We are about to change my elderly parents primary physician. A geriatric internist, he is friendly but his follow-up is terrible. Medications that he has prescribed and need his approval for refill languish for weeks, somewhere in limbo, and require multiple calls to get filled. Each of my parents take nearly 20 pills apiece and feels that they are overmedicated. When they have asked him about this, he seems unfamiliar with what he has prescribed for them and states that he will taper them down and then does nothing. They feel that this doctor prescribes pills to mask aches and pains but does little to find the source. However, who is willing to take on new patients in their mid-80’s with numerous ailments, albeit age appropriate?
It is not news that our healthcare system is failing. HMO’s are on the lookout for healthy, profitable patients, according to doctors David Himmelstein and Steffie Woodhandler in “For Patients, Not for Profits”:
Not surprisingly, research shows high satisfaction and good outcomes for healthy HMO members. But even the best HMOs under treat the sick. HMO stroke patients get less rehabilitation and more often end up in nursing homes. Medicare HMO patients are denied needed home care. Depressed patients in HMOs are less likely to be diagnosed, get less treatment, and are more frequently disabled by their illness. Poor, sick patients have a 21% higher risk of dying in HMOs than in fee-for-service care.
How does one go about finding the increasingly rare, caring, responsible doctor willing to treat failing, elderly patients? Your feedback on your experiences would be really appreciated.