Should My 92 Year Old Father Get A Different Doctor?
August 23, 2014 10:38 PM   Subscribe

My 92 year old father went for his annual physical in May and I have had concerns with the quality of care he has received both during the physical and in several followups. However, I don't know if I should encourage him to go to a different doctor (there aren't many locally who are accepting new patients, and I don't know their quality, but we could try). Details after the jump.

In May my 92 year old father (frail, poor short-term memory, but otherwise in good health) went for his physical.

The physical lasted less than 15 minutes, possibly only 10 (I'm going by my mother's report at the time as she went in with him, and I trust that it is accurate; she's good with that sort of detail). I'm a little dubious about the quality of such a short physical, but I'm not a medical professional, so I don't know for sure. My mother says that his breathing was checked but no rectal was performed. She can't remember much else about it (I only asked her for the details this past week).

Since then, the following issues have arisen:

- the doctor has asked my father to go from 1 to 2 pills a day of a supplement that he had never previously prescribed
- the doctor noted that one of my father's blood levels was alarmingly low and if it was not improved, organ failure could result. He gradually increased the dosage of the relevant medication/mineral supplement (different from the one mentioned in the previous point). My dad went from 1 to 2 daily and then from 2 to 3 daily. After a couple of months of monitoring blood levels, the doctor directed that my father's intake go from 1 to 2 a day. I had to point out that because of his previous direction my father was already at 3 pills a day, so then he raised the level to 4 a day
- the results of 3 weeks of blood work went missing and the absence was only noted when I called because I was concerned about my father's blood levels. The lab results were finally located, but the doctor did not receive timely information on my father's health. After they were located I had to call back twice to find out what the results were

On the plus side, the doctor has treated my father very well in person and has been kind to my anxious mother when she is with my father (I went in to their last appointment and took notes).

On the one hand, everyone makes mistakes. I know the doctor is extremely busy, and he works out of a very busy multiple doctor clinic which allows for both appointments and walk-ins by people who are not previous patients; I get that the administration might be strained. However, this is multiple mistakes over 3 months.

Also, I don't know that a new doctor would be any better. There are very few accepting new patients, and the one that I've had recommended to me has very mixed reviews on a ratings site.

I've considered staying with this doctor and writing a polite letter outlining my concerns and cc'ing it to the regulatory body. However, I wonder what result that would have on future care.

My parents are willing to be guided by my recommendations on this and they are also willing to have me go to every doctor's appointment from here on in, to take notes and ask questions, and to keep track of all the details of the medical care. Although I can follow up on the things I know about, I can't foresee everything, so I'm concerned about that.

What would you recommend I do? Switch doctors and take a chance that the new one will have issues as well? Write the letter and take the chance that there is poorer care with the current doctor as a result? Or . . . ?

Thank you in advance for any help you can give me.
posted by anonymous to Health & Fitness (5 answers total)
There was actually just a similar question recently, the vast majority of responses recommended a geriatrics specialist, and I would absolutely recommend the same thing to you.

Don't bother with the letter to the regulatory body at this point. That seems way out of proportion to the complaints you have, usually reserved for very serious complaints about unethical behavior - it really does get the physician potentially in a huge amount of trouble (i.e. investigation by the Department of Public Health) and if you think he's a nice person and these small errors were unintentional, doing that to him doesn't appear warranted. Certainly feel free to inform the practice of the reason why you're switching to a new physician - they should know, because it sounds like they need to make some improvements in how they track patients' health issues and meds to prevent errors. Don't expect other doctors to necessarily have longer appointments, though. 10-15 minutes is very standard for primary care visits, sadly, since insurance (especially Medicare) doesn't incentivize longer visits and practices have to pay the bills.
posted by treehorn+bunny at 11:11 PM on August 23, 2014 [3 favorites]

Going along to all visits and tracking stuff is absolutely helpful. If you can I would definitely do that. I did with my MIL for the last few years of her life and it made a difference because she wasn't able to track details herself at that point and as you've seen your father's doctor's office isn't tracking everything well. I think that's not uncommon these days and being up on the details can only help your parents.
posted by leslies at 4:59 AM on August 24, 2014 [2 favorites]

Your father is 92 years old. At that age, some doctors like to make a person comfortable without doing anything invasive. Why should he have a rectal exam? If cancer was found, it is unlikely that he would survive the treatment, it would only upset him. Unless he is having treatable symptoms that his current doctor is ignoring, I wouldn't switch.
posted by myselfasme at 5:34 AM on August 24, 2014 [4 favorites]

Our GP happens to be a geriatrics specialist. Our physicals are thorough and last about 30 minutes. We get blood work, ekg and have long philosophical conversations with our MD. He's also a pharmacist (I suspect that's the Asperger's talking) so he's very interested in how drugs interact and how they contribute to our health.

At 92 I think that someone who specializes in the health of old people is probably the way to go, and it gives everyone a graceful exit from the existing GP.
posted by Ruthless Bunny at 5:36 AM on August 24, 2014 [1 favorite]

I agree a geriatrics specialist is a possibility, but no matter what, if you can accompany your parents to the majority of both their appointment that would be the best outcome. It is difficult even for a non-octogenarian to remember everything at an appointment and, no, you aren't a doctor so you won't know everything, but it is so very helpful to have another person be an advocate and knows what is going on, especially if you take notes.
posted by dawg-proud at 9:23 AM on August 24, 2014 [1 favorite]

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