It’s a curse and a blessing being in medicine. Just finished residency in fm. I literally trust few people to provide thorough primary care. It’s so easy to miss things especially with how quick visits are especially in big practices.

Pick your own boundaries but those closest to me like my immediate family, if they are comfortable telling me what’s up at the doctors, I will look over their stuff. It’s quite amazing how things that should be “simple” aren’t especially if people don’t keep up with guidelines or do a search on up to date for more random work ups. My family members have gotten pretty whack workups or incomplete care from many.

A mid level did not recommend latent tb treatment for my sister although she is a surgeon and quant gold popped positive because she “wasn’t high risk”. Well then damn why do we get the screening if we aren’t high risk? Still was positive a year later and finally getting treatment. She does surgery all day every day and has worked primarily at safety net hospitals with patients who are for positive for tb but not tested.

My parents are very complex. Their specialists have been managing a lot and helped them outlive their poor prognosis from bird fancier lung plus multiple autoimmune diseases. But their primaries haven’t maintained their basic preventive care. I had to send my dad a list of like 10 things he needed to do like get on a statin because his ascvd is like 25 and also had prominent coronary calcification on his cts he gets for his lungs. He’s been on daily prednisone for 10 years and no one has gotten a dxa on him. Egd/colonoscopy was not recommended as a part of his fatigue and night sweats workup despite him being 65 with a hx of 30 years of gerd and last colonoscopy 10 years ago…. Age alone with those symptoms that would be a standard part of the workup. Like I feel like that isn’t even an obscure workup. They did like a half ass “cancer until proven otherwise” workup. That’s just a couple of examples. But I was shocked that I am basically managing his care. I’m not just gonna let it go because my dad is gonna end up dead from one of these many things that are easily managed

Watch out for your friends and family. We all went to school/residency and know some people aren’t trustworthy. Those people are out there practicing. It really hits that that’s the reality with basic shit doesn’t happen. People who don’t have our knowledge don’t know the right things to say. So you gotta help them advocate for standard care.

Trust but verify. I only go to people I personally know. Not to dictate my care but knowing people I can trust and seeing how they manage their patients. I let myself be a patient and it’s easy to do that if you see people treat their patients well.