Doctors! What Are They Thinking?

Doctors don't seem to have the sense God gave a goose.

I am benefiting greatly from medical science thanks to having finally arrived at Medicare.  (And Medicare is a whole other *good* topic!)  Yet I cannot figure out some of my doctors' reasoning.  Even if I specifically ask for something I need, my wishes may as well be fishes.

I have a PA-C for my PCP (Primary Care Provider).  She has boundless common sense, listens to my wishes and actually does what I ask (unless it would be bad for me in which case she explains).  Need a referral to a specialist within bicycling distance?  No problem. Our neighborhood is full of all kind of specialists.  Want 90 day prescriptions?  No problem!

My previous MD doc's office interpreted 90 days as some drugs 30 days, some others 60 days and..oh yeah, some 90 days.  I was running to the pharmacy every month even though I'd have much preferred quarterly.  

Now I have a new specialist, a cardiologist, who needs to go in search of a brain.  First visit:  I give him a detailed list of my existing prescriptions.  He glances through it and sees I am on one cholesterol med and one ACE inhibitor-type blood pressure med.  Out loud he tells me he may want me to take a beta blocker-type bp med, but he won't know for sure until after my echo-cardiogram.  Sounds right to me, so I don't give him any static or advice about meds.

The next day, my pharmacy notifies me my two new prescriptions are ready for me.

What????

He had ordered an increased dosage of the ACE inhibitor and the same dosage of my cholesterol med.  No mention of this to me during the appointment at all.  I refused the cholesterol drug and declined to take the bp drug until my other prescription ran out.

I have advised this doc to not order any meds without discussing it with me first.  I won't know until next time whether this went through one ear and out the other or if the advice stuck.  I am not optimistic.  Not pessimistic either.  Just skeptical.

So now we have the echo results and I'm being prescribed the promised beta-blocker.  No problem.  He explains that I have a big aortic root, that the blood vessel that comes out of the heart to supply the rest of my body with oxygenated blood, is 4.0 cm in diameter.  This is, he tells me, the upper limit of normal.  Then he says I should be seen by a heart surgeon for evaluation.  I am skeptical and say so.  If it is the upper limit of normal, isn't that normal or close enough to normal?  He says, he couldn't sleep at night if he doesn't refer this case to a cardiovascular surgeon.  I reluctantly agree to accept an appointment, and remind his staff that I need a referral to a neighborhood doctor.  

A couple of days later I get a call from the office of a cardiovascular surgeon in *Goodyear*.

 What????

I did some simple research through the Arizona board of medical examiners (azmed.gov). I learned that there is a group practice of CV surgeons two floors downstairs from the cardiologist's office, one mile from my house.

Okay.  Call me peeved.

I'm not amused at the notion of CV surgery anyway.  I'll keep you posted.