Had a new patient in today for and emergency exam. She wanted treatment, but her blood pressure was ballistic- 185/112 the first reading. My diastolic cutoff for surgery is 100.
I asked her if she had a physical exam recently. “Every year for the last 4 years,” she claimed.
“And what were your blood pressures at those visits,” I asked her.
“I don’t know. They have all been Telehealth visits and they do not take my blood pressure.”
There you have it. The patient has “physical exams” every year, her blood pressure is in stroke territory, and nobody knows it so nobody medicates it.
Neither can anyone listen to her lungs when breathing either. They cannot look really get a good look at her nail beds and get an idea of oxygenation.
But I guess they order some blood tests and see some blood chemistry and cells counts.
Insurance companies are such sleaze pushing patients to get the jokes of exams. Both my wife and I have been repeatedly goaded to have Telehealth exam to save the company money, and we both refused.
There are many places in my 80% liberal county that required masks even in 2024. Telehealth is not good medicine. No wonder we have so much antibiotic resistance.
I recently had a bad experience at a GI in July because of their failure to maintain their HVAC. As soon as I left, I was fine but while I was there, I had a coughing fit and really bad sialorrhea so a mask was completely useless. It was humiliating.
I’m doing well with my new GI and while I was nervous about the prep for the colonoscopy (family history and pelvic issues), I found out my former boss used them (and maybe my current boss too). My current boss was like don’t even eat 1/2 a cracker or they’ll cancel. I’m like thanks for the tip but darn, I was stuck with an afternoon procedure so it’s 36 hours for me instead of 30
The more this system evolves, the more I detest and despise the insurance monster.
I’m sure you have much more elaborate and detailed observations from the front lines, but to the best of my understanding, there is too much reliance on insurance overall for routine clinic visits and discretionary treatment, as well as government regulation strangling competition resulting in oligopolized cartels.
That’s a terrible combination…a needy consumer base (involving pretty much everybody) and a limited set of providers.
Same, my wife got a bug bite in the garden last summer and needed antibiotics, she did her follow up online. Easy peasy, but it wasn’t a major medical condition. IMO everyone should have an in office check up every year, I can’t see how it can be done remotely.
A physical can’t. We weight you, measure you, etc. Now I have heard of one company trying to do it remotely by providing a Blood pressure cuff, etc. but that is just a tech company trying to make it big with the next big thing.
My home BP device consistently measures about 5-6% higher than when I let a medical professional do it. Happened again yesterday. So, if it tells me I’m in the range, I am OK.
Funny thing is not many docs use old-fashioned mercury column sphygmomanometers anymore. At my last medical visit, the medical assistant used virtually the same Omron machine I have at home.
We have measured the BP different ways and the difference between methods is hardly worth a thought- except for wrist machines are not so repeatable. The biggest source of inaccuracy is cuffs not sized right for the arm, not the machine itself.