You Sure About That, Doc?

So don't believe what the doctors say,

They're just making things up so they can get paid,

It's not me they're talking about, anyway,

So don't believe what the doctors say.



-Dave Alvin, "The Man In The Bed"

I miss my old doctor.

Don't get me wrong, I like my new one too. But my old one, who retired a couple of years back, had the same twisted sense of humor as me. I could say, "Doc, it hurts when I do this," and he would come back instantly with, "Well, don't do that." I also liked having a doctor who was, shall we say, able to cast some shade. I suspect it made it harder for him to chastise me about my own weight. My new one disappears if he turns sideways and looks like he could run a marathon tomorrow, without training. And he does get after me for my pudge. Grrr.

At the end of last month I had a physical--necessary for me to accompany the boys to Philmont this summer. In the course of it I had the expected lectures about needing to lose weight and get into shape to be able to withstand the rigors of the New Mexico mountains. He also ordered blood tests, and explained to me that there was a change in procedures these days for treating hypertension and cholesterol in men. He explained that now, they would take into account my vital signs, my blood test results, my family history, etc., etc., and issue a "cardiovascular score." Apparently I wanted to earn a 4% or less--which would mean, he explained, that if we took 25 men of my exact same age, condition, history, and etc.s, then over the next decade, one out of the 25 of us would have some sort of "cardiovascular event." Given the level of nagging, I thought he expected me in double digits.

This week I got my results. Apparently my cardiovascular score is a 2.1%.

I had to laugh out loud, which caused me nearly to choke on the Oreos I was scarfing while on the couch watching mindless TV and definitely not exercising.

You sure you got the right guy, Doc? I mean, I'm 22 years away from the age when my dad was found to need multiple coronary bypasses and died as a result of the surgery. I know I'm not as fluffy as Gabriel Iglesias, but I take more after him than not--I know I'm back up to just shy of the weight I was at in 2006 when I said Enough. My diet is hardly ideal, I'm sure, and as for exercise, well, I'm most fond of pushing paper. I do the Philmont workup hikes, I've even been spotted in the gym downstairs at work this year a handful of times. But at 2.1 rating? Color me skeptical.

In looking through the blood test results, I see my cholesterol is still well within the good range. I remember my first cholesterol test years ago; the number came back so low Mary and I promptly went out for a steak dinner.

I don't think, though, that steak dinners are called for this time. Maybe it's that first statistic--that I'm 2/3 of the way to the age my dad died--that brings a little more circumspection to the process. I have every expectation that Philmont will wring a couple of pounds off my frame. And I know I ought to do better. So I don't find myself celebrating the 2.1 score. It's more of a "yeah, sure, whatever," and back to the difficult work of slowly becoming middle-aged.

Is There A Doctor In The…Neighborhood?

I have to find a new GP…and I really don't want to wade into that swamp.

My doctor for the last twenty years has "retired"--I put it in quotes because he has stepped out of the practice and has opened a boutique concierge-care service for those (not me) with plenty of disposable income.  I loved seeing him: once, when I began having trouble with my knee, I led with the classic, "Doc, it hurts when I do this." "Well, don't do that," he knew to reply. I also enjoyed having a doctor whose body-mass index was roughly mine, as it tended to cut down on the "you really need to lose weight" commentary.

His former practice remains, and in fact for a couple of things here and there I've been in to see the nurse practitioners.  But I need a new doctor, and I don't really have an attachment to anyone else at that old practice--which has become more difficult to drive to since we moved here in 2004.  It's gotten really old to have to drive at least half an hour to see the practice--and that's non-rush-hour traffic.  Surely there has to be someone much closer by who can be what I need.

I've begun the process, as it seems one does these days, by searching online and through my insurance provider, to see who in the area out here by the house actually takes my insurance.  I then began checking other websites: healthgrades.com or WebMD or any of a dozen other places, all in an effort to learn more about the candidates nearby.  But what am I looking for in a doctor?  In many respects I have no idea.  For instance, I seem to have two principal choices in age: either folks who are over 55 (experienced, not much I could throw at them they haven't seen; but, prone to retiring themselves in the next decade or so), or around 30-35 (likely having the freshest training from med school; but do I really want a doctor younger than me? Isn't that what old people have?).  Or, do I take a sexist approach and rule out all the women, regardless of qualifications, so I don't have to discuss prostate health with one as I age?  Do I care about where he went to med school?  Not so much as I do whether he's been disciplined by the state board…all of which is out there now.

And other considerations exist that weren't dreamt of two decades ago when I found my retiree.  How user-friendly is his website? Will he interact via e-mail, or does every question have to be done in person at an appointment (at $20 apiece)?  And how many layers of answering-system hell do I have to endure to make a simple appointment?

It all feels so…commercial, like I'm comparison shopping for a new car.  Or vaguely "gotcha," as if the negative comments posted up about a doctor are truly representative of his service, instead of just being the pissed-off ones who are prone to posting anyway.  Gone are the days, it seems, when everyone knew the doctors in town, which ones were good for which kinds of patients.

I'm left with a sense of dread as I begin this effort.  I hope it won't be as difficult as it appears likely to be.