The “Other” PCP

It never really hit home until I was sitting with a bunch of friends at a party and the subject of dermatologists came up. I was the only straight male in the group, and I sat silently as the other gushed about how much they loved, not liked, but loved, going to the dermatologist. After a while, I spoke up. “Ew,” I said. Unless there was a serious problem, why would anyone want to see a dermatologist? They looked at me like I had two heads. They liked some random guy poking and prodding them. They liked being examined. Ew.

I don’t like doctors. It bugs Dr. SJ to no extent, but I will only go to the doctors is there is a damn good reason to go. The greatest invention of medicine is urgent care, what we call “doc in a box,” where you go without an appointment with a specific complaint and the doc deals with the specific complaint and otherwise leaves you alone.

Dr. SJ insists I go to annual routine examinations. I tell her I’m fine and I don’t need to go. She tells me I’m foolish, which strikes me as beside the point. I tell her that even if wanted to, I have nowhere to go. I used to have a primary care physician, a young woman doc, but as she became more experienced and got more patients, she became more annoying. Instead of her seeing me as soon as I was put into a room, I got some high school kid asking me  personal questions that were none of her business and with whom I had no interest in engaging.

When the doc finally deigned to show, after a half hour of my life was lost forever, she gave me 3 minutes of quality time telling me generic nonsense about weight and cholesterol, as if I planned to spend the rest of my life eating veggies and statins. I felt fine, just as I had at my last exam, ten years earlier. And if I was about to drop dead, so be it. We all have to go sometime.

But the last straw that I had a medication that required refills, and then the script ran out and I needed a refill, as both the doc and I knew it would, I was informed by the very official receptionist that I had to come to the office for a visit first. I did, and after sitting in the exam room and telling the high school kid come in the clipboard that I already answered the questions three months ago and had no interest in doing so again, was met by a PA who refilled the script. I then got a bill for $150 for an office visit that I neither wanted nor needed. Guess where that bill ended up?

In the New York Times, a woman named Jancee Dunn explains why men don’t go the doctors. Of course it was a woman writing about why men do or don’t do things, because who would know better? She uses her husband and his father as her lead in.

Last year, my husband Tom received this memorable text from his father: “FYI, getting brain surgery tomorrow. Don’t worry. I’ll be fine.”

This was the first we had heard about his brain surgery. When Tom phoned his dad and asked why he wasn’t told sooner, my father-in-law had a clear explanation: He’d delayed his visit for so long that, when he finally saw a doctor, his symptoms had progressed and he was immediately booked for the procedure. (Happily, he fully recovered and is fine.)

To put this into man words, he didn’t go to the doc until he had good reason. And it all worked out fine, although it wouldn’t have changed anything if it hadn’t.

It appears that this is a shared trait among the men in my family. Over the summer, my husband pretended an abscess on his back didn’t exist until it resembled a dolphin’s dorsal fin, and he ended up in Urgent Care, still protesting that it was probably a bug bite.

And buried in her biased presentation of post hoc revisionism is the point, that until Tom knew it wasn’t a bug bite and required medical care, it didn’t. We get a million bumps and bruises in life. We wake up feeling a pain every morning and, by midday, it’s gone. Problem solved. Go to a doc and they’ll want to take x-rays, an MRI, send you to a specialist and stick a finger up your butt. Have you heard the sound of latex snapping from behind you? It’s not pleasant.

But avoidance can make the anxiety and fear worse, said Nora Brier, an assistant professor of clinical psychiatry in the Perelman School of Medicine at the University of Pennsylvania. And if a patient waits until symptoms are severe, “it does tend to propagate a stigma that they should be scared of the doctor’s office,” Dr. Bajic said.

I’m going to take a leap of faith and assume “Nora” is a woman. Another woman explaining why men do things. I’m shocked. But is it “anxiety and fear,” or is it just the annoyance, the wasted time, the needless cost and the fact that physicians always seem to find some anticipatory procedure or medication for a problem you don’t have. Does the doc always tell you to do, or not do, something, even though you’re only there for an exam?

After the prescription refill fiasco, I dropped her as my PCP. I asked Dr. SJ if she had someone else to be my new PCP, and she gave me a name of a physician she thought was excellent. Her office was almost an hour away, which was almost an hour too far, but I called to find out whether she would be the type of doc I could live with. Her officious receptionist informed me that I could not question the doc as to her bona fides, as to whether I wanted her to be my primary care physician, but had to come in for an office visit. I hung up the phone. No one lives forever.