Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
KevinMD
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
  • 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
KevinMD
  • 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
  • About KevinMD | Kevin Pho, MD
  • Be heard on social media’s leading physician voice
  • Contact Kevin
  • Discounted enhanced author page
  • DMCA Policy
  • Establishing, Managing, and Protecting Your Online Reputation: A Social Media Guide for Physicians and Medical Practices
  • Group vs. individual disability insurance for doctors: pros and cons
  • KevinMD influencer opportunities
  • Opinion and commentary by KevinMD
  • Physician burnout speakers to keynote your conference
  • Physician Coaching by KevinMD
  • Physician keynote speaker: Kevin Pho, MD
  • Physician Speaking by KevinMD: a boutique speakers bureau
  • Primary care physician in Nashua, NH | Kevin Pho, MD
  • Privacy Policy
  • Recommended services by KevinMD
  • Terms of Use Agreement
  • Thank you for subscribing to KevinMD
  • Thank you for upgrading to the KevinMD enhanced author page
  • The biggest mistake doctors make when purchasing disability insurance
  • The doctor’s guide to disability insurance: short-term vs. long-term
  • The KevinMD ToolKit
  • Upgrade to the KevinMD enhanced author page
  • Why own-occupation disability insurance is a must for doctors

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

< 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

  • Symptoms with normal labs deserve a better question

    Shiv K. Goel, MD
  • International medical graduates need real protections

    Vasilii Khammad, MD, PhD
  • Point-of-care ultrasound transforms emergency medicine

    Joshua Guttman, MD
  • Health outcomes rely on more than just health care

    Jalene Jacob, MD, MBA
  • Doctors with mental illness need our care, not silence

    Michael F. Myers, MD
  • Primary care access is the real problem, not the system

    Payam Zamani, MD
  • Most Popular

  • Past Week

    • Expanding the SOAP framework boosts health outcomes

      Deepak Gupta, MD and Sarwan Kumar, MD | Physician
    • The handwashing standard nobody finished. Until now.

      Bernadette Burroughs, RN | Conditions
    • Your doctor saved your life but won’t return your call [PODCAST]

      The Podcast by KevinMD | Podcast
    • Primary care access is the real problem, not the system

      Payam Zamani, MD | Physician
    • How corporate medicine is eroding truth and patient dignity

      Ronald L. Lindsay, MD | Physician
    • Why bipolar II is not just a milder version of bipolar I

      Ethan Evans, MD | Conditions
  • Past 6 Months

    • I Googled my own name and a corporate clinic I’ve never worked at appeared [PODCAST]

      The Podcast by KevinMD | Podcast
    • How corporate health care ruined the medical profession

      Edmond Cabbabe, MD | Physician
    • Clinicians are failing at value-based care because no one taught them the system [PODCAST]

      The Podcast by KevinMD | Podcast
    • A humorous parody of medical specialties and the modern patient

      Sidney J. Winawer, MD | Physician
    • 13.1 reasons running a half marathon beats practicing medicine

      John Wei, MD | Physician
    • Medicare practice expense cuts will hurt patients

      John Birkmeyer, MD | Policy
  • Recent Posts

    • One silly mistake can sabotage your medical career before it starts [PODCAST]

      The Podcast by KevinMD | Podcast
    • Symptoms with normal labs deserve a better question

      Shiv K. Goel, MD | Physician
    • Can clonal hematopoiesis improve blood cancer screening?

      Jason Liebowitz, MD | Conditions
    • International medical graduates need real protections

      Vasilii Khammad, MD, PhD | Physician
    • Why psychiatric medications often fail autistic patients

      Carrie Friedman, NP | Conditions
    • Missed claims filing deadlines threaten patient care

      Assinatha Mukantaganzwa | Finance

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

    • Expanding the SOAP framework boosts health outcomes

      Deepak Gupta, MD and Sarwan Kumar, MD | Physician
    • The handwashing standard nobody finished. Until now.

      Bernadette Burroughs, RN | Conditions
    • Your doctor saved your life but won’t return your call [PODCAST]

      The Podcast by KevinMD | Podcast
    • Primary care access is the real problem, not the system

      Payam Zamani, MD | Physician
    • How corporate medicine is eroding truth and patient dignity

      Ronald L. Lindsay, MD | Physician
    • Why bipolar II is not just a milder version of bipolar I

      Ethan Evans, MD | Conditions
  • Past 6 Months

    • I Googled my own name and a corporate clinic I’ve never worked at appeared [PODCAST]

      The Podcast by KevinMD | Podcast
    • How corporate health care ruined the medical profession

      Edmond Cabbabe, MD | Physician
    • Clinicians are failing at value-based care because no one taught them the system [PODCAST]

      The Podcast by KevinMD | Podcast
    • A humorous parody of medical specialties and the modern patient

      Sidney J. Winawer, MD | Physician
    • 13.1 reasons running a half marathon beats practicing medicine

      John Wei, MD | Physician
    • Medicare practice expense cuts will hurt patients

      John Birkmeyer, MD | Policy
  • Recent Posts

    • One silly mistake can sabotage your medical career before it starts [PODCAST]

      The Podcast by KevinMD | Podcast
    • Symptoms with normal labs deserve a better question

      Shiv K. Goel, MD | Physician
    • Can clonal hematopoiesis improve blood cancer screening?

      Jason Liebowitz, MD | Conditions
    • International medical graduates need real protections

      Vasilii Khammad, MD, PhD | Physician
    • Why psychiatric medications often fail autistic patients

      Carrie Friedman, NP | Conditions
    • Missed claims filing deadlines threaten patient care

      Assinatha Mukantaganzwa | Finance

MedPage Today Professional

An Everyday Health Property Medpage Today

Copyright © 2026 KevinMD.com | Powered by Astra WordPress Theme

  • 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...