My doctor of many years was moving away. Man, was that unexpected! I had just seen him, and he had said nothing. His office person handed me a letter on my way out, telling me the news. I got in the car and sobbed.

I loved him.  My husband and I had been with that practice fairly soon after moving to the area over 50 years ago.  We liked our first doctor, Dr. Portes, our second, Dr. Blair, and now Dr. Loiacano.  He’d taught me the nuances of healing from a hurt ankle.  After an appointment, he’d sit awhile and ask how my life was and how Howie was.  And, when Howie almost died in his hospital emergency room, he came in and said, “Well, what does it feel like to have nine lives?” 

And now he was leaving me!  I felt such a loss of a really trusted and kind doctor. 

Now what? I was 77 and looking for someone new. I asked around. No strong recommendations from friends. I looked online. No strong write-ups of anyone in my area.

Finally, I found a young woman doctor at an iffy hospital. I met with her and thought she was OK. I became her patient and things were OK for about a year. Then my numbers changed. My potassium was high. She calmly said we should do another blood test and, meanwhile, I stopped eating my banana-a-day.

The next blood test showed the same high potassium numbers, so she took me off of a blood pressure medication that was associated with driving those numbers up and substituted another one – hydrochlorothiazide. Yikes! Howie had been on that for his heart. Did I have a heart problem? No, this was for blood pressure. OK!

The next blood test my potassium was OK but my kidney numbers were up. Geesh! Next blood test was the same. At that point, she prescribed a kidney ultrasound and told me to find a kidney doctor. Geesh! What the heck was going on?

I procrastinated. During my procrastination, I got a letter from the hospital saying my new doctor was leaving! I didn’t cry this time. Now I was mad and frustrated. I’d have to go looking for a doctor again!

I decided to wait on the ultrasound and specialist until I found a new doctor and new hospital. I procrastinated again, tired of hearing no strong recommendations. But I knew I could not procrastinate forever. Finally, my daughter, a direct primary care pediatrician, said, “Mom, why don’t you switch to direct primary care?” Duh! I’d never considered that. “You have insurance and Medicare,” I thought! “Why would you pay for a doctor when you don’t have to?”

I need to pause my story and explain what direct primary care is. These are doctors who work for themselves, not hospitals, and who don’t use insurance or Medicare. No hospital or governmental agency is driving them to see more patients for shorter amounts of time. They get paid through your membership in their practice, a monthly charge that I discovered is not unreasonable.

So, I realized that my daughter was giving me good advice. I went online and started asking around. A friend recommended her own doctor, a direct primary care woman in Oak Park.

I switched.

Of course, she took fresh tests to check my status at that time. My kidney numbers were still high. But did she send me to a specialist and for an ultrasound? No! Surprise of all surprises, she tells me to drink more water (I wasn’t) and that hydrochlorothiazide is a diuretic that can be hard on the kidneys and elevate those numbers. Since my blood pressure was a bit low on the regimen I was on, she said to stop the hydrochlorothiazide. If my pressure stayed under 140/90, she said that would be OK.

I immediately stopped the hydrochlorothiazide. Surprisingly, my blood pressure stayed just fine, thank you, around 120/60 or less. I didn’t need that med for my blood pressure at all! I was taking an unnecessary drug that may have been the cause of the high kidney numbers!

I now have to wait another month to do a blood test for the, hopefully, new and normal kidney numbers. But meanwhile, I’d been automatically put on an unnecessary drug with its own side effects. Not good!

I shudder to think what course my life might have taken if my previous doctor hadn’t left. I would have had a kidney ultrasound and started working with a kidney specialist. Who knows if that specialist would have taken me off the hydrochlorothiazide? One would have hoped so, but I can see that it might have gone a totally different way.

The end is yet to tell, of course. If my kidney numbers return to normal, then I thank my daughter for suggesting direct primary care. I also thank Dr. Ingrid Liu for thinking this out so that I dodged a bullet that was coming at me because of a medication prescribed for me that I didn’t need!

My daughter says this is what happens when doctors don’t have time to think things out and, instead, just prescribe or send you off to a specialist. They just don’t have the time to consider a patient’s whole story. In reading this to a friend, she told me her doctor is allowed only eight minutes with each patient, and my friend worries that if she gives her doctor a good review after the eight-minute appointment, that her doctor will be cut down to seven minutes! This seems to be becoming the norm for regular medical care. But who knew? I didn’t, and it could have hurt me.

How would a typical patient know the pressure doctors are experiencing to produce, just produce, rather than provide quality care? They aren’t going to tell you. But I will!