We are a commune of inquiring, skeptical, politically centrist, capitalist, anglophile, traditionalist New England Yankee humans, humanoids, and animals with many interests beyond and above politics. Each of us has had a high-school education (or GED), but all had ADD so didn't pay attention very well, especially the dogs. Each one of us does "try my best to be just like I am," and none of us enjoys working for others, including for Maggie, from whom we receive neither a nickel nor a dime. Freedom from nags, cranks, government, do-gooders, control-freaks and idiots is all that we ask for.
My Doc, a fine fellow, a med school Prof, a solo practitioner, and a non-golfer, is getting frustrated with the direction of medical practice these days and, along with that, feels a little frustrated with his patients too. He has too many of them, but just wants to be an old-time doc and friend to his patients instead of an Obamacare industrial doc on an assemby line.
She Who Must Be Obeyed forces me to get a "physical" every three years or so, just to annoy me. A gallon of blood, a total body scan, stress test, colonoscopy, fully poked and prodded, finger up the butt, etc. Costs a fortune. Doc also insists on a half-hour interview about how my life is going, Diet, happiness quotient, work, friendships, exercise, sex life, how are the kids, future plans, fun and recreation. Thinks he's a shrink, and likes to talk to people about their lives, while I would rather leave my body off for a check-up like leaving the car at the shop.
Actually, I think he's a very fine, caring Doc who happens to hold the strange, idolatrous and heathen belief that health is life's priority. (Plumbers feel the same way about your plumbing, don't they?) He does a good job at never appearing to be in a hurry, so I feel lucky to have him in case I develop a problem. We all will, sooner or later. Eventually, it will be a fatal problem. We can all count on that.
I put it all off as long as I can because I am allergic to doctors, much as I respect them. Anyway, last week he told me that, for my age and build, he wanted me to achieve a 36" waist. He also said, in all care and kindness, something like "If you don't want to follow my advice, I invite you find another doctor." Almost that, anyway. He was also rough about my cigar pleasure, but figured that 2/day was OK with him. Maybe 3. When I pressed him, he confessed to a few per week himself.
My question is always "What good is one's health if you don't have a fun, stimulating, adventurous, satisfying, and somewhat decadent life?"
And I am not even Medicare age. He opted out of Medicare a couple of years ago. He says Medicare reimbursements cannot cover his staff's wages as a solo guy. What it means is that he'll still take on Medicare-age patients, but they will have to pay him themselves from their piggy-banks. If truly poverty-stricken, he'll offer a break but no freebies. He doesn't "take" any insurances either.
He also told me that, when he decided to opt out, Medicare patients comprised 30% of his practice population, consumed 90% of his time, and comprised 25% of his income. He figures he donates a day per week at a teaching clinic, and that that is enough charity for him. How many people donate 20% of their work time and income to charity?
Like most doctors these days, he prefers not to bother with people who do not want to take decent care of themselves. The price you pay to have him available to you if you get in trouble is the occasional exam and sanctimonious health lecture. For me, every few years, stretched out as long as possible.
My HMO doctor and I have a good working relationship: I tolerate him as a physician who is told by his "superiors" how to practice the best medicine, and he tolerates me as a patient who takes his advice with a bit of salt (at least 3 grams per day, as an earlier post at MF recommended). If I had $1 for every standard "good medical practice" that eventually turned out to be wrong in terms of the science, I could live comfortably in retirement without my Social Security and Medicare benefits, both. When compared with the physical sciences, medicine is still in the dark ages of rattles and incantations. Physician, please spare me the lectures.
Down to 36 from what?
I personally am not, nor will be, "friend" with my doctor. Pondering this, it occurs to me the only reason he is my doctor in the first place is because the insurance said I needed a primary care doc, and he had room out of the 6 in the office! This probably because more people left him for someone else, thereby giving him room for more clients.
Now that CDL's don't require a 2 year physical, I should find him much more tolerable, say, if I break a bone during office hours! Otherwise, the only useful thing I've seen from him was the "snip-snip."
To quote from a SIRC review of Dr. Michael Fitzpatrick's book 'The Tyranny of Health' -
'In his conclusion to the book Fitzpatrick returns to his blunt message that "Doctors should stop trying to moralise their patients and concentrate on treating them", and he enlists the help of the microbiologist Renee Dubos to reinforce his point:
"In the words of a wise physician, it is part of the doctor's function to make it possible for his patients to go on doing the pleasant things that are bad for them – smoking too much, eating and drinking too much – without killing themselves any sooner than is necessary." (The Mirage of Health, 1960)'