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26 May, 2009

GP visit numero uno

I had my first GP check-up since being in the states this week. Turns out I'm doing ok. He was even polite in telling me to get some more exercise and eat healthy. In fact, I thought he was a pretty decent doctor but it's a little too early to form my complete opinion on him yet. However, my trip to the doctor reminds me about the power of the mind and in particularly it's influence over the body. It's something that is easy to forget at a doctors visit. They check your weight, height, blood pressure, your breathing, ears, throat and nose but not once did he say "Well, how are you this week? What's going on?". Of course if he did ask that he would probably get a short "nothing, fine" understatement from me but a potentially hour long conversation from someone who came in with a hang-nail. Shouldn't someones overall well-being be a part of the examination though?

When the nurse came in to get a base level reading of my overall health she asked the usual things, any prescriptions? any conditions? Allergies? The usual. At one point she said "Now, have you ever suffered any anxiety or depression". I was on a roll of saying "no" and so reflexively I said "no". As she wrote it down, I thought a little harder and said "Well, actually that's heck of a question. Of course I have been anxious and depressed in the past but nothing that was normal or didn't pass. " I suppose the question was to check previous mental health status or prescriptions but I felt I had to suffix my answer in case she mistook me for an emotion-less psychopath. That was about it for mental health questions though.

I think a great solution would be to have a mental health professional on staff. Between the nurse leaving and the doctor coming in I had at least 15 minutes of waiting time. I also had 5 minutes of waiting time before the appointment. I'd relish the chance to chat over my concerns in that time. Hey, they may even *shock* be related to my health problems. Take insomnia for example. Wouldn't a chat about current worries, stresses, anxieties and depression lead to a better conclusion about treatment than simply covering up the problem with a prescription? I don't suppose it will ever happen, but wouldn't that be a more holistic approach to modern medicine?


Paul Higginbotham said...

Great points. I started going to a new GP a few years ago, and I was surprised that the forms I had to fill out for my initial visit included a mental health questionnaire. I'd never seen that before, but it only makes sense.

And I liked my doc too, once I convinced him to take the straight jacked off of me.

Spike Nesmith said...

"Wouldn't a chat about current worries, stresses, anxieties and depression lead to a better conclusion about treatment than simply covering up the problem with a prescription?"

Of course not! You're forgetting one thing about American medicine; if the solution to a problem doesn't wring more money out of you, specifically money that goes to the drug companies whose pocket your doctor is in, it's not going to fly.

"Do a few sit-ups, watch a Lifetime movie and eat a fruit cup" won't get them early retirement or a new BMW!

Chris James said...

Good point, Spike.

Seriously, do the manufacturers of "talking" send out an army of sales reps armed with steak dinners at The Chop House and free clicky pens?

The Film Geek said...

Patient care is one reason for that information, of course. Another is the legal implications for the medical provider. But I'm always curious if the real reason for collecting the mental health informtaion is to provide basic data for the drug company representatives who frequent the offices on a daily basis.

Five new patients that said they have at some point been depressed? Tell it to the drug rep and start the capitalist machine rolling.

Good post, by the way. I'm always curious of your take on medical care in the U.S. or $

Dr. Detroit said...

Some very cynical views of doctors! While there are loads of issues with health care in this county and around the world, sometimes it's just a matter of finding the right doctor.

In each city where I've lived, I've probably gone through 2-4 GP's before I found one that listened and didn't just try to fit in as many patients *cha-ching* in a day as possible.

I like a doctor who takes a holistic approach by listening about current life issues which can affect health, as well as listening to what new or strange aches and pains I have. I know my body better than anyone else so it annoys me if they don't want to listen when I say something is different.

I'm happy with the doctor I have now, but there are some doctors that are more self-serving than caring.

By the way, drug companies are no longer allowed to distribute promo "freebies" like ink pens and note pads to physicians.

The Film Geek said...

Doctors are fine. It's the system I think sucks. No pens or trinkets, but that Friday afternoon lunch spread at the regional hospital here, catered by the local office of a big time drug firm, is pretty elaborate. And, I'd add, better than the pens.