Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Here’s an example of bad primary care

Richard Young, MD
Physician
February 11, 2015
Share
Tweet
Share

As much as I have given the “ologists” and other members of the dysfunctional U.S. health care system a hard time in previous posts, it’s only fair that I call out bad family medicine as well. I have a great example.

I recently saw patient who is relatively new to the area who had seen another family physician in my community. He is 39-year-old male, and his only significant potential health problem is borderline hypertension.

When he came to see me, he brought a bag full of about six medicines and was scared because he was told that he had a whole host of medical problems. Best I can tell, there were some insurance issues that caused him to seek care at my facility: private doctors not taking one of the low-pay exchange plans I suspect. He had saved a copy of the paperwork he received from the previous family physician, which included a “complete set of blood work.”

It would take too long to write out all that he was subjected to, so I’ll give you the main categories of blood tests. They included panels (meaning more than one test per panel) of labs for cardiac dysfunction, cardio-metabolic markers, lipids, lipoprotein particles and apolipoproteins, inflammation oxidation markers, myocardial stress/function, platelet function, lipoprotein genetics, platelet genetics, coagulation genetics, other metabolic functions, renal, sterol absorption markers, sterol synthesis markers, glycemic control (more than an A1c), insulin resistance, beta cell function, electrolytes, liver functions, male and female hormones, thyroid function (8 tests in that panel), urinalysis, CBC with differential, PSA, omega-3 fatty acids, omega-6 fatty acids, other fatty acids, and a few more that are harder to categorize.

The patient’s TSH was perfectly normal, but this doctor had prescribed levothyroxine. His cholesterol was 203, LDL 133 and HDL 54, but she put him on a statin. His blood pressure, best I can tell, was never measured higher than the low 150s, but he was prescribed three blood pressure medicines. His pressure was way on the low side of the normal range when measured at my clinic. He also brought a list of stuff from the grocery store he was supposed to take every day such as so many teaspoons of cinnamon, cloves, and some other plants and spices.

What an incredible waste. This poor guy was exposed to financial harm, psychological harm, and completely unnecessary medications. I made my best guess about the minimal regimen he would require to keep him in good stead for the next few years (one blood pressure medicine). I have not seen him back yet for follow-up.

I wish there were some mechanism to report this heinous care that did not involve the state medical board. This lousy care is just as bad as when a cardiologist performed an unnecessary stent or an orthopedist does an unnecessary joint replacement.

At least I have a glimmer of hope that this kind of behavior could be captured using billing data. As the pundits talk about quality of care and metrics, reforming this kind of outlier poor performance would be much more meaningful to our country’s future than the meaningless use criteria being foisted on us now.

Richard Young is a family physician who blogs at American Health Scare.

Prev

How should a medical society support its physicians? Like this.

February 11, 2015 Kevin 5
…
Next

Don't give life to the killers of yesteryear

February 11, 2015 Kevin 3
…

Tagged as: Cardiology, Endocrinology, Primary Care

Post navigation

< Previous Post
How should a medical society support its physicians? Like this.
Next Post >
Don't give life to the killers of yesteryear

ADVERTISEMENT

More by Richard Young, MD

  • When medical protocol meets family concerns

    Richard Young, MD
  • Patients in Sweden received fewer post-op opioids. Why is that?

    Richard Young, MD
  • Medicine is too complex for computers to keep up with or understand

    Richard Young, MD

More in Physician

  • How shared language saved a patient from isolation

    Syed Ahmad Moosa, MD
  • The shocking risk every smart student faces when applying to medical school

    Curtis G. Graham, MD
  • The physician who turned burnout into a mission for change

    Jessie Mahoney, MD
  • Time theft: the unseen harm of abusive oversight

    Kayvan Haddadan, MD
  • Why more doctors are leaving clinical practice and how it helps health care

    Arlen Meyers, MD, MBA
  • Harassment and overreach are driving physicians to quit

    Olumuyiwa Bamgbade, MD
  • Most Popular

  • Past Week

    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why specialist pain clinics and addiction treatment services require strong primary care

      Olumuyiwa Bamgbade, MD | Conditions
    • Harassment and overreach are driving physicians to quit

      Olumuyiwa Bamgbade, MD | Physician
    • Why peer support can save lives in high-pressure medical careers

      Maire Daugharty, MD | Conditions
    • When a medical office sublease turns into a legal nightmare

      Ralph Messo, DO | Physician
    • Addressing menstrual health inequities in adolescents

      Callia Georgoulis | Conditions
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
  • Recent Posts

    • How shared language saved a patient from isolation

      Syed Ahmad Moosa, MD | Physician
    • The shocking risk every smart student faces when applying to medical school

      Curtis G. Graham, MD | Physician
    • Clinical ghosts and why they haunt our exam rooms

      Kara Wada, MD | Conditions
    • High blood pressure’s hidden impact on kidney health in older adults

      Edmond Kubi Appiah, MPH | Conditions
    • Deep transcranial magnetic stimulation for depression [PODCAST]

      The Podcast by KevinMD | Podcast
    • How declining MMR vaccination rates put future generations at risk

      Ambika Sharma, Onyi Oligbo, and Katrina Green, MD | Conditions

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 34 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why specialist pain clinics and addiction treatment services require strong primary care

      Olumuyiwa Bamgbade, MD | Conditions
    • Harassment and overreach are driving physicians to quit

      Olumuyiwa Bamgbade, MD | Physician
    • Why peer support can save lives in high-pressure medical careers

      Maire Daugharty, MD | Conditions
    • When a medical office sublease turns into a legal nightmare

      Ralph Messo, DO | Physician
    • Addressing menstrual health inequities in adolescents

      Callia Georgoulis | Conditions
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
  • Recent Posts

    • How shared language saved a patient from isolation

      Syed Ahmad Moosa, MD | Physician
    • The shocking risk every smart student faces when applying to medical school

      Curtis G. Graham, MD | Physician
    • Clinical ghosts and why they haunt our exam rooms

      Kara Wada, MD | Conditions
    • High blood pressure’s hidden impact on kidney health in older adults

      Edmond Kubi Appiah, MPH | Conditions
    • Deep transcranial magnetic stimulation for depression [PODCAST]

      The Podcast by KevinMD | Podcast
    • How declining MMR vaccination rates put future generations at risk

      Ambika Sharma, Onyi Oligbo, and Katrina Green, MD | Conditions

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Here’s an example of bad primary care
34 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...