Unsure of my dad's doctor...

[SweetLikeSugar]

I'm going to start out by saying that I'm not asking for medical advice, I just need some opinions here.

My parents have been seeing the same PCP for about 15-20 years now and they really like him but I am starting to wonder if this doctor is kind of blowing off something that could be more serious. My dad recently had an x-ray for lower back pain and the radiologist saw an "abnormal widening of his aorta." That was then followed up with a sonogram and his PCP called him back and said that the radiologist was wrong and that there is "nothing to worry about." He did confirm that there is a widening of his aorta but it doesn't require a follow-up of any type. My dad is beyond giddy with this result as he hates to go to doctors.

About 5 years ago, my dad had some episodes of angina over a few weeks and saw his PCP for it. He requested a consult to a cardiologist but his PCP refused to refer him to one. My dad then asked him if he could have a stress test done and still the doctor refused. My parents ended up finding a cardiologist anyway and he sent my dad for a stress test and a few other tests which showed that my dad had had a prior MI. I suggested that they run, not walk, away from this PCP. And with this latest episode, I'm extremely frustrated with this PCP. My parents are very reluctant to leave him because "he'll just call in whatever prescription we want without even seeing us in the office...it's so convenient!" I don't know if I'm overreacting because it's my dad, but it's MY DAD!!

I'm not quite sure what I'm trying to get at with this post, I just needed to vent my frustrations to some other nurses!! Thanks for listening!

[FLArn]

Your father is a grown person and is responsible for his own choices, if you have already voiced your concerns regarding his MD then you have done all you can do. Unless you question your father's competence to make decisions---but that opens a whole new can of worms!

[rkitty198, BSN, RN]

I am not entirely sure if it is due to reimbursement, but I have been noticing that MD's are not getting consults either!

Cancer patient with HR in the 160's for weeks and the Oncologist never even consulted a Cardiologist, or a Neurologist after having seizures.

[netglow, ASN, RN]

Yup. Stubborn parents. They never know the stress they cause their kids.

I have stubborn elderly parents as well. Remember, you can suggest, teach, etc. but if AOx3 they can just get as sick as they please. Problem with that is they forget the burden they become once they do. Especially the 70-80 yr olds still of past thoughts. My parents believe that whatever happens, there will always be a cure, always be great pain relief, and that they will always be able to come back home to live should they get sick or injured.

Nothing could be further from the truth. So, I am frank about this, which is painful for me as it sometimes seems to insult, and also there's the risk that they will also hide stuff from me. I have thought long and hard, and strange as it may seem, if my father falls off the roof (yes, he likes to clean his gutters) he will fall into the ranks of all those other old guys who have a tragic end that their RN children cannot prevent.

[Horseshoe, BSN, RN]

Yup. Stubborn parents. They never know the stress they cause their kids.

As the mother of two teenagers I would like to add "and vice versa" to your post.

To the OP: If this were my Dad, I'd get a second opinion if I had to pay for it myself. That's the only way I could have peace of mind about this given his past MI and the PCP's failure to pick up on it or even investigate his disturbing symptoms.

[ktwlpn, LPN]

Remember,too that you really have no way of knowing exactly what has transpired in the doctor's office.You only know what your parents are telling you. A similar situation happened with my mother-she was minimizing some of her symptoms and not reporting others to our PCP.She died of cancer within 18 months and for years I felt guilty for "missing it" Until some pointed out the above to me. That generation is notorious for under-reporting pain and blindly following doctor's ordes without question....

[Frozen08]

It would also be wise to keep in mind that most PCP are well trained to treat and diagnose most of these issues without needing "specialists". Stable angina? Why involve the cardiologist or do a stress test if fits the clinical picture perfect, simply advise patient and put them on ASA and nitro. AAAs do not usually require treatment until they get particularly large, the risk of treatment far out ways the benefit depending on the size of the aneurysm. A watch and wait plan is often used until the aneurysm gets to an operative size...

All that said; a good second opinion is never a bad idea.