I read Joan's blog about the Phy. today and my heart goes out to her. I can fully relate to her frustration through some Doctor apointments of our own.
Paul's Neuro is little help to us but unless we travel 2 hours to a larger town, he is the only choice for us and I think it is important to have a local Neuro in case of Hospitalization. Paul calls him a "Pill Pusher". And this from the patient.is correct, at this point. Originally, he did call for many tests, but after he concluded he had Parkenism/Dementia/Altz. he doesn't check his BP, gait, anything. Paul seldom says anything to the Doctor. Comes in for a couple minutes, asks him how he is doing, looks at his chart, asks if he needs more prescriptions and that's it....twice or once a year. I told our Prim. Phy. how I felt and told him I would like him to monitor his needs so that is how our situation stands. I do take him to a University Hospital once a year and they do a mental update on him and if it weren't the distance involved would use only them and the Primary. I really do appreciate this site and reading about how other spouses deal with similar problems.
Imohr, I know this is going to sound weird, but between your primary and the University Hospital visit wouldn't it be enough? If he needs a local neurologist while hospitalized wouldn't your primary be in a position to call one in?
Frankly, once the diagnosis is in, there really isn't much a neurologist can do for these patients. Someone does need to track them so when services become appropriate they can be called in and so there will be history in case of hospitalization, but frankly you are already doing that.
DH's neuro told us last May when he prescribed Namenda there was really nothig more he could do for him and I could just take him back to his GP to renew the prescriptions. He did say that if anything came up to call him. He also said that if any new meds or treatments became available he would contact me.
I guess there's nothing left to do. Seems like there should be something more but I don't know what it would be.
It seems as though we get meds from many sources here. I think it depends on the level of comfort and/or expertise of the individual doctor; the size and type of practice, etc. The neurologist we have seen most recently will not see patients who haven't gone thru the testing stages (blood, MRI, etc.)., and we see a primary doctor for most things, and a geriatric psychiatrist for mood/med management.
I think it will vary depending also on the size of your medical community. Most important is that we have someone willing and able to monitor meds as needed because of either the need of the patient or the need of the caregiver. Additionally, due to legal, disabiltiy, or other "claims" some visits may be necessary for other than only medical reasons.
PatB, you are absololutely right. My husband is seen by a cardiologist and neurologist and a family doctor according to the schedules they think appropriate. He gets telephone and in-person pacemaker checks as appropriate. He gets regular blood tests (literally monthly) because his drugs require that. That is what is appropriate for the place we live.
But, I really hate to see anyone here pushing themselves to the edge when it is not necessary so they can get in one more doctor's appointment. It could be the straw that will break the camel's back.