Pcp

[Creed3]

Hi Everyone!
I was just wondering how many of you have a family practitioner as your pcp and how many have a doctor who specializes in internal medicine. I have found over the past year or so that my family doctor just can't handle me anymore. I am such a specialized case now that even my cardio thinks that I should see an internist. I have just taken the steps to transfer my records to a new doctor.

Yall Take Care!
Gail

 

[LUVMyBirman]

Hi Gail,

My last two docs have been internal med. I have found that they are not 100% versed on valve replacement. My former doctor down south only had one patient other than myself. Old ball and cage valve. Highly respected practice though.

My current doc has not shared that info with me. I do have the feeling I am one of very few. If you look at valve replacement stats as a whole....it would make perfect sense out of all of the internal med docs out there......they would average 1-2 valve replacement patients. Especially the younger variety. We may be common on VR.com..but very spread out in reality. Guess that is the reason why we have cardioligists!

 

[Bryan B]

Interesting you should mention this. When I found my family doctor I was really happy. I really liked his style, was comfortable going to him, and my initial dealings with him were all positive (he got rid of my bronchitis when 2 other docs failed to accomplish this). Unfortunately I continued to have recurring problems with my health and I was eventually diagnoised with endocarditis. I think he was slow to check for this possibility considering my medical history and I finally insisted on an echo which confirmed it. I'm not even sure he thoroughly read the medical history form I filled out during my first visist in which I listed my heart conditions (VSD & AI). Since my diagnosis his demeanor with me has changed, although I have never said anything that would lead him to believe I blamed him for missing it. I also have panic disorder, and my continuing health problems always seem to get blamed on my anxiety now. During the follow up visit when he took my PICC line out I told him I was still feeling fatigued and did not feel like I was back to my old self. He told me my heart was fine and increased my anxiety meds. I insisted on a cardiology consult anyway because I never saw one during this whole time, and he seemed put off that I insisted on this. After meeting with the cardio he told me within 2 minutes I needed surgery and the surgeon I saw 2 hours later confirmed it. My family docs response was that he could understand their view but thought that I would have been fine without the surgery. I plan on changing my PCP to an internist after I have surgery (if I ever get a date).

Can you tell you struck a nerve with me?

 

[Karlynn]

An internal med dr. that I had as my PCP - pre-valve replacement, was the one that was just sure I was nuts, not having all the arrhythmias and wanted to prescribe valium to rid me of my troubles. This is the same dr. that treated me for the arrhythmia I had during pregnancy, but told me it would go away once I had the baby. Since it didn't, it meant I was letting my mind work overtime - in his opinion.

Now I have a family practitioner as my PCP. I've been with him for 11 years. He knew of my "angel" cardiologist (now deceased) and had quite the respect for his reputation, so basically anything I told him, he made certain he took very seriously. He is a very good diagnostician (which I believe are worth their weight in gold) and listens very well.

I had 2 cardiologists throw up their hands and say they could do nothing for me, prior to my valve replacement.

So I guess the jist of my story is - get a good doctor. It might be an intern. med guy, or a family pract., or even a gynecologist, but get one that listens, is a good diagnostician and that will be honest when they have reached their limit of knowledge. It may take some shopping around. You may want to check into DO's as well as MD's. My cardiologist now is a Doctor of Osteopathy. They have the same amount of training as MD's but they are also trained to look at the whole body and how disease effects many things.

Good luck !

 

[ALCapshaw2]

You are not the first and won't be the last to fall into that plight Gail. And, you may still have to 'educate' your new provider on your unique issues.

 

[Nancy]

Joe has a doctor of Internal Medicine. Joe's problems are so complicated. He interfaces with this doctor the most, and his Coumadin management is done by this doctor. He has been invaluable.

 

[fyrfytr]

Hi Gail,
My PCP is a Dr. of Internal Medicine. He is the one that set me up with my Cardiologist and now my Cardiologist comes to my PCP's office twice a week to see patients here in town. This is also where my coumadin is managed.
Take Care

 

[Creed3]

Thanks Everyone!
This is something I have been thinking about for a long time. There have been a few small issues that have occured where my family doc or someone in his office just messed up. One doc there perscribed the wrong dosage of meds and if I wouldn't have questioned it, would have been in trouble. Another doc missed my cardiac problem all together. I suffer from anxiety and I think they all felt I was just being a worry wort. I know my doc felt bad when he found out he missed my diagnosis. Another doc I saw kept telling me that my pain was all muscle pain. They also prescribed me wrong meds when I was sick. They had me taking things that someone on coumadin and hbp meds should not be taking. My cardio also thought that I should see a doctor who will be very very cautious with me and not take chances, no matter how small the chances are of causing a problem. I work at a hospital and I know of a very good internist. I have talked with him regarding my position and he answered all of my questions and was very patient with me. We happen to be friends and I know his wife and kids. My kids and his kids all go to school together. I just feel very comfortable with him and he knows that I am a person that asks a lot of questions and is very involved with my medical treatment. I don't just blindly do what a doctor says.
Thanks again for all of your responses. I guess the important thing is finding a good doc whether they are a family doc, internist etc....

Take Care!
Gail

 

[tommy]

My PCP is an FP - treats my whole family. He is in a very busy practice, so I occasionally I'm seen by another partner if I'm in a hurry.

If it is something serious/heart related, I'll call the cardio first or go to ER.

 

[Karlynn]

Gail,
I'm glad you know first hand of the doctor you are looking at. There are great doctors, good doctors, so-so doctors and bad doctors in all areas of practice and it's very stressful to find them by trial and error. Being comfortable and assured by a doctor you are thinking of seeing is half the battle.

 

[Birky]

Drs.

Drs.

Mine pcp is here in town and I go to him with things that I don't call the Cardiologist on. All my protimes are done in a coumadin clinic where the cardiologist is. I really don't feel very confident with the care here but prefer to go to a teaching facility. I have been with the same cardiologist for 15 years so I am pretty confident with him and his great staff. There is something like 30 in that group. They are very fast in responding. I have been having headaches since the surgery and we have been going back and forth with both trying to come up with a solution but still don't have an answer. I was prescribed a beta blocker but decided not to take it. It would slow me down since this is what it did before. I am on Cardizen and Lanoxin already and am loving my new found energy and do not want to compromise this. They do not want me taking Imitrex since I have had high blood pressure which is now controlled. Seems like their has been a lot more problems after than before. Hopefully it will get straightened out. Sorry for rambling,

 

[Harpoon]

if you can't find someone who's got some 'decent" picture of what your condition is like and how to handle it then at the very least find a physician who's willing and open to communicate with your cardiologist(s)...


In fact, the best way may be to ask your cardiologist about refering you to a PCP if you want/need to change...


My primary doc was kept abreast of my condition all through my stay in Cleveland by the folks at Cleveland Clinic. They talked to him and my primary cardiologist at least once a week and let them know what was going on.

I didn't know any of this until I went with my wife (she sees another doctor at the same family practice) and he came out to see me. There aren't too many people who I have come into contact with since surgery who were near dumbfounded to see me stand up and shake their hand. he knew what I had been through, he knew it and he understood it.

He may not have known the particulars about my condition with regards to how exactly my heart functions now and it's efficiences, but he has a strong enough understanding of what's going on now to help me if I need it and to consult with my primary cardiologist or my surgeon in Cleveland if I'm in trouble.


My primary cardiologist monitors my coumadin, but my PCP also gets the PT/INR results (and any other lab work) and can at least alert me if there's something going on.


Ask around, ask your cardiologist for places to look. KNow that you're not going to find a PCP who's a "specialist" in heart valve patients, that's a contradiction in terms. PCP's are general practicioners, they know enough about a WIDE variety of diseases and conditions to be a first line of defense when something's not right. They know how to treat basic problems like colds, flu, etc, and they know how to recognize signs of more serious problems which they should then be refering to someone who specializes in that particular field.