Monday, August 9, 2010

Concierge Medicine Update

As reported earlier, I hired my concierge physician back in April and had my annual physical in May.  This was my first physical in at least 15 years.  I had all kinds of blood work done and had my first EKG. Everything was normal, which is great, but also frustrating, since my mystery pain has come back with a vengeance.  I have pain in both feet (my right toe and ankle are visibly swollen), my right thumb, my right elbow, and both hips.  The pain is not extreme, but it makes walking (and writing with a pen or pencil) very difficult, and the constant pain just wears on me.

So far, I'm a bit disappointed with my doctor.  He has definitely spent more time with me than a regular doctor would, and I've spoken to him on the phone a few times, which is unheard of in a regular practice.  But I don't get faster appointments or less wait time at the office, as promised.  I had my physical over two months ago and I'm supposed to get a CD with the results on it, but still haven't received it, so I have nothing at all in writing.  (I can't wait to tell you how my cholesterol levels have changed since I rejected the low-fat Standard American Diet in favor of red meat and fat!) And this doctor is as stumped about my pain problem as every other doctor.  His only suggestions so far have been to get moderate exercise and to have a genetic analysis done.  The exercise does not help and might even make things worse (but I'm loving it for other reasons and so will keep doing it, as I'll write about soon).  And after doing some research, I think the genetic analysis is a dead end and my doctor can't give me any coherent reasons for doing it.  The fact that he suggested it makes me distrust his judgement a bit, but at least he did have a discussion with me about it, and he respected my position and didn't push it.

I know that medicine is still a young science and we can't get answers for everything, but even I can think of many other things to try for my pain.  In fact, I've found something that seems to be helping that not a single doctor has ever suggested: ice.  This is the first time I've had visible swelling with my pain, and when something is swollen you ice it.  Duh.  I've been using ice and cold compresses on my feet for the past two nights and this morning I was able to walk straight down the stairs - as opposed to going down sideways or backwards - for the first time in a couple of months.  If I can solve this with ice instead of the painful and expensive PRP therapy, I'll be thrilled.  Also, the fact that the pain responds to ice might tell us something about its cause.  If I had a regular doctor, I'd have to make an appointment to tell him about the ice and assess our next action, but with my concierge doctor, I can just call him.  I only need to go in if he needs to see me or run tests, and that is a benefit.

So, overall, I don't know that I'm getting my money's worth, but I am getting some benefit.  (I also got a referral from him for a dermatologist who seems much better than my old one, so I suppose that's something too.)  I don't know if I'll continue with this doctor after our one year agreement.  It might be worth it for continuity's sake, but it might be better to just put that $1,500 per year into my FSA and opt-out of socialized medicine altogether by not using my health insurance.  I think if I could stabilize my health, that might be the better option.  I'll assess that when the time comes.

I know many of my readers have been interested in my experience with concierge medicine, especially considering the state of health care at present. For more information on how to protect and maintain your health in an irrational society, I highly recommend Dr. Paul Hsieh's article in the Summer, 2010 issue of The Objective Standard: How to Protect Yourself Against ObamaCare.  If you don't have a subscription to TOS, you can buy the article a-la-carte at the website.


  1. Having experienced a variety of similar pain problems in the past, now gone, I can sympathize and empathize. They were a subset of general inflammation (-itis) problems, including terrible dermatitis, now gone.

    For me, the solution was partly dietary and partly posture correction therapy (home exercises daily).

    I learned to ask not only why I am having pain (this was the dietary component for me) but why I am having pain in particular place (the posture component).

  2. Amy,

    Has anyone ever mentioned something called "complex regional pain syndrome" or "reflex sympathetic dystrophy" to you? Without knowing a lot of details about your pain this was a possiblity that occurred to me, that is often missed.

  3. [...] mentioned recently that my new doctor recommended moderate exercise to alleviate my pain.  I’ve not had a stable [...]