How many Drs. is enough Drs.?
My dad currently sees 12, no exaggeration 12 DRs. He had frontal lobe radiation for a growing meningioma, radiation killed the meningioma but caused the cognitive issues. He has a Neurologist, neuro oncologist, neuro surgeon, Sleep Medicine neuro, ophthalmologist and neuro ophthalmologist, cardiologist, dermatologist and derma surgeon, audiologist, orthopedic (back issues), dentist, psychiatrist, Geriatric internal medicine not to mention podiatrist (he comes to my dad’s AL and the physical therapist) not to mention CTscans, MRI, sleep test, cardio scan trips for testing, when is enough enough? I work full time, have a family of my own with a husband recovering from a mild stroke and the aging love of my life, my pup, with both #1 and #2 incontinence. the point and the question is do any of you deal with this many DRs? How do you keep track of them all? Do we really need all of them? How do you keep your sanity? Lol
You may also request of MDs who are not doing actual in office exams that they move to virtual visits.
I sure wish you luck.
How old is your Dad? Mom was in her 80s when I started asking for yearly appts. Then when nothing changed, numbers were stable, I stopped taking her. One Dr. allowed tests at six months and agreed she would only come in if there were changes. I don't see why you would need a surgeon one the operation was over and you had a follow up or two. The oncologist, maybe once a year if Dad is cancer free. Why do you need 2 eye doctors.
Am I approaching his care in the wrong way?
Your dad has mine beat for the number of drs. Before dad went on hospice he had his PCP (that dad wanted to see every 2 month - doc and I kept it at every 3), dermatologist/surgeon min of every 6 mos unless more CAs found, neurologist every 3 mos, VA for hearing as needed, eye doc every 3 mos, cardiologist as needed; Orthopedic as needed. Sometimes I met myself coming an going. Most often the AL facility would drop dad off - I'd meet him at dr and take him back until it got to hard to get him in the car. At that point they took and picked up and I met at dr and followed van back to AL most of the time so I could visit mom too.
I was by this time retired - but it was exhausting - because with dad there was usually an appt for dad multiple times a month. The VA was the worst because the AL van didn't go that far and there was parking issues and construction at the VA so I drive to drop off point get him settled in the lobby find a parking spot then walk a mile back to the building find dad go to audiology, get dad's hearing aids adjusted then reverse the process. It probably took an hour for just the process of dropping off, parking, walking, walking, getting car and picking up.
Dad died 2 years ago. And after COVID started I moved mom to the AL dr - so the dr visits have pretty much dried up.
Then of course there was mom's dr visits - however she negotiated her own dental and eye appts.
I wouldn't have accompanied them to the appts but whenever I asked what the dr had to say their responses was I thing the dr said ... . It was easier to go myself to see what the dr actually said.
Is there any other family that can help with the dr visits? You do have your hands full and I wish you all the best.
Right from the get go - why is dad seeing both a Neurologist and a Psychiatrist? My daughter has a psychiatrist, and he has told us that a neurologist can prescribe mental health drugs as well as a psychiatrist can; you might want to check with dad's neurologist to see if he/she can take over the care dad's getting from his psychiatrist. It seems to me that your dad is being referred to a lot more doctors than he really needs, as well as getting a lot of unnecessary tests.
How old is dad? What is the prognosis for him after the cancer? These are all things to take into consideration when deciding how much medical intervention to proceed with. This might be where you want to find a geriatric doctor with a case manager on staff. This might also be a time when you ask the various doctors, point blank "what good is this test/treatment/etc. going to do for my dad and his conditions?" If you're starting to get answers from different people that seem to put dad's care at cross-purposes, like I did with mom, then consider which of dad's illnesses are the most debilitating and maybe choose to concentrate on those.
See, here's my concern for you. You have your dad and all of his doctor appointments; your husband, recovering from a stroke and all of those subsequent doctor appointments, and a sick pet, whom I am sure is also being shuttled back and forth to the vet. So when was the last time YOU went to the doctor for a check up? Dentist? Because when I was in your shoes, the very last thing I wanted to do was to sit in yet ANOTHER doctor's office for my own appointments. I had to make a firm promise to myself to NOT neglect my own health; and many were the times I had to mentally give myself a kick in the backside to make me keep my promise to myself.
Cutting back on the unnecessary doctors and tests is NOT elder abuse. Really, try and find a PCP for dad that will work WITH you on eliminating some of the unnecessary appointments, for your own sake.
Good luck.
I think you and your dad should read it.
You have 17 doctors? How can you manage all of them without a medical secretary?
I can't even imagine what your life is like, my friend.
I've got a headache just thinking about your 17 doctors.
Maybe my mother can lend me one of her specialists to help my headache LOL.
No, you are not approaching his care the wrong way. In the beginning of Moms care I went along with everything. As time went on I started to question. Why was she going to her PCP every two months when there was nothing wrong with her. She was on B/P and Cholesterol meds only. State only requires every 6 months for prescription renewals. When I took her the Nurse ask me why I was back. Told her I had no idea but if he says "so why are we here" She won't be back unless we need a refill or she is sick. He asked and no more every two months. One Dr was a recommendation because of a thickening of her stomach. He felt it was caused by her Gerd so saw him every 6 months with mo change. So we went to a year. Once her Thyroid numbers were normal, went to a year with labs in 6 months. Both times I asked if we could make it a year. I went 3 years without seeing any of my doctors. Dentist I worked in. I stopped Moms urologist because she had been Cancer free for five years and at 85 he still wanted to do a scope. She was in the early stages of Dementia so I would never have put her thru an operation.
Just listed all ur Dads doctors. As said, don't see where a neurologist and Psychiatrist are both needed. If its for his cognitive problems, a neurologist is all you need. Also Sleep Med neuro, why can't the neurologist take care of this.
Surgeons - once the operation or procedure is done and there is a follow up why do you need to take him back. Once he is off Chemo, why the need for an oncologist?
Ophthalmologist/ Ophthalmologist neuro. I understand why the need but the Ophalmologist can't see a any differences then send Dad to a neuro if needed.
Just rambling here but do you see what I am trying to say. You may have too many hands in the pot. If ur not happy with the new doctor, look for another. My Moms doctor was not a generic doctor but the people my Moms age loved him. He was very good with them. I found him easy to work with when questioning why Mom was on certain meds still after the problem was resolved. Thats another story. Hospitals and how they don't work with the patients PCP when they don't have Privledges at that Hospital.
Curious, did u call his former Drs office and ask why they dropped him as a patient? Why would the AL be sending his Dr. test results? Was Dad using an "in house" Dr?
When she moved to Independent Living, there was an on-site geriatrics doc.
He sent her to a geriatric psychiatrist (also on-site) and they were able to get her anxiety under control.
Suddendly, her BP was no longer such a big problem and we ended the endless cycle of anxiety-fueled visits to her PCP, referral to a specialist and more meds.
She continued to see her dentist (which the IL place could get her to) and I took her to occasional opthamology appointments.
We finally got him down to seeing his VA Primary and his regular Primary - they are the ones that handle all of his medications (now THAT list....goodness!), his eye doctor, his cardiologist (this one is down to annually now), his podiatrist (diabetic and they have to do his toes and check his feet), dermatologist, and urologist. Now by my count that is 7...but in the last 6 months he has had 13 doctors appointments and that is us "controlling" it, so yeah...thankfully, he only has those 7 now. If he had his way he would go to to the doctor every day. He LOVES it. He LOVES going to the hospital too. He will ask to go to the ER for a cold. He was offended a few years ago when they wouldn't admit him when he went to the ER with cold symptoms. We had to practically sit on him during the worst of COVID in our area because we knew it wouldn't be the same experience he was used to and part of the reason he enjoys it so much is that he enjoys the attention he gets while in the hospital. We explained that if he went into the hospital during COVID and really didn't need to be there, he would be going in alone first of all, and that we wouldn't be allowed in at all for the duration. And that the nurses that normally gave him so much attention barely had time to breathe, were understaffed, were praying they didn't get sick themselves, didn't have time for his usual brand of humor that calls them into his room 10 times a day just to chat and that he was exposing himself to something that could potentially kill him for no reason whatsoever. So miraculously he stayed home and we didn't have a single health crisis or hospital visit the entire time. We are making this stretch as long as possible. That is not to say that if he had a true medical emergency that we wouldn't rush him to medical care right away. But he absolutely craves medical attention like nothing I have ever seen, it's like an addiction for him. And we had to find some way to curtail it.
The sheer number of medications he is taking, and the fact that they actually counteract each other boggles the mind. The side effects of the list combined! And the fact that the doctors don't interact and even the pharmacies that he uses aren't tied together. (VA vs retail vs mail order) At last count I think he is on 30+ medications. He actually asked him primary for another medication one day and his primary said "We are trying to get you on LESS medication not more!!" If he could take a pill for it, he is on board!
It is scary how easily docs Rx stuff, then another to counteract side effects, and so on. Many don't even take the time to consider what else the person is taking. There was a woman where I worked who was younger than me and she was already on 7 medications! Who knows how many she's up to now.
My mother had multiple Rxes as well, but unrelated (vaginal cream, BP meds, cholesterol, calcium, and who knows how many other?) At some point she just stopped taking/using them, except for the BP meds. No consult with anyone, she just stopped. I didn't argue with it. She also didn't keel over or have any medical issues after stopping them. Do beware, some medications might require weaning off rather than just stopping them.
Personally my plan is to avoid whatever I can. First time cholesterol showed up high (5 years since previous doc exam, records went to storage, so no way to compare), immediate reaction was to suggest meds. Nope. It took me some time to work it out (all the info they had at the time was useless - eggs, bacon, sweets, etc.) but between dietary change (eliminate processed foods mainly) and joining the new gym at work (treadmill only), it resolved itself. They start the osteoporosis testing way too soon for most and when they told me to take Fosamax, I checked it out and said no way will that EVER cross my lips. Recent test, new doc also tried, but I said no. I managed to get the previous 2 test results from the previous provider and the newer results are actually better! I do take Vit D3, but no Rx, just OTC.
Thankfully I have no real medical issues, so I never took any regular meds and still don't take any. Suits me FINE! The longer I can avoid them, the better!
If you can't go to a local pharmacy, you can try discussing all the medications with one on the phone (VA?) Of course many were Rxed there, so they may balk at eliminated anything. It would probably be better to consult with a disinterested 3rd party (have all Dx along with all Rx.)
Another option is to talk to each of his doctors about his prognosis for the problem each is treating. Try to talk about ceasing care with those where the prognosis is poor. Also, try get as many of his appointments lined up on the same day.
You are correct is realizing you only have so many hours in the day to work, take care of others, and take care of yourself. May I suggest that you need more help. If your father is amenable to living in a fulltime skilled nursing facility, the staff will make sure he gets to his appointments and you can ask for copies of all the doctors' notes.
As I noted in another comment, my mother stopped taking/using some of the stuff she had been prescribed, and it didn't impact her at all. Once I had to step in (just over 90, dementia) and coordinate/manage everything, we were down to PCP, dentist and Mac Deg specialist. PCPs did try to recommend 6 month visits, but generally that was 1 year - we did have to maintain that to get Rx for BP meds. Mac Deg was 4x/year for recheck and treatment (those were long between my drive to get her there and the whole process took 1.5-2 hr.) Dentist was 6 months, but after move to MC, we only managed one visit. The next one I requested YB to take her as I couldn't support her weight anymore - he arrived too late and on top of a $50 no show charge, they told me next appt was a YEAR away.
Honestly, depending on the person's age and what is being "treated", a lot of appts and medications are overkill. Of course we want what's best, but sometimes less is more...
OMG! Please if you know the answer to how many doctor's is enough, I'm begging you to let me know it.
My mother's collection is so far at nine different doctors (she hasn't caught up to your father yet). This month we're celebrating the addition of doctor number TEN. Totally unnecessary of course.
I hate to say so, but it seems to me like the doctor collections are a kind of social calendar for the elderly. It is with my mother. She has some health issues and at almost 84 that's to be expected. However, she believe nothing they tell her if their diagnosis doesn't match what she thinks she has. She also refuses to follow any of their recommendations or care plans. God help us all.
And depending on your problems, you'll have a Dr for each one.
So, no in your Dad's case he's seeing a lot if Dr's because he's got a lot of problems.
You can't see a foot Dr if you have a tooth problem 😊
My mother is 89, I am her POA, and she also has 12 DRs. Not to mention 13 meds. She has Kaiser Ins., so the vast majority of her appointments, and her pharmacy are in one, of two locations. Where we live, the two Kaiser facilities are less than 1 mile from each other, so this usually helps. She has so many appointments, with so many doctors that I went to the wrong campus on several occasions. So, I now have a file on my computer with all her doctors listed as follows:
I did a Table (Microsoft word) with 5 columns.
Merged the top line, centered and bold with the
Name of the building, address and phone number
Below that the five columns are labeled as follows:
Specialty, Doctor, Phone (some have their own number), 1st year seen and the 5th I left blank for any short notes.
I made one for both locations
I have another Table with other care givers and the Pharmacy number.
It all fits on 1 sheet of paper and I keep it updated with a hard copy in the folder I take to every visit.
In addition, I did the same thing with all her diagnoses (oh, so many.), and medications. Including the supplements and medications she has discontinued and why.
Now, when she has an appointment and they ask me questions, I have the answers right there.
Being responsible for another person can be overwhelming for anyone.
I hope things improve for you and your loved one.
Hang in there, you can do this.
It can seem excessive even for people who are a bit younger and have fewer issues.
The specialized knowledge might be beneficial as long as there are not conflicting therapies or medications among the various treatments. Each doctor should have access to all medications and treatments their patient is getting elsewhere but I don't know how carefully all doctors pay attention or consider contraindications.
At age 72, I have 2 cardiologists, 2 primary care, 2 Rhuematologists, 1 orthopedic surgeon, 2 ENT 's, 1 cardiac surgeon, 1 dermatologist, 1 opthamologist, 1 dentist, 2 podiatrists. I have double of some, because we split our residency. It's often difficult to keep track of blood work and tests, between doctors.
My only other advise is to ask the purpose and necessity of some tests recommended for your dad.
I also keep a notebook for some of my tests to share with other doctors.
Best wishes.
I also have file folders similarly arranged—this is where I put EOBs—explanation of benefits, discharge notes, letters from Social Security, etc. Again, prioritize the files so the more frequently seen doctor files are more easily accessible. I live 1500 miles from my brother and I couldn’t do anything without this. The smaller size lets me put it in a tote bag easily if I need to. I generally take it on the road with me when I have errands. I never know who’s going to call.
Yes, some people have 10, 15, 20 doctors, because many conditions have cross-over affects. The goal is to have a triage list of them: which doctors MUST be kept in the loop at all times, and which ones are "one and done"?
There should be a GP, the main neurologist (who coordinates or at least is aware of the others), psychiatrist, and dentist. But you should not be his Uber - if he has no one else to go with him to appointments, look into a senior transportation service in his town or literally use Uber or Lyft. If he is too impaired, then you start getting into other questions - does he live alone? Does he needs 24/7 care?
Some of the other responses are unrealistic - yes, maybe he should be followed up less frequently by some of them, but the goal is to have him at home and get the same care as if he was in the hospital and the specialists would visit him. Except much cheaper.
The transportation is the key issue, and the time it takes. Look into getting help specifically for that - a teenaged niece or nephew could drive him to appointments?