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Today was an exhausting day for me. My mother had an appointment with her PCP at the geriatric clinic. I got the feeling that the doctor didn't have a clue on anything to do to help my mother. The more the doctor talked, the more tired I became. I got the impression she didn't think that I was doing enough -- that I should be spending my days making sure she was active and entertained, and that I should spend my nights monitoring her activities. She did the normal recommendations that we hear for older people, but she didn't know my mother at all.

My mother's regular PCP retired over two years ago, so we switched to a geriatrician in a clinic, who went immediately on maternity leave. My mother was seen by whoever was available until her PCP returned from leave. Then there were two visits before the PCP told us she was moving to another state. She turned us over to a new PCP in the clinic. She doesn't seem to understand old people at all, particularly not my mother.

At the end of the appointment I realized that it was wasted time. My mother was more confused than ever and couldn't figure out which way to go to even get out. I was more confused, because I don't even know what the doctor recommended. Besides, I felt she was clueless about how to help.

Mom and I went out to eat, then came home. I slept the rest of the afternoon and woke up, still exhausted from the doctor visit. It seemed almost too much to get her medicines ready and take the trash out. I was that tired. Hoping for a better day tomorrow.

I am getting tired of teaching new doctors about my mother. Doctors are so unstable now, moving from place to place. I wish it were like the old days when doctors hung up their shingles at their offices and stayed there. This hospital-associated doctor thing gets tiresome fast when the staff is not stable.

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My very best advice for your benefit as well as your Moms is just because your Mom is still mobile and you can mentally and physically take her to these grueling appointments does not mean that it is still the safest for either of you. If I were you, I would run, not walk, to the nearest phone book and call the office of a visiting Physician who will also suggest a home healthcare agency to come out to your home and help you a great deal. You will be so happy that you did. Trust me, I know how exhausting it was taking my Mom to all of her appointments and the majority of any testing proceedures can be easily done under your own roof. You might want to ask yourself, what can ultimately happen to you and your Mom if you stretch yourself to mental and physical exhaustion? Hugs to you and your Mom!
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The conversion of paper files to a computer has been in place where I live for several years now and it works great.... now patients don't need to run x-rays, paperwork or prescriptions back and forth between doctors, it's all done on-line within seconds. If you happen to go to the ER your medical information plus insurance information that can be sent from your primary doctor within seconds.

Now while driving home with my parents from a doctor appointment, we can stop at the pharmacy and the prescription is already for pickup because their doctor sent it to the pharmacy via her computer while my parents were still in the exam room. Lab tests are now send to the doctor's computer, no waiting for the paper results via regular mail. And now we the patient can go into our file from our own computer and see what the doctor had written, preview our own lab results, etc.

I understand transferring all the paper files over to computer memory wasn't an easy task. I assume if a patient hadn't visited the doctor in the past 5 years, that file wouldn't have been put into the computer. Now those walls full of manila files are gone... and no more grabbing the wrong file. The computer files are first sorted by birthdate, then by name to get the correct patient.

The solo practitioner was great back in it's day, but don't forget we had to go here and go there for x-rays, blood tests, EKG, etc. Now with large group practices, lot of the testing is done on-site.
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My dads doctor has 4 other practitioners in his group. The upside of a group is you can always be seen the day you call for emergencies (not a well visit). I personally see a sole practionet, he is off on Wednesdays (I am always sick on a Wednesday) , Friday afternoon, etc. so looking at it for convenience sake for sick visits, I would perfer a group.
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Unfortunately, that is all too common among doctors. You really have to dictate what you want them to do.
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Unfortunately, nostalgia for the old fashioned solo practitioner is an exercise in futility. My husband is a solo practitioner (pediatrician), and were it not for the fact that he is already at retirement age, he would have joined a large group a few years ago. New, and expensive, requirements keep being imposed on doctors, and the solo guys just can't afford to comply. When electronic medical records become mandated for my husband, he will close his practice rather than spend the $200,000 required to update hardware and software and convert almost 30 years of patient files. Currently, his income has dropped to about 30% of what it was 10 years ago because of reduced insurance and Medicaid reimbursements and the cost of new requirements. If not for the fact that our own children are grown and educated, and our retirement income is in place, he could not continue with the current practice. He enjoys his small practice where he knows his patients by name, knows their medical history and family situation, and even sees some second generation patients. He has only three employees, who have worked for him for years, and who also know the patients. Real people answer the phone and there are no phone menus for exhausted mothers who have been up all night with a sick child to navigate.

Today, doctors either spend a considerable amount of time entering data into a computer, or must hire a person to follow them around all day making the entries. A new criticism is that the doctor spends his time looking at a computer screen instead of focusing on the patient during a visit. Reduced reimbursements mean that doctors must see more patients each day to meet expenses. No wonder it is harder for doctors to get to know their patients. The changing personnel that Jessiebelle is talking about is often the result of doctors changing groups for a better lifestyle due to pressure to meet production quotas. I hate that medicine has become so focused on the bottom line and not on patient care.

I also struggle with taking my mom to her PCP. She lives in an assisted living facility, but I still spend about four hours getting her ready, driving her to the appointment, waiting, seeing the doctor, getting lab work done, driving her back home and getting myself home. Then she is more confused for a couple of days. I have tried in vain to find a doctor who makes house calls in my town. She currently sees an internist who has his own practice, but he is also nearing retirement, and I dread finding a new PCP for her.
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Ferris, she does have a PCP. The only thing is they keep changing. She is with UAB Geriatrics. With two doctor changes, maternity leaves, and their professional seminar schedules, it feels like we're being juggled.
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With Medicare only, you can choose your PCP. Stop trying to be in a group as this will continue to happen to your mother.
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When there is a clinic, you may not always see the same doctor when you go in. This is unfortunate for you have to explain to each doctor what is going on with your mom. It can be very frustrating. You may want to change her doc. Look for one that specialized in the elderly or those with dementia. You may also be able to get some in home assistance for your mom, contact your local area agency on aging or bureau of senior services. They have programs for in home assistance and caregiving services that you could benefit from. If there is a local adult medical day care, you may want to check it out. It's been my experience that the adult medical day care is a great place for socialization, a variety of activities and a meal. You can only do so much, make sure you keep a journal of all the things you notice about mom, keep a list of her medications along with the dosages and the number of times she takes them per day. Make a list of any questions you may have for the doctor before you go so you won't forget anything once you are at the doctors. this will make appointments easier. Good luck
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With both my Mom and my MIL I kept a three ring binder that was divided into sections according to the type of doctor they were seeing. I had names, appointments, why we were there,what the doctor said and any meds given or prescribed. It was the only way I could "stay on top of things". MIL was seeing about ten different docs and it was up to me to keep them up on what each of the others were doing. I also wrote questions ahead of time to ask the doctor myself and sometimes gave these to the nurse to relay to the doc ahead of time. Saved us lots of time and since Mom and MIL both had dementia I could ask things without them knowing everything being discussed. My MIL often looked at me as I were the one with dementia since she could not remember or was in denial about the things she was doing. Having medical POA on both of them certainly made my job easier.
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So sorry for all the typos, you can tell I am exhausted.
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My whine moment about doctors. When the time it takes to get washed, dressed, get in car, travel to doctor, sit in waiting is 5x longer then the time you actually saw the doctor. After reading all this, I almost feel blessed when mom could barely walk amymore and we switched to a homebound geriatrician who came to the house once a month. We had this woman doctor and she was the best doctor my mom ever had. I don't think some of these foctors actually realize how hard it is to get an elderly person to the doctor. My dad was up coughing all night. He is washed and dressed and back in bed because we don't need to leave for another 20 mins. It is just 9:30am here and i am already exhausted so I can ffully understand Jessie when you say doctors appointments are exhausting!
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Finding doctors that are the right match for the patient isn't easy, as we all well know. Last week I changed my Dad's geriatric doctor to a regular family doctor who is located a stone's throw from their house. We were impressed on how this young doctor handled questions to my Dad, and felt that doctor had a handle on how to deal with the elderly.

Since my parents are already in their 90's, a regular family doctor would work just as well.
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cwillie, it sounds like you've been going through the same thing I have been. I know there is nothing that anyone can really do for my mother. We do need the prescriptions, though, so we are lucky that there have been people there to do that. I remember how difficult it was when the first PCP retired. It was very hard to find a replacement, since many people are not taking Medicare patients now in the US. Even many of the geriatric clinics are taking only people who have private insurance.
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At least you have the option to seek out a different doctor. When my mom's GP retired we were thankful a new medical centre with a team of doctors was available to us, but unfortunately the turnover there has been high and mom has had several doctors over the last few years. In rural Ontario there is still a shortage of doc's, and when the last one left mom was an "orphan" patient. GP's here are the gatekeepers to all medical care, there are no tests or specialists without their referral, so to be an orphan patient is not a good thing. If we hadn't belonged to the medical centre we would have had to rely on emerg or walk-in clinics. As it was we were still seen by a different doc every time we needed something. Thankfully one doctor said mom needed more focused care and took her on as a patient. Bonus that she also took me on, as my doctor was over an hour away at my former home. Double bonus that she even makes house calls! The down side is that I don't completely trust her judgment, but it would be next to impossible to find another doctor taking on new patients.
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In this day of hospital-linked doctors, the old-fashioned single doc is hard to find. Medicine has certainly changed. Can you imagine a young person trying to grasp Marcus Welby and realize that doctors actually were like that at one time?
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Find a PCP who has NO partners and is at least ten years younger than the patient. LOL good luck.
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