Archive for January, 2008

DEAR DR. GOTT: My husband and I are both in our mid 70s and have recently moved to Florida. We both just finished a so-called complete physical examination by two different doctors.

Since we’re both disappointed with what was done, or should we say what was not done, please tell us what should have been done and what tests should have been ordered.

DEAR READER: Because you indicate you have relocated to Florida, I would interpret you took your medical records with you or had them forwarded to your new physicians. This would have allowed a review of any existing problems and X-ray and laboratory test results. Issues such as hypertension, diabetes and cardiovascular disease should have been discussed and followed up.

An appropriate exam for a man in his seventies should consist of a complete medical history, physical examination and EKG as a baseline study if an abnormality exists or if the test had not been done for more than a year. His physician should have ordered a colonoscopy if one had not been done in the past ten years, annual blood tests (especially for cholesterol and prostate cancer), and possibly a stress test to rule out cardiac disease. Other testing may be indicated if there are signs of disease or ill health.

An appropriate examination for a woman in her seventies should consist of a complete history and exam, to include a pelvic exam (Pap test is not necessary), a baseline EKG, colonoscopy every 10 years, annual mammogram, and a bone density every two years under Medicare payment guidelines. Having provided this calendar, if there are signs of breast abnormalities or osteoporosis, the testing should be performed more frequently. Lab tests for cholesterol, anemia and other areas of concern should be included. Further testing may be indicated in special circumstances.

If you have a problem with your new physicians, meet with them to express your disappointment and allow them to respond to your concerns. It’s often difficult at any age to adjust to a new physician with a different style than one might be accustomed to, and for you to feel comfortable with change, you need to resolve any issues.

To give you related information, I am sending you a copy of my Health Report “Choosing a Physician”. Other readers who would like a copy should send a self-addressed 4 ¼” X 9 ½” letter-sized stamped envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.