meds if you are good with your diet - especially if your numbers are typically good. So I agree with his ideas, but I disagree with the timing and tactics.

I disagree with the notion of "giving up" on getting down to a healthy weight - especially if you have diabetes - just because of family history. I'm having this argument with my mom right now about high blood pressure. If all your family members were not overweight at all, had great diets, had great activity levels and THEN were all still having issues, sure, I get the genetics argument.

[foundmylazybum]

What a waste of a copay. In terms of exercise, this is what the CDC recommends for a woman at your mother's age

www.cdc.gov/physicalactivity/everyone/guidelines/olderadults.html

I hope your mom feels better soon, and that you all can find a better doctor for her!

[laurenpetro]

A) I agree with penguingirl.

B) I wonder if his malpractice insurance just went up that morning.

[GailGoldie]

I know hundreds of doctors... and your mom's is an asshole, even among some of the more assholier doctors I know- this guy is a douchey asshole.

time for a new doc for sure.

That type of rant WOULD be OK if he had seen a patient many times, with diabetes issues, and the patient was not compliant, etc.... but for the first visit, and a post-hospital/sick visit to add, that is just insane.

[backinpgh]

Should any 69 year old woman be exercising for AN HOUR AND A HALF A DAY? That sounds ludicrous to me.

[LLYS]

Good advcie from a jerk.
Losing 10 pound on a person her size will do wonders tp change her health.

She was fortunate to find a physian to accept her as a patient as so many physicians are not taking on new Medicare patients.

There will be much more focus on weight, diet and good food vs bad food if we want to keep Obamacare.

I am borderline diabetic (X syndrome blood panel) (from a family of diabetics) 5'3"and weigh 124, exercise and eat healthy. Genetics play a part, but by following the advice given by this Dr I have been able to avoid crossing that line into Diabetes.

Sorry your mom had a bad experience, but hope she will not dismiss his advice.

[Deleted]

May 26, 2012 8:50:46 GMT -5 UMaineTeach said:

that sucks
time for a new practice - and if that urgent care is near by I would stop in with my symptoms and see the old dr.

Not all the advice was bad, but it was inappropriate given the reason for her visit. I'd probably find a new doc. And just want to say I totally disagree with the suggestion to go by the urgent care. As someone who works in an urgent care, NOTHING is more obnoxious than people trying to come in for primary care complaints. You just can't manage things like that in an urgent care setting and it is frustrating for everyone.

[ttt]

May 27, 2012 7:17:57 GMT -5 @LLYS said:

Good advcie from a jerk.
Losing 10 pound on a person her size will do wonders tp change her health.

But not if there's something else seriously wrong with her. Losing 10 pounds isn't a cure-all. If there's something else wrong with her, the doctor failed completely to see it because of his focus on her weight.