Went to my new/old doctor today - was I too harsh?


(Michael) #1

Here was my review after being unable to convince my new and soon to be old doctor to give me any of the following tests (Insulin, Glucagon, NMR lipidprofile, LP_a, APOB100/APOA1 ratio, CAC score, or Kraft Test). Apparently the only thing I need is an A1C and standard lipid profile in her opinion. My family thinks (and I can often be brutally honest) my comment about obesity was overboard (yes, I stole it from Dr. Barry), but I would not go to a hair dresser with a crazy stupid haircut, a tailor who’s clothes don’t fit, so why would I listen to a doctor who looks very unhealthy… Was this too much? - rate my post from 1 (I am a total complete @ss) to 10 (way too nice) :).

Had my first, and last appointment with Dr. Ali who took over from my previous family physician in Kanata. Staff seemed friendly enough and we started a little late for the appointment, but not too bad. Unfortunately Dr. Ali was a complete wipeout. As someone wise once suggested, never take health advice from someone who is obese and or overtly unhealthy looking themselves. Putting appearances aside, I asked some questions up to five times consecutively including pointing out that she was not answering my questions to get answers. In the end she did not have an answer to the first such question, but the fact that she did not listen to the question itself is the real problem. This happened again in our conversation. In the second case she never did answer the question which was - has your suggested treatment every helped anyone get better/cured? While I never did get an answer if she ever helped even one patient with her suggested treatment, her immediate response was that it “was not about curing the patient”. Seriously, that was her response to my question. Personally, I would rather visit health care professional who actually want to help their patients, not one who follows a rote script regardless of the patient or their results. I pushed a few times repeating the question - has your suggested treatment ever actually cured/helped anyone, including again, pointing out that she was evading the question and not answering but I never could get an answer. Assuming the lack of answer was because her plan has not helped anyone, again, why would I take her advice if she knows it does not work? I pressed a little more in our conversation evoking medical terminology and trying to open a discussion. She would make noises in response, but not once did she continue the conversation, point out a misunderstanding on my part or show any evidence for her line of thinking. Overall I would say she showed a lack of understanding of basic nutrition, basic health parameters, medical terms/tests or knowledge of how to interpret the results. I have already dropped her as a doctor (had my first appointment an hour ago) and will await for the province to find me a new doctor or go without a doctor rather than waste my time with this one.

In Ontario Canada, you cannot order your own medical tests. They MUST be requested by a physician. You cannot (easily) find your own physician and the process often takes months to years. It took my daughter almost 2 years to find a new one with many many phone calls and attempts. This is going to be a pain to get in to see a new doctor, and even then there is no guarantee that I can find a doctor who knows anything about diet or health outside of a prescription. I will keep trying I guess.


#2

Government Health Care, and good health care, gotta pick 1 sadly! I’m with you on the mindset though, I’ve always used the personal trainer that’s fat and weak analogy, why take advise from somebody that can’t do it themeselves.

In Ontario Canada, you cannot order your own medical tests. They MUST be requested by a physician.

Nope! In the bodybuilding world I see the Canadians bringing up Blue Horizon a lot for how they get their bloods done, probably worth a look. Or a excuse for a quick vaca across the border and get tested for everything while you’re down here.


(Bob M) #3

I can’t figure out what happened. You went in asking the doctor to give you all those tests you wanted? Or what?


(Michael) #5

I will take a good look at Blue Horizon - thanks for the link/suggestion. I did notice though that it seems the tests are still ordered by a doctor, just not one that turns into an obstacle - or at least that is what I read with:

Do I need a Doctors referral to use this service?

  • No you do not require a Doctor’s Referral, we provide one when you have placed an order.

So I think that you place an order, a doctor sends the request on your behalf and then the results are sent to you from said doctor (unless I am misreading).


#6

That’s how all those places work, in the US as well, you buy your tests, they email you the lab req, you go test and then you usually get an email from them telling you your results are in and you can log in and download them, you never directly deal with a doctor in person, phone or email. They just have a Doc on staff to rubberstamp all the orders.


(Michael) #7

It was my first meeting with this doctor, and I had wanted to get an NMR lipid profile and fasted insulin at a minimum. I did have a long list of those and other tests I would be interested in (vitamin/mineral hair analysis, fecal analysis of fat percentage and others). In the end, I got nothing that I wanted, and a blood test form for the standard stuff with an explanation that “Your 10.5 A1C score was because you were 30 pounds overweight last year, and now that you are no longer overweight, you no longer have insulin resistance, so no need to measure insulin or LP_a or anything else on your list.” I asked how I could get these tests done if I was willing to pay myself (and suggested that maybe I needed to goto the States), and the doctor had no idea how I could do that (this was my first question that I needed to repeat multiple times before she answered that she did not know).


(Michael) #8

You deleted your post, but I thought it was a good one. I do not know if it is outright illegal for a non accredited medical professional to order blood tests, but the testing labs told me that require a requisition from a doctor. Naturopath’s can order blood tests in Ontario it seems (found out today), but those tests would then have to paid out of pocket. Officially a Naturopath is not a medical doctor, but they have similar education and licensing. If you get more detailed facts, please let us know.


#9

How do you get a Blood Test in Ontario Canada?

  1. Order Online. Select your required blood test from our test menu or call us on 0800 5951592 - Phone line open from 6am - 2pm
  2. Arrange an appointment at your local Dynacare, located around Ontario.
  3. (ensure you have checked if you need to fast before attending your blood draw)
  4. Wait for your blood test results, once they’re ready we will send them to you via email within the turnaround time stated on the website.

Do I need a Doctors referral to use this service?

  • No you do not require a Doctor’s Referral, we provide one when you have placed an order. This is free of charge, and a consultation is not required unless stated on certain tests.

How soon will I get my results?

  • The turnaround time is a guide only, and will sometimes depend upon assay run schedules. Most results are provided within the time frame provided, but there may be technical difficulties, or the results may need to be re-run to check accuracy, or our Doctor may be held up passing comment. We can easily give you a status report, so please do email us or phone us to chase results, not the Laboratory itself.

---------------this is from that Blue Horizon website. note number 2 answer, does this mean ya can get the tests easily? I would call specifically this Blue Horizon and maybe ask again?? I have no idea how this all goes down in Canada but I wish you luck.

Were you too hard on this doctor. Not that I can see. You wanted questions answered and while for some you got none and others ya got very vague useless responses. Sounds like this Dr. is not a good fit for ya :wink: but one has to truly trust a Dr and be in some kinda sync with them when it comes to our medical care so…you should move on as you need to move on and get another one as a primary? or however you guys do it.

I hope the testing works out for ya!!!


#10

I wonder why the doctor was unhealthy and unable to communicate? Over-worked? Loss of the passion for the work? I hope they take the experience and some time for self-reflection.

I go to my general practitioner(s). I have one who markets herself as a functional doctor. But she has some listening challenges and I can see her formulate an answer before we complete the discussion points. My old doctor was great, he was middle-aged, overweight, worn out, so he was very similar to me. Perfect doctor as he did become interested in what I was doing to myself with low carb WOE. He was curious again, so ordered tests to see what was happening. He retired. Dang it. The new young doc is good, we disagree, but he agrees to order the tests, and then we debate. It’s OK. Australia. Social medicine.


#11

@FrankoBear
ya got a kinda good new fit cause you got one curious about you and will discuss and that is good! Debate is good, cause I did it with Dr. H when I hit her about 30 yrs ago, but I tell ya in the end, if personalities match ok, that debate becomes a connected understanding and each are open to differences from that.

----------------for me my primary is great. Women my age. Got her on a rush when I moved here, needed Dr fast for being hurt farming so I got into the ‘new facility’ and boom, me and her hit it off and she is a ‘very loose type of friend’ to me but in the end, we connected and she is ‘low carb’ advocate so she ‘gets zc’ but doesn’t ‘like it’ cause I am ‘missing out on nutrients’ from plants and I won’t accept the plants as the good guys cause off them I am wonderful…but she can’t disprove the weight I lost and the healthy I am now against her ‘I AM LC’ thoughts but it is cool. IF I SEE her and it takes me dying to do that literally, we connect back like it was yesterday and chat and she fixes me fast and I go on my way but she says, you still eating only meat now and I am like yea, she says, cool you are doing SO well but ya know, just gotta say it, ya need plant nutrients and all and I am like, hear you! and smile big and she says, no ya don’t and I am like yes I do and it is funny in the end.

so how we connect with our Docs is a very personal great or devastating interaction. I got a great one!

This can be a very big hiccup in life…medical and those we deal with and not a single doubt on that for me. Very stressful and personal and so personal as we are talking our ‘final health’ and what we need for ourselves on this entire planet in this universe ya know. We know what we want and need, now we just ‘play’ around til we find that right match or that right fix to what we require health wise is all we can do.


(Bob M) #12

As an engineer who has spent thousands of dollars on testing, I see the benefit of tests. But there is also a detriment. Many, actually. Here are some of my results:

You’ll note that my Lp(a) is in the top 2% or so of people. Top 2%. Apparently that’s deadly:

Yet, I have a zero score on a CAC scan and have verified no aortic stenosis. And, my values are so high that if I drop them by 50% (not possible under any currently known mechanism), I STILL am double the supposed “good” value. Double.

What do I do with this information?

Then look at my fasting insulin. My HbA1c went down, but my fasting insulin went up? How can I have a range between 3 and 33? (Note: the highlighted yellow is after 4.5 days fasting.)

Take a look at my HOMA-IR. I’m insulin sensitive or insulin resistant, depending on the day.

So, I can understand the desire to have information. It’s just sometimes, the information makes no sense.


#13

you are blinding yourself thru numbers and facts you ‘need to hit’ thru research ‘too much’ maybe as your physcial body transformaton continued and you learned so much it was a detriment?

just asking but we all know good knowing is great on our personal truths but we also know we can easily get in our own way thru ‘some number’ on a chart we ‘believe’ but has no science to back it up?

again just a straight on forward chat on our focus and more as we ALL go down this road and who is you in this :slight_smile:

I say this all cause I am not you in any on numbers and never ‘tested’ and dont do ketosis blood stuff and never do insulin checks and more and I am that ‘rogue’ that just eats and lives and finds my way better by me…I am like polar opposite’ of those that must track ‘everytihng in my body’, I am never a numbers person when I let ‘it go’ but I am also a small part coming into real chagne in life on food intake…so I am not ‘a sciency one’ other then I KNOW what it takes for body life survival and what it doesn’t require’ and after that I don’t care…now thru my journey but we are so diff coming and what we need but do we HOLD onto old needs for no reasons or is it who we are?

Again just a chat :sunny:

we vary alot but our physical bodies on our changes and how we feel won’'t hit old info on what science was an expects alot of times on this ‘micro science of life’ as we live in now??? I know ya get my drift here LOL


(Denise) #14

We have so much information nowadays that I’ve been noticing how much lack of care is available. When I was younger I used to just blindly listen to whatever doctor/nurse said but now I question everything. I get whatever tests are allowed on my insurance and try to figure things out on my own because for me, in this small town, my income etc., I just won’t be getting the care I would prefer, which would be a naturopath probably. Never had one so I don’t know I would be better off.

As far as the good health of a doctor, or lack thereof, I think that a person can have a lot of knowledge, but not use it. It’s easy for them to tell us how to do it though right :wink:


#15

I agree that I want my doctor to explain exactly why they will and will not order a test but I am also the person that downloads every lab report, often before the doctor looks at it!

One thing though you really did not specify how she was unhealthy and whether she was obese. Which are two are separate issues. I particularly am uncomfortable with equating the two in women. Having eaten low carb very strictly for the last 6 weeks (and worn a CGM as an experiment, not diabetic) and done intermittent fasting on average 36 hours a week and taken Berberine and other supplements which I researched and not lost an ounce (but I feel good), I have to take issue with the obesity comment. Note I have been low carbing since 2017 with mixed success. I lost 50 lbs in the beginning and gained 40lbs back in years 2-4 while still mostly eating low carb and almost always eating a whole food diet, it crept back on because for some reason I think my body wants to be a certain weight although I keep hoping I am wrong. I have a BMI in the low mid 30s so it is not that I do not have weight to lose. Some people still have not found that magic formula. Yet I have listened to most 2Keto podcasts, interviews with Thomas Seigfried, most of Dr. Fung’s blog posts before 2019 (probably all of them), more than one Taubes book, Nina’s book, articles by Lustig and so on. Not everyone can lose weight even when they fast! It is something I am learning to accept although I keep looking for options and not finding any, my body seems to want homeostasis at a 32 BMI. Meanwhile if someone saw me in the street and I tried to give them health advice (I would not I am not a healthcare professional) they would ignore me. Fat is one of the few prejudices left. One of my parents has always been thin, the other has always had a battle with weight. Low carb seems to be helping but also exercises a tremendous amount (and always has, former competitive athlete and likes exercise). Looking at both my parents, you would assume the thin one is healthier but that is not true. Thin parent who is a TOFI had bypass and almost died 5 years ago and has had diabetes for close to 30 years. Thin parent is the reason I started low carb and keto 5 years ago. Since surgery has been eating low carb and doing well with it except keeps losing weight and has to sometimes eat carbs to keep weight on! Meanwhile thin parent could no longer take diabetes medication shortly after surgery when A1C went under 6 from eating low carb and diabetes meds made thin parent hypoglycemic (anecdote only, of course speak to a doctor before med changes)!

As for testing, not in Canada so no idea if socialized medicine limits what tests are authroized. What is the standard under socialized medicine, is she constrained as to what tests she can order under your system? We have insurance that covers all testing and one of my kids has a condition, whenever I want the full panel done I have to reassure their pediatrician that I am not worried about the cost


(Michael) #16

According to this doctor Lp(a) is NOT used to measure cardiovascular disease risk. In her opinion it is a marker to identify diabetes only, and also apparently, not worth measuring because A1C is much better. Of course, she also told me insulin levels had nothing to do with diabetes itself, since insulin resistance was only related to the amount of body fat and without body fat, you could not be insulin resistant, and therefore there was no need to measure it.
I think you can see how the conversation was a bit frustrating.


(Michael) #17

Absolutely. But then again, would you take advice from an events organizer who was always late, or a tailor who’s clothes did not fit? It may be that this doctor has a good reason to look unfit that would explain everything. Had her comments/advice made any sense I would not have even mentioned her appearance and would have given a good review. But I will admit her appearance did immediately concern me that maybe she does not understand (as many do not) how to be healthy herself, but it was not until she spoke that I realized my possibly incorrect assumption was not incorrect.


(Michael) #18

First let me say thank you for being brave enough to post a dissenting opinion. You are quite correct that a made some assumptions based on initial impressions which may have been incorrect. While she was overweight, my comments also stemmed from her body shape, her muscle tone and her skin color/appearance. She is young (did not look it), but had no muscle tone anywhere, and looked like she had never exercised in years. This observation made me concerned about her knowledge, but it was not until she spoke that she confirmed my fears based on the appearance.

Some of the test I requested had already been issued by the previous doctor she replaced (for example my fasting insulin). The only reason to deny the test was to deny me the information I requested with the reasoning being it was not useful - and that she therefore disagreed with my previous doctor’s judgement.


(Denise) #19

Well you hit the nail on the head Michael, it depends on their advice. I know just enough about myself and my body, that I won’t take advice that doesn’t make sense to me. With people that love to give advice, but not take it themselves are typical in my experience. It’s like “do as I say, not as I do” :wink: I’ve given advice, or information that I don’t always practice but it’s always something I know that works. I think doctors, along with everyone else in the world, would be much better off being honest with themselves first, then it might be easier to get honest with others. Know what I’m saying?


(Jim Scott) #20

Yep. I’ve used Quest and LabCorp very successfully for years. It is a little more expensive than if I convince my doc and get it paid through my HMO - but not THAT much, really. Last time I had a bunch of tests through HMO I paid $98 copay. With LabCorp it would have been $150. Well worth it to not fight with doc.


(Jim Scott) #21

“According to this doctor Lp(a) is NOT used to measure cardiovascular disease risk. In her opinion it is a marker to identify diabetes only, and also apparently, not worth measuring because A1C is much better. Of course, she also told me insulin levels had nothing to do with diabetes itself, since insulin resistance was only related to the amount of body fat and without body fat, you could not be insulin resistant, and therefore there was no need to measure it.”

WOW! Total BS. Yes, get a new doc. Most docs unfortunately do not a lot of nutrition info or latest science. They parrot whatt hey were tough in med school - which in the case of metabolism and nutrition isn’t much. You might have better luck with an endocrinologist. She is the one that diagnosed me with IR years ago and has been very helpful. Endo’s know a lot more about this than GPs.

In terms of ‘curing’ western medicine is practiced entirely on controlling symptoms, not curing disease. THEY know that, THEY think that’s OK and now she said it out loud. Don’t get me wrong, western medicine is a miracle and very good. But there lack of caring about root causes is costing us lives and $$$ big time.