My new patient leaned back in the exam room chair and fixed his eyes on me.
“I don’t need a doctor to tell me that I need a bunch of tests or medications. I know that if I lost weight and ate better I might live longer.” He paused as if to measure my reaction before continuing:
“I know my heart isn’t in good shape. All I’m looking for is a doctor who will give me my fluid pills and treat me if I have a cold or get cellulitis or something that’s fixable. Can you do that for me?”
“Sure”, I nodded.
“You know, the last few doctors I had all wanted to run my life and tell me what to do, but it’s my body and I don’t want to take a bunch of statins and things that don’t help me feel better now.”
“So you didn’t stay with them…” I began. He was talking faster now, and interrupted me:
“One even fired me because I refused to do what he told me! And I fired the next one before he had a chance to do the same thing. I could just see where that one was headed!”
His face was getting red and he shifted in his chair.
“Well,” I began, “I never tell anybody what to do.”
He raised his eyebrows. I continued:
“My job is to give you options and help you find ones that work for you. There’s no law that says people have to take cholesterol pills or go for colonoscopies. You don’t have to change the oil in your car every 3,000 miles unless you want to, right?”
“If you never change the oil, your warranty might be void, but your car may work just fine anyway.”
He nodded. “I get ‘ya.”
“Here’s what I would ask of you if you keep me as your doctor: If I prescribe your fluid pills, I would want to see you and get some basic blood work maybe twice a year to make sure the pills I give you don’t cause any problems with your potassium or kidney function.”
“That sounds reasonable”, he said, sounding relieved.
“Other than that”, I continued, “you see me if you need me.”
“It’s a deal!” He shook my hand.
He hesitated for a moment.
“About this colonoscopy thing. I had a prostate exam by a specialist a couple of years ago, and he said I didn’t need a scope…”
“Urologists do a different kind of scope. They do cystoscopies to look inside the bladder. That’s probably what he was referring to and not a colonoscopy.”
“Yes. Didn’t someone in your family have colon cancer?”
“My brother did. He’s got a bag now. He’s five years older than me.”
“Hmm, you might want to get checked then. Your risk is increased because of that.”
“Yeah, maybe I should. Would you do it in my situation?”
“I would and I did. It’s in my family history, too, so I had one a few years ago.”
He thought for a moment.
“Okay, Doc, set me up!”
“Sure. We’ll set you up with the gastroenterology group at Cityside.”
“Thanks. I’ll see you in six months.” He shook my hand again and added:
“Unless I get sick and need you sooner!”