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My dad currently sees 12, no exaggeration 12 DRs. He had frontal lobe radiation for a growing meningioma, radiation killed the meningioma but caused the cognitive issues. He has a Neurologist, neuro oncologist, neuro surgeon, Sleep Medicine neuro, ophthalmologist and neuro ophthalmologist, cardiologist, dermatologist and derma surgeon, audiologist, orthopedic (back issues), dentist, psychiatrist, Geriatric internal medicine not to mention podiatrist (he comes to my dad’s AL and the physical therapist) not to mention CTscans, MRI, sleep test, cardio scan trips for testing, when is enough enough? I work full time, have a family of my own with a husband recovering from a mild stroke and the aging love of my life, my pup, with both #1 and #2 incontinence. the point and the question is do any of you deal with this many DRs? How do you keep track of them all? Do we really need all of them? How do you keep your sanity? Lol

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Yes..I understand this too well..My mom had a 10 MDs with 4 appts monthly....then I put my foot down. I became her POA. I asked her internist what he could handle. She was 86 and hating the visits. And all the meds. We stopped a lot of meds…we no longer chase an allergist, Ra doc, podiatrist {I trim her toe nails}, ear nose throat guy, cardiologist, urinary guy, lung specialist etc. She now sees an internist and a dentist..yup thats it. She has improved getting off all the high powered {high priced meds}. I even had her taken off the injectable osteoporosis med, the RA infusion meds and the overpriced blood thinner. She takes a baby aspirin and Fosamax once a week by mouth {osteoporosis}…we are using old school drugs for blood pressure…2 years later she functions better and is more alert. She regained her weight. She is thriving! She moved out of memory care {her memory got better} to an assisted living. After 27 years as a geriatric nutrition staff member I saw so much over medicating due to the elderly non stop complaints to doctors. After I took over moms affairs I stopped the constant MD visits and both of us are a lot happier…Discuss the problem with the internist and weed out the unnecessary drugs and MDs ….doctors are now air traffic controllers…the more complaints the more specialists…
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Some of these doctors are CURRENTLY treating your Dad, I would imagine. Some HAVE TREATED him in the past. Those that treated him in the past should explain why you are still seeing them. You should discuss this with your Dad's primary. Ask him "Which of these specialists are actively treating Dad now; which do I need to continue to see on an annual basis, and which can I leave behind now. I cannot cope with 12 doctors, nor can any care facility."
You may also request of MDs who are not doing actual in office exams that they move to virtual visits.
I sure wish you luck.
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SusanHeart
My mother is 89, I am her POA, and she also has 12 DRs. Not to mention 13 meds. She has Kaiser Ins., so the vast majority of her appointments, and her pharmacy are in one, of two locations. Where we live, the two Kaiser facilities are less than 1 mile from each other, so this usually helps. She has so many appointments, with so many doctors that I went to the wrong campus on several occasions. So, I now have a file on my computer with all her doctors listed as follows:
I did a Table (Microsoft word) with 5 columns.
Merged the top line, centered and bold with the
Name of the building, address and phone number
Below that the five columns are labeled as follows:
Specialty, Doctor, Phone (some have their own number), 1st year seen and the 5th I left blank for any short notes.
I made one for both locations
I have another Table with other care givers and the Pharmacy number.
It all fits on 1 sheet of paper and I keep it updated with a hard copy in the folder I take to every visit.
In addition, I did the same thing with all her diagnoses (oh, so many.), and medications. Including the supplements and medications she has discontinued and why.
Now, when she has an appointment and they ask me questions, I have the answers right there.
Being responsible for another person can be overwhelming for anyone.
I hope things improve for you and your loved one.
Hang in there, you can do this.
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Ah, yes, the revolving door of one doctor leading to another doctor, often times with them giving you conflicting advice. My mom had CHF; she saw a cardiologist. After every trip to the hospital, she was told to follow up with her cardiologist, as well as a kidney specialist. We decided (her, me and her cardiologist) that the kidney doctor was superfluous: I *knew* the kidney doctor would tell her she was taking too many diuretics, and she should cut back on them, which of course would lead to fluid buildup from the CHF, and then a trip back into the hospital where they would, invariably, put her on diuretics. Since she had no other kidney issues, the effects of fluid buildup would do her more harm than reduced kidney function, because the chances were that the CHF was going to kill her long before kidney failure would set it. It was a harsh decision; but I didn't want her final months spent doing nothing but being shuttled back and forth to doctors all day.

Right from the get go - why is dad seeing both a Neurologist and a Psychiatrist? My daughter has a psychiatrist, and he has told us that a neurologist can prescribe mental health drugs as well as a psychiatrist can; you might want to check with dad's neurologist to see if he/she can take over the care dad's getting from his psychiatrist. It seems to me that your dad is being referred to a lot more doctors than he really needs, as well as getting a lot of unnecessary tests.

How old is dad? What is the prognosis for him after the cancer? These are all things to take into consideration when deciding how much medical intervention to proceed with. This might be where you want to find a geriatric doctor with a case manager on staff. This might also be a time when you ask the various doctors, point blank "what good is this test/treatment/etc. going to do for my dad and his conditions?" If you're starting to get answers from different people that seem to put dad's care at cross-purposes, like I did with mom, then consider which of dad's illnesses are the most debilitating and maybe choose to concentrate on those.

See, here's my concern for you. You have your dad and all of his doctor appointments; your husband, recovering from a stroke and all of those subsequent doctor appointments, and a sick pet, whom I am sure is also being shuttled back and forth to the vet. So when was the last time YOU went to the doctor for a check up? Dentist? Because when I was in your shoes, the very last thing I wanted to do was to sit in yet ANOTHER doctor's office for my own appointments. I had to make a firm promise to myself to NOT neglect my own health; and many were the times I had to mentally give myself a kick in the backside to make me keep my promise to myself.

Cutting back on the unnecessary doctors and tests is NOT elder abuse. Really, try and find a PCP for dad that will work WITH you on eliminating some of the unnecessary appointments, for your own sake.

Good luck.
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We have a similar situation and FIL also has VA doctors he sees. Additionally because he is nearly immobile and mostly homebound he uses doctor's visits as his social outlet. We finally had to start weeding out who he truly needs to see vs the ones he didn't actually need to see regularly because he would just willy nilly schedule appointments with them to get out of the house. As it takes 2 people to take him to the doctor every single time and at least 1/2 of his doctors (VA based) are over 90 minutes away we had to put a stop to the non-required appointments pretty quickly because it meant at least a half day off work for at least one family member each time to assist SIL in transporting him every single appointment and he was scheduling these every week.

We finally got him down to seeing his VA Primary and his regular Primary - they are the ones that handle all of his medications (now THAT list....goodness!), his eye doctor, his cardiologist (this one is down to annually now), his podiatrist (diabetic and they have to do his toes and check his feet), dermatologist, and urologist. Now by my count that is 7...but in the last 6 months he has had 13 doctors appointments and that is us "controlling" it, so yeah...thankfully, he only has those 7 now. If he had his way he would go to to the doctor every day. He LOVES it. He LOVES going to the hospital too. He will ask to go to the ER for a cold. He was offended a few years ago when they wouldn't admit him when he went to the ER with cold symptoms. We had to practically sit on him during the worst of COVID in our area because we knew it wouldn't be the same experience he was used to and part of the reason he enjoys it so much is that he enjoys the attention he gets while in the hospital. We explained that if he went into the hospital during COVID and really didn't need to be there, he would be going in alone first of all, and that we wouldn't be allowed in at all for the duration. And that the nurses that normally gave him so much attention barely had time to breathe, were understaffed, were praying they didn't get sick themselves, didn't have time for his usual brand of humor that calls them into his room 10 times a day just to chat and that he was exposing himself to something that could potentially kill him for no reason whatsoever. So miraculously he stayed home and we didn't have a single health crisis or hospital visit the entire time. We are making this stretch as long as possible. That is not to say that if he had a true medical emergency that we wouldn't rush him to medical care right away. But he absolutely craves medical attention like nothing I have ever seen, it's like an addiction for him. And we had to find some way to curtail it.

The sheer number of medications he is taking, and the fact that they actually counteract each other boggles the mind. The side effects of the list combined! And the fact that the doctors don't interact and even the pharmacies that he uses aren't tied together. (VA vs retail vs mail order) At last count I think he is on 30+ medications. He actually asked him primary for another medication one day and his primary said "We are trying to get you on LESS medication not more!!" If he could take a pill for it, he is on board!
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disgustedtoo Jul 2021
For the prescriptions, can you take the list to a local pharmacist and discuss them? They are better versed in what the meds are for and what interactions might happen. Having 30 medications is ridiculous!!!

It is scary how easily docs Rx stuff, then another to counteract side effects, and so on. Many don't even take the time to consider what else the person is taking. There was a woman where I worked who was younger than me and she was already on 7 medications! Who knows how many she's up to now.

My mother had multiple Rxes as well, but unrelated (vaginal cream, BP meds, cholesterol, calcium, and who knows how many other?) At some point she just stopped taking/using them, except for the BP meds. No consult with anyone, she just stopped. I didn't argue with it. She also didn't keel over or have any medical issues after stopping them. Do beware, some medications might require weaning off rather than just stopping them.

Personally my plan is to avoid whatever I can. First time cholesterol showed up high (5 years since previous doc exam, records went to storage, so no way to compare), immediate reaction was to suggest meds. Nope. It took me some time to work it out (all the info they had at the time was useless - eggs, bacon, sweets, etc.) but between dietary change (eliminate processed foods mainly) and joining the new gym at work (treadmill only), it resolved itself. They start the osteoporosis testing way too soon for most and when they told me to take Fosamax, I checked it out and said no way will that EVER cross my lips. Recent test, new doc also tried, but I said no. I managed to get the previous 2 test results from the previous provider and the newer results are actually better! I do take Vit D3, but no Rx, just OTC.

Thankfully I have no real medical issues, so I never took any regular meds and still don't take any. Suits me FINE! The longer I can avoid them, the better!

If you can't go to a local pharmacy, you can try discussing all the medications with one on the phone (VA?) Of course many were Rxed there, so they may balk at eliminated anything. It would probably be better to consult with a disinterested 3rd party (have all Dx along with all Rx.)
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With our medical systems, every MD is another income source. That's part of the issue as well.
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I'm currently reading a book by Atul Gawande, M.D. called Being Mortal: Medicine and What Matters in the End.

I think you and your dad should read it.
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To your reply to me

No, you are not approaching his care the wrong way. In the beginning of Moms care I went along with everything. As time went on I started to question. Why was she going to her PCP every two months when there was nothing wrong with her. She was on B/P and Cholesterol meds only. State only requires every 6 months for prescription renewals. When I took her the Nurse ask me why I was back. Told her I had no idea but if he says "so why are we here" She won't be back unless we need a refill or she is sick. He asked and no more every two months. One Dr was a recommendation because of a thickening of her stomach. He felt it was caused by her Gerd so saw him every 6 months with mo change. So we went to a year. Once her Thyroid numbers were normal, went to a year with labs in 6 months. Both times I asked if we could make it a year. I went 3 years without seeing any of my doctors. Dentist I worked in. I stopped Moms urologist because she had been Cancer free for five years and at 85 he still wanted to do a scope. She was in the early stages of Dementia so I would never have put her thru an operation.

Just listed all ur Dads doctors. As said, don't see where a neurologist and Psychiatrist are both needed. If its for his cognitive problems, a neurologist is all you need. Also Sleep Med neuro, why can't the neurologist take care of this.

Surgeons - once the operation or procedure is done and there is a follow up why do you need to take him back. Once he is off Chemo, why the need for an oncologist?

Ophthalmologist/ Ophthalmologist neuro. I understand why the need but the Ophalmologist can't see a any differences then send Dad to a neuro if needed.

Just rambling here but do you see what I am trying to say. You may have too many hands in the pot. If ur not happy with the new doctor, look for another. My Moms doctor was not a generic doctor but the people my Moms age loved him. He was very good with them. I found him easy to work with when questioning why Mom was on certain meds still after the problem was resolved. Thats another story. Hospitals and how they don't work with the patients PCP when they don't have Privledges at that Hospital.

Curious, did u call his former Drs office and ask why they dropped him as a patient? Why would the AL be sending his Dr. test results? Was Dad using an "in house" Dr?
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I keep a little 5”x8” binder with tabs for Medicaid, Medicare, Social Security, hospice, skilled nursing facility, etc., titled Dave’s Stuff for my brother who has a glioblastoma. In the front inside pocket I have a card with all his info—member ID numbers, case number for social services and Medicaid, his daughter’s information, etc. The binder is where I keep notes and information from phone calls, PIN numbers, etc. So you could customize it and make a tab for each doctor. Prioritize the tabs— I’m sure there are doctors he sees more frequently than others. Put those in the front.

I also have file folders similarly arranged—this is where I put EOBs—explanation of benefits, discharge notes, letters from Social Security, etc. Again, prioritize the files so the more frequently seen doctor files are more easily accessible. I live 1500 miles from my brother and I couldn’t do anything without this. The smaller size lets me put it in a tote bag easily if I need to. I generally take it on the road with me when I have errands. I never know who’s going to call.
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We finally got a gerontologist from our hospitals Senior Care Center. He has been a godsend about managing referrals, insurance, discussing options with us. We see him every three to six months (more if urgent), and he helps to figure out what next. I didn't like the idea of needing a gerontologist, and we were both perturbed when my husband's cardiologist sent us to one. What fools we mortals be! I don't know if that is an option for your Dad, but I would ask someone at the AL place if they know one who comes there.
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