Is it Time for a New General Practitioner?

Okay PMC members, I have a question. Is it time for me to find a new general practitioner?

Here's the situation.  Back in June, while digging up a crepe myrtle to move to a new location, I strained my back pretty bad. Several days later, I went to my general practitioner. I've seen this guy for years and he's pretty good with general ailments. I've even been to his house for parties. Small town so everyone knows everyone else. For things like colds, thyroid, anxiety, strains and sprains, I think he's fine. 

But lately, he says things I think are inappropriate and do nothing to relieve anxiety about a condition that I've only had for 18 months (the pacer implant). Hear me out.

When I go see him about the strain after yanking on a tree, I explain the symptoms and that the pain is in the mid part of my back and sometimes radiates to my chest. When I ask him if it could be a pinched nerve or a disc (I've had two ruptured disc surgeries in the last 15 years) -- he looks at me and said, "or it could be your heart. After all you do have a funky heart..." So he listens to my heart, does an ECG, then comes to the conclusion it is my back. He orders a couple of anti-inflammatory shots and some meds and sends me on my way.

A month later, my back is no better so I go back. Again I ask him if he thinks it is a pinched nerve or a disc and he throws out another "could be your heart" comment - then he says he thinks it is my back. This time he orders x-rays and another oral anti-inflammatory. But before I go, he throws out the comment, "you know, even if it is a bad disc, no surgeon is going to touch you. With your heart, no surgeon would take the risk..." When I told him my cardiologist says I'm doing great, he raises his eyebrows and walks out. By the way, the x-rays showed no ruptures. It even showed my pacer is in the same position it was when it was implanted. But I know if it continues, I'm just going to call my neurosurgeon's office so they can do an exam. My pacer is MRI compatible so all I need is to have it cleared with my EP before and after I have one if it becomes necessary. 

Now between these two back pain visits to my GP, I had a visit with my cardiologist (the EP for my pacer). He gave me an excellent report. Heart is strong, my pacer works an average of 0.4% of the time and he thinks that's when I sleep. I do have some episodes of SVT (supraventricular tachycardia) from time to time and I take 50 mg of Metoprolol Succinate daily, 25 mg extra up to 3 times daily if I have episodes. He patted me on the back as I was leaving my check-up and said at the rate I'm going, I could live to be 90 (I'm 57).

My brother and several friends think I need to get away from this GP because of things he's said in the last year or so. For example, a few months back he said he said since I had episodes of asystole (which led to the pacer implant) - he had to be extra careful what he prescribes since I could drop dead (yes, those were his words) -- then he said, "oh that's right, you have a pacemaker." Another time he said my heart is strong every time he checks it and he wishes they would just turn it off or take it out (to which I replied it is better to have it and not need it than to need it and not have it). Then another time he completely forgot I have a pacemaker and I had to stop him to remind him I do have one. Over the last few months I also saw him for the sniffles. In these coronavirus times, I asked if he thought it was my sinuses. He looked at me and said, "either that or a brain tumor. But it's probably your sinuses..." 

Before I close this out, in addition to my regular EP I see, I've had a second opinion at one of the largest medical schools/cardiology centers in the state which has a stellar reputation for treating heart issues. The second opinion EP I saw concurred with everything my regular EP is doing and said he wouldn't change a thing.

So now I'm opening it up for your opinions. While I do think my GP is capable when it comes to regular maladies, his comments are really beginning to irritate me. Actually, sometime I feel more anxious after I leave his office than I felt going in. I realize that you see physicians for their knowledge and abilities, not necessarily for their personality. But I think bedside manner (or should I say exam tableside manner) counts a lot. It is a small town practice, one of the few here. There is one other doctor in this same practice and he is well liked by everyone he encounters (he used to be an ER doctor so he's seen it all). No other doctors in town are accepting patients. My next option would be to drive 25 miles to the next city to see a general practitioner. 

While I'm leaning towards seeing the other doctor in the same practice, I'd like your opinions in this situation. 

And ....... GO! 



by AgentX86 - 2020-07-30 14:14:47

Yeah, I'd find a new PCP in a heartbeat. He obviously didn't look at your medical history before seeing you. That's simply unacceptable.

However,  in my opinion, you made a couple of mistakes too. Doctors are people too. They don't want their authority to be preempted by their customer. If you're going to tell him what's wrong, why do you need him?

That splits into two paths. If you know/think it's a disc, why bother with the PCP? Go directly to the specialist, who you have a relationship with anyway. If you are going to go to a PCP, tell him the symptoms and let him do what he was trained to do.

It is time to move on

by Gemita - 2020-07-30 14:22:12

Yes it would certainly be easier to stay with the practice but to change your doctor because they know you and hold your records, and you will not have to travel far, although you might end up meeting your old doctor from time to time during a visit which might be a bit uncomfortable.    If you do go to the new doctor, certainly do not get involved “socially” otherwise you might find yourself in the same position in no time at all. Familiarity and all that !!

You have clearly lost some trust, respect and confidence in your present doctor and you need to have a doctor that you feel comfortable with again, so yes go for it.

Thank you!

by Mark.n.NC - 2020-07-30 15:00:56

Agent X86: I get what you're saying. The issue with the neurosurgical appointment is that I need a referral from my GP. The neurosurgery practice has a policy that if you haven't been seen in their practice for a period of 12 months, even if you're a previous patient, you must have a referral from another physician. Besides that, the average wait is four months unless it is an emergency. The reason I went to the GP was because of the pain. But the appointment with the neurosurgeon is already in the works. 

Germita: Thank you. My current GP's office is 2/10 of a mile from my house versus 25 miles to see another. Convenience is a huge plus. And I've thought about the awkwardness of running into my current GP if I go see his partner. I'm thinking maybe I could schedule my appointments when they aren't working the same days (they usually work alternating weeks and occasionally work the same days). My current GP is a likable guy and I have no doubt he's intelligent. That's why I'm torn I guess. It just seems that in the last year or so, his personality has almost taken a dark tone. A good friend said it's almost as if he deliberately says things to get under my skin. True or not, I don't know. While most people may say just go see a new doctor, it just isn't that easy or at least for me anyway. Heck, maybe I knew the answer to my question all along. Just needed reassurance that it is the right thing to do.  

New doctor sounds best

by Gemita - 2020-07-30 15:37:20

Yes, don't be afraid to move on Mark, you might be pleasantly surprised and as a former ER doctor, he could be very useful.

Our doctor has moved to another practice and hubby and I were very concerned about who was going to replace her.  But our new doctor is young, energetic and full of ideas and we are not disappointed.  

Yes it is not an easy decision, especially if you know your current doctor well and "socially", but do what is best for you.  When we start thinking about moving on, in my experience "it is time to move on".  Change, refresh and you may find yourself with a new lease of life too !!  Good luck and stay well

Awkward Encounter

by Swangirl - 2020-07-30 18:05:25

I had an eye doctor who during my appointment asked my professional advise about her acting out teenage bi-polar step-son and was never focused on my vision problem.  I  was hesitant for a long time to reschedule with the other physician in the practice but eventually I had the courage to do it.  The former doctor had misdiagnosed and mistreated my problem and I literally would have lost my vision if I had stayed with her.  Yes it was uncomfortable to see her in the waiting room.  I felt we had a collegial relationship.  But the new doctor referred me to a specialist for critical surgery that saved my vision.  He's still my doctor today.  

Your needs are the highest priority.  Even if it requires a 50 mile round trip.  

Thanks Swangirl!

by Mark.n.NC - 2020-07-31 22:16:40

Swangirl: Thanks for the response. It sounds like your situation may fit in with what Gemita was talking about. I've known this doctor since he came to town, became a patient, then would see out and about. As I mentioned, being a small town, everybody knows everybody. I've been to his home for parties and get togethers and I've known his wife's family since before they ever got married. 

But like you and Gemita said, it may be time to move on. I do like the guy and no doubt he's a smart guy. But when I sit down with a doctor, whether it is a GP, cardiologist, whoever, I want my issue to be the focus of his attention. If I go in with a stubbed toe, I don't need my heart to be thrown in out of nowhere. 

My brother and niece see my doctor's partner and give him rave reviews. Others do as well. I'm 99% sure my next visit with be with the other doctor. I just need a breather I think. 



by Gotrhythm - 2020-08-02 14:47:37

It sounds like you've lost confidence in your PCP. I understand your delimma--been there!--but it really boils down to why go to a doctor that you, not a doctor, feel like you need to second guess?  Would you keep going to a lawyer that you weren't sure understood your case?

Let's be fair though. Any doctor, knowing our heart condition, would be remiss if he/she didn't at least consider whether whatever symptoms we present with could be a heart attack. 

I have learned not to wait for any doctor to give me a referral. When it's clear to me that somthing is wrong, and their treatment is ineffective, I don't waste time hoping they'll send me to a specialist. I ask for a referral.

Dr change

by islandgirl - 2020-08-02 16:43:15

Maybe you should go to an ortho?  My friend recently went through the same thing....went to an ortho who ordered a CT scan, which showed a disk/cushion problem--bulging disk?  She had PT for about 4 weeks for stretching and core strength with no improvement.  She told me her insurance requires PT.   She was sent to a spine specialist.  She had surgery with immediate pain relief and a 1" incision.  I took her to the hospital and we were driving back home in 4 hours from when I dropped her off.  He should have directed you to PT and a CT scan.....  just my opinion.  It sounds like your EP would clear you for surgery.  


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