The Wife and the Doctor

January 6, 2011

Scott J. Capozza, MS, PT

Since being diagnosed with cancer, I’ve kept every appointment with my oncologist.  I now live an hour and 15 minutes away from him, but I never switched doctors because I like continuity of care (plus I preach it to my own patients).  Since 1998, I have not missed one blood draw, CT scan, or scheduled appointment with him.

But going to a primary care doctor?  Well...that’s a different story.

I thought since I was seeing my oncologist on a regular basis, that would be enough to cover all of my health care needs.  Granted, my visits with my oncologist grew farther and farther apart as I became a long-term survivor (from 3 months to 6 months, and now yearly).  But I figured since he was drawing my blood, giving me a quick once over, and well, he is a doctor, then I didn’t need to make an extra appointment with a primary care doctor, right?

Wrong.

I don’t know how common this phenomenon is, but it seems like I’m not alone.  I know several other survivors who treat their oncology office visits as their annual wellness visits too.  This does belie a larger problem, at least in the younger age groups.  According to the CDC, the number of primary care annual visits for 15-24 year olds decreased from 1995 to 2005.  People in their teens and 20’s need to be screened for hypertension and high cholesterol, as well as monitored for diabetes and educated on cancer screenings, just like the rest of the adult population. 

How do we get more young people to see a primary care physician for an annual check-up?  Education and making sure that it’s covered by insurance are two places to start.

For me, it was something a little more ominous: threats and bribery.

My wife Katy had been on my case to see a PCP since we'd started dating.  It was the same merry-go-round discussion: she’d say I needed to make an appointment, that I couldn’t keep treating my oncologist as my PCP, and I’d tell her I would do it and then I wouldn’t.  Finally, this past May, she pulled out the big guns: she threatened to not get me a birthday present this year if I hadn’t made an appointment.  Now my back was up against the wall: she meant business, and really, she was right.  If something happened where I had pneumonia or needed a prescription, I couldn’t just call up my oncologist.  So, partly to do the right thing and partly to call her bluff, I finally made an appointment for the day after my birthday.  Here’s how that conversation went down:

Me: “Honey, guess what?  I made an appointment to see a PCP!”

Katy: “Oh!  Oh..wow...that’s...great.”

Me: “You didn’t get me anything for my birthday, did you?  You didn’t think I’d actually do it.”

Katy [with a very worried look on her face]: “No, no! I got you something, really I did.”

So for the first time this century (I told you it was bad), I went to see a doctor who was not an oncologist.  And you know what?  It was fine.  My doctor is a good guy, we were able to talk sports while also going over my history.  I had blood work that revealed that my cholesterol is a little high, which apparently had never been screened for in the blood work from my oncologist.  And why would it?  My oncologist is looking at my tumor markers, not my cholesterol.  I also had my first ever prostate exam, and that wasn’t so bad either. (Guys, here’s the lowdown on this very important exam: one test, two fingers, three seconds.  That’s it.  Get over yourselves and get it done.)

And the timing could not have been better.  Literally two weeks after becoming a patient with my PCP, I had an allergic reaction to poison ivy and needed prednisone and steroid cream to get rid of it.  If I hadn't had my PCP to evaluate me and call in the prescriptions, I would've been a very unhappy camper.

The moral of this story?  Everyone, cancer survivors included, should see their PCP on a regular basis.  Oh, and don’t make a bet against me that you can’t back up. 

And in case you were wondering, I did my birthday present...three months after my birthday...

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