5 ms·

About a decade ago, I got a physical after having not set foot in a doctor's office in about 12 years. The doctor asked what made me come to get a physical afte

by ganley 10y ago

About a decade ago, I got a physical after having not set foot in a doctor's office in about 12 years. The doctor asked what made me come to get a physical after so long, and when I said nothing in particular, he pretended to write on his clipboard "Wife made me come here." He said middle-aged guys with no obvious health problems pretty much only come to the doctor for one (or both) of two reasons: Their wife made them, or they want Viagra.

thaumaturgy 10y ago
It's not just a macho thing. I pretty severely injured an ankle back in September, at MMA, and for the first time in my life (at 38) it doesn't seem to be healing up very well. I keep finding new little movements that cause it to feel pretty wrong ("popping", "pulling", cold sensation, mild short-term pain, weakness). One of these happened in front of my girlfriend, who ordered me to see a doctor, so I did. I filled out new copies of all the paperwork I filled out a year ago when I was grievously ill, sat around for a bit, got into the doctor's office, his assistant appeared and asked me a couple of questions, then the doctor appeared after a bit and asked me the same questions again. He palpated my ankle for a few seconds, told me to get a brace, and then left the room without another word. Unless you're wealthy enough to afford a dedicated physician, there's just really no point in seeing a doctor for anything less than "I might be about to die". ...which sucks, because I'm a huge proponent of preventative medical care. It's just not available for most people.
- ganley 10y ago
  No idea which of us is more typical, but my doctor is awesome. Preventative care is deductible-waived, so there's really no good reason other than laziness for me not to get a regular annual physical.
- barsonme 10y ago
  > Unless you're wealthy enough to afford a dedicated physician I think it depends on your doctor. My GP is fantastic. He's always running late because the company he works for slots patients in 30 minute intervals, but he takes as long as is needed for his patients. I'm not even close to wealthy ($50k/year) I can go to him for anything from the flu to broken bones to high cholesterol without thinking, "this is pointless".
- walshemj 10y ago
  But you don't know if that of pain is going to kill you or not
DanBC 10y ago
> He said middle-aged guys with no obvious health problems Why would anyone see a doctor unless they had a health problem? (Or wanted health advice?)
- ganley 10y ago
  A health problem that you are aware of. You're supposed to see a doctor periodically because they might catch health problems that haven't yet advanced to the point that you know they're happening.
  - DanBC 10y ago
    It's not surprising that the US has such a problem of overdiagnosis and overtreatment. http://www.bmj.com/content/349/bmj.g5432 http://www.bmj.com/content/349/bmj.g5432
- Tepix 10y ago
  If you are middle-aged (or older): to get a checkup
- nommm-nommm 10y ago
  Annual physical exam (AKA annual wellness visit, annual preventive exam, periodic health exam, and routine checkup) - http://www.webmd.com/a-to-z-guides/annual-physical-examinations http://www.webmd.com/a-to-z-guides/annual-physical-examinati... Last I knew though they weren't evidence based.
- PeterisP 10y ago
  Regular preventive checkups are (or should be?) a thing. Quite a few deadly things need to be caught before they become obvious problems. As a crude example, prostate cancer is one of diseases causing death for men; and has the "nice" property that if it's detected early in a screening then it's (usually) treatable with minor side effects, but by the time it causes symptoms serious enough to seek a fix for the symptoms, it generally has grown enough to be lethal.
  - 10y ago
ergothus 10y ago
I can't deny the conclusion, and I agree that men are socialized to not show weakness ("macho"), but for me, I tend to avoid going to the doctor because, as a general rule, it rarely helps and it always costs money. (macho-ness may make more sensitive to that, hard to really know) I was very sickly as a child. Every doctor's visit did nothing to change this (it wasn't even "Hmm, you have a trend", it was "oh, you have a cold/bonchitis/etc.) It wasn't until I was 30 that I learned I was allergic to pollen, molds, dustmites, cats, dogs, and rats - basically everything that won't kill you (no food allergies I've nailed down) - and that discovery was made when my symptoms suddenly got dramatically worse for months, and I pinned down the only three things that had changed in that time and went to an allergist myself. Each winter for several years since then I would get bronchitis, and the coughing and shortness of breath would last for months. Every doctor told me to take some Delsym and wait 4-8 weeks. I eventually pieced together that this is my allergies (which, while treated, aren't gone) draining into lungs overnight and slowly being coughed up during the day. Some anti-inflammatory treatment that is now legal in Washington turns out to have stopped that for the last few winters. I've had two rounds of kidney stones in the last 5 years (each involving at least two stones, because apparently the inflammation from a kidney stone tends to "shake more loose") - Doctors couldn't do much beyond painmeds and flowmax. (First time though, I had a $1000 CT scan (I think it was CT - I get CT and MRI mixed up) because the doc suggested it.) I had pneumonia once - didn't realize it, it was just a bad cold/cough that got dramatically worse. Calling my doctor for an appt gave me something in 3 days. Day of, I wasn't sure I would be breathing by the time of the appt, so I was going to go to the ER. (which would have been ridiculously expensive). My wife took me to a local urgent care clinic (PatientFirst in VA) because she was worried about the wait time at the ER. They were awesome, saw me immediately as I walked in (they could hear me breathing), did in-house xray of my lungs and o2 sensor. Now that I'm in Seattle, the local clinics work differently - they REALLY want you to have a primary care physician. I recall a doctor there once saying that's because they want someone to coordinate your care, maintain a big picture view, and proactively look into potential issues. I told her I'd never had a PCP do any of those things) I'm not knocking medical science - it's a near impossible job: "Debug this program to which you don't have the source code, can't control or even know all the environment and inputs, and if you crash it someone dies". It's amazing they can do what they can, and in certain circumstances they are responsible for saving and improving a lot of lives (see above having pneumonia). But the reality is that if I went to the doctor every time some part of me hurt (and now that I'm 40, that's a lot of parts) based on my past experiences, I'd just spend a lot of time and money and be not much better off. So I'm all for being cautious on big things like chest pains. I'm all for knowing the warning signs of stroke, heart attack, and the like. But going to the doctor for every little thing? Seems a waste.
eon1 10y ago
The whole "getting a physical" annually is purely an old school American thing anyway. I don't know anyone in my country who does this - although apparently nowadays US med associations recommended you go visit a doctor every 5 years or so if you're under 40. Still, if I walked into a doctor and said "is anything wrong with me?" with no symptoms or obvious indication that this might be so, they would probably take blood pressure, do a breathing test, ask me if anything was actually wrong, and then wonder why I was wasting their time (or maybe ask if I was looking for a medical certificate cos I didn't feel like going to work, heh).
- derefr 10y ago
  Personally, I kind of wish my GP was there to help me optimize my health, rather than just to diagnose illness. Like, all those dietary restrictions they give to people who've had heart attacks? Why not give them to me before I have a heart attack, so I won't ever get one? Make my life more of a hassle, so that I live longer! I want to have someone in my life who plays the same role that a dental hygienist plays a dentist visit, but for my general physical health.
  - DaUR 10y ago
    > I want to have someone in my life who plays the same role that a dental hygienist plays a dentist visit, but for my general physical health. You better not expect doctors to be that. Most of them still believe cholesterol causes heart disease, for example, or that you need 50% carbs in your diet.
  - eon1 10y ago
    Okay.. so that kind of sounds like you need a dietician, which is someone you can ask your GP for a referral for, or in many cases just book an appointment with. Your GP doesn't send you to the dentist unless there's something so wrong with your teeth it's impacting the rest of your health; why would it be any different for your diet?

by ganley 10y ago

thaumaturgy 10y ago

It's not just a macho thing. I pretty severely injured an ankle back in September, at MMA, and for the first time in my life (at 38) it doesn't seem to be healing up very well. I keep finding new little movements that cause it to feel pretty wrong ("popping", "pulling", cold sensation, mild short-term pain, weakness). One of these happened in front of my girlfriend, who ordered me to see a doctor, so I did. I filled out new copies of all the paperwork I filled out a year ago when I was grievously ill, sat around for a bit, got into the doctor's office, his assistant appeared and asked me a couple of questions, then the doctor appeared after a bit and asked me the same questions again. He palpated my ankle for a few seconds, told me to get a brace, and then left the room without another word. Unless you're wealthy enough to afford a dedicated physician, there's just really no point in seeing a doctor for anything less than "I might be about to die". ...which sucks, because I'm a huge proponent of preventative medical care. It's just not available for most people.

ganley 10y ago
No idea which of us is more typical, but my doctor is awesome. Preventative care is deductible-waived, so there's really no good reason other than laziness for me not to get a regular annual physical.
barsonme 10y ago
> Unless you're wealthy enough to afford a dedicated physician I think it depends on your doctor. My GP is fantastic. He's always running late because the company he works for slots patients in 30 minute intervals, but he takes as long as is needed for his patients. I'm not even close to wealthy ($50k/year) I can go to him for anything from the flu to broken bones to high cholesterol without thinking, "this is pointless".
walshemj 10y ago
But you don't know if that of pain is going to kill you or not

DanBC 10y ago

> He said middle-aged guys with no obvious health problems Why would anyone see a doctor unless they had a health problem? (Or wanted health advice?)

ganley 10y ago
A health problem that you are aware of. You're supposed to see a doctor periodically because they might catch health problems that haven't yet advanced to the point that you know they're happening.
- DanBC 10y ago
  It's not surprising that the US has such a problem of overdiagnosis and overtreatment. http://www.bmj.com/content/349/bmj.g5432 http://www.bmj.com/content/349/bmj.g5432
Tepix 10y ago
If you are middle-aged (or older): to get a checkup
nommm-nommm 10y ago
Annual physical exam (AKA annual wellness visit, annual preventive exam, periodic health exam, and routine checkup) - http://www.webmd.com/a-to-z-guides/annual-physical-examinations http://www.webmd.com/a-to-z-guides/annual-physical-examinati... Last I knew though they weren't evidence based.
PeterisP 10y ago
Regular preventive checkups are (or should be?) a thing. Quite a few deadly things need to be caught before they become obvious problems. As a crude example, prostate cancer is one of diseases causing death for men; and has the "nice" property that if it's detected early in a screening then it's (usually) treatable with minor side effects, but by the time it causes symptoms serious enough to seek a fix for the symptoms, it generally has grown enough to be lethal.
- 10y ago

ergothus 10y ago

I can't deny the conclusion, and I agree that men are socialized to not show weakness ("macho"), but for me, I tend to avoid going to the doctor because, as a general rule, it rarely helps and it always costs money. (macho-ness may make more sensitive to that, hard to really know) I was very sickly as a child. Every doctor's visit did nothing to change this (it wasn't even "Hmm, you have a trend", it was "oh, you have a cold/bonchitis/etc.) It wasn't until I was 30 that I learned I was allergic to pollen, molds, dustmites, cats, dogs, and rats - basically everything that won't kill you (no food allergies I've nailed down) - and that discovery was made when my symptoms suddenly got dramatically worse for months, and I pinned down the only three things that had changed in that time and went to an allergist myself. Each winter for several years since then I would get bronchitis, and the coughing and shortness of breath would last for months. Every doctor told me to take some Delsym and wait 4-8 weeks. I eventually pieced together that this is my allergies (which, while treated, aren't gone) draining into lungs overnight and slowly being coughed up during the day. Some anti-inflammatory treatment that is now legal in Washington turns out to have stopped that for the last few winters. I've had two rounds of kidney stones in the last 5 years (each involving at least two stones, because apparently the inflammation from a kidney stone tends to "shake more loose") - Doctors couldn't do much beyond painmeds and flowmax. (First time though, I had a $1000 CT scan (I think it was CT - I get CT and MRI mixed up) because the doc suggested it.) I had pneumonia once - didn't realize it, it was just a bad cold/cough that got dramatically worse. Calling my doctor for an appt gave me something in 3 days. Day of, I wasn't sure I would be breathing by the time of the appt, so I was going to go to the ER. (which would have been ridiculously expensive). My wife took me to a local urgent care clinic (PatientFirst in VA) because she was worried about the wait time at the ER. They were awesome, saw me immediately as I walked in (they could hear me breathing), did in-house xray of my lungs and o2 sensor. Now that I'm in Seattle, the local clinics work differently - they REALLY want you to have a primary care physician. I recall a doctor there once saying that's because they want someone to coordinate your care, maintain a big picture view, and proactively look into potential issues. I told her I'd never had a PCP do any of those things) I'm not knocking medical science - it's a near impossible job: "Debug this program to which you don't have the source code, can't control or even know all the environment and inputs, and if you crash it someone dies". It's amazing they can do what they can, and in certain circumstances they are responsible for saving and improving a lot of lives (see above having pneumonia). But the reality is that if I went to the doctor every time some part of me hurt (and now that I'm 40, that's a lot of parts) based on my past experiences, I'd just spend a lot of time and money and be not much better off. So I'm all for being cautious on big things like chest pains. I'm all for knowing the warning signs of stroke, heart attack, and the like. But going to the doctor for every little thing? Seems a waste.

eon1 10y ago

The whole "getting a physical" annually is purely an old school American thing anyway. I don't know anyone in my country who does this - although apparently nowadays US med associations recommended you go visit a doctor every 5 years or so if you're under 40. Still, if I walked into a doctor and said "is anything wrong with me?" with no symptoms or obvious indication that this might be so, they would probably take blood pressure, do a breathing test, ask me if anything was actually wrong, and then wonder why I was wasting their time (or maybe ask if I was looking for a medical certificate cos I didn't feel like going to work, heh).

derefr 10y ago
Personally, I kind of wish my GP was there to help me optimize my health, rather than just to diagnose illness. Like, all those dietary restrictions they give to people who've had heart attacks? Why not give them to me before I have a heart attack, so I won't ever get one? Make my life more of a hassle, so that I live longer! I want to have someone in my life who plays the same role that a dental hygienist plays a dentist visit, but for my general physical health.
- DaUR 10y ago
  > I want to have someone in my life who plays the same role that a dental hygienist plays a dentist visit, but for my general physical health. You better not expect doctors to be that. Most of them still believe cholesterol causes heart disease, for example, or that you need 50% carbs in your diet.
- eon1 10y ago
  Okay.. so that kind of sounds like you need a dietician, which is someone you can ask your GP for a referral for, or in many cases just book an appointment with. Your GP doesn't send you to the dentist unless there's something so wrong with your teeth it's impacting the rest of your health; why would it be any different for your diet?