More and more i find that, at least in America, if you're talking to a GP you're just talking to a human interface of insurance approved treatment algorithms.
"More and more i find that, at least in America, if you're talking to a GP you're just talking to a human interface of insurance approved treatment algorithms."
I largely agree, although from a slightly different angle. Many newer doctors just read from their Epic WebMd equivalent and record your answers. I assume it's so they don't get sued.
Imho, a brilliant solution is direct primary care. For $80/mo, I have access to a dr that works for me, and not my insurance company. Absolute game changer in that he has a bias toward understanding and optimizing rather than gaming insurance metrics to be rated as a double-plus preferred provider or whatever.
Also gets my lab work done at a fraction of what my insurance deductible would be.
Combine it with a high deductible insurance plan to hedge against the truly catastrophic/expensive possibilities.
There are direct primary care providers all over. Google it. I can’t recommend direct primary care highly enough.
A rose by any other name, and all that.
It's truly amazing. Our doctor knows us all well, can get responses to email or text within just a few minutes, generally same day appointments, or next day if she's really busy. Most things we don't even need to go in for - I did a recent international trip, and she just ordered me all of the needed travel medications without having to stop in.
Consider talking to a couple local dpc providers and see which you feel you’d work best with.
A lot of docs do DPC for a while to build up a client base, then exit to concierge, keeping a third of their previous roster at three times the cost.
And what I learned is that I can swing my blood pressure from slightly low to slightly elevated simply by how I sit, how relaxed I am, and untold other variables that result in being able to consciously swing it 20+ mmHg, and other times it can swing that much (or more) just between multiple consecutive readings where I don't move/etc between them.
I've also had Nurses swap the Cuff size and drop that much, or just do two in a row in the Dr's office and get massively different results.
So, for me, I don't know how to determine an actual bp if the noise is greater than the signal. Taking the average over multiple times a day, for a few weeks is probably reasonable. But then, I'm pretty sure the amount of exercise and what I eat day to day could swing it one way or the other depending on the time of the year (aka I sweat a lot more during the summer and drop weight, etc).
Or just assume that your systolic will be about 3 points higher if you weren't sitting for five minutes, or whatever the normal correction is for you. You shouldn't accept a diagnosis of high blood pressure from your doctor if (as is most likely) they aren't measuring it correctly, but the deviation from the "correct" measurement also isn't random.