Every once in a while I find something that I think "I sure wish more people were aware of this" or "I wish more doctors would check/treat this".
So many people die before they need to, or are debilitated with an illness long before they should be, because their primary care physician is likely NOT that interested in proactive care of the patient, because their paycheck is signed by a hospital 'employer' and that reimbursement comes from a third party insurnce company or Medicare or Medicaid or whatever. The way to survive in that environment as a physician is to do lots of quick, two-problem, visits, and follow institutional protocols, referring anything possible to the various 'specialty clinics' run by their employing hospital. It all has to do with reimbursement with the Holy Grail being "the four-minute level-4". A simple problem with a complication (sore throat with allergy flare) is enough to qualify for a level-4 billing, which is the second-highest 'complexity' (which is a joke, since patients come in with 8-10 problems or issues that SHOULD be addressed), and you can do that in four minutes, as defined by how many boxes you click on the computer screen.
So unless the PATIENT is proactive, they will get their cancer found when it is barely possible to make it, bouncing through chemo, radiation, and surgery, like a pinball in a machine, or their heart disease will be found when they have a 95% blockage and a CABG or a couple stents may slow things down. We give lip-service to finding things 'early' when they are preventable or much easier to treat, but that isn't going to be done very often in the current system.
WHICH IS WHY I ADVISE PEOPLE to keep their insurance for 'the big stuff', but go OUTSIDE the third-party payment of insurance for their primary care, and then optimize that primary care by finding a physician who doesn't deal with insurance, but who you pay DIRECTLY. Typically fees amount to anywhere from $40/month to $160/month - the low-end for healthy young people needing no more than a thorough physical once a year, middle-range for middle-agers with hypertension, lipid issues, menopause, and other things who typically need a couple face-to-face visits and some labs or other followup that can be done via internet or phone, and the highest end for someone on very complex regimens of medication or heavy doses of pain meds who needs to be seen every 3 months to comply with the law, plus lots of other compliance stuff.
Anyway, more and more primary care docs are doing that - we make about a fourth to a half of what the hospital-employed docs make, but we save money at homoe because we can look in mirrors without them shattering. Some Nurse Practitioners are doing the same thing, and some are very good. Of course there are both MD and NP doing 'DirectPay' who are just doing glitzy gimmiky stuff, but you can pick them out by their marketing and attitude.
Anyway, here's one example of a test that you won't find most 'employed' docs even offering, but it is SO helpful in figuring out the vague 'fatigue' patient where you've alredy ruled out the common, easy stuff. Typically these folks just get told they are depressed and left to flounder. They eventually get so metabolically out of whack and do get depressed, and it is sad if instead they COULD have been fixed.
This is one of the more basic tests - https://www.youtube.com/watch?v=B5oemBHuP4E
For women I think this one is better and not that much more expensive - https://dutchtest.com/wp-content/upload ... 062022.pdf
I've referred to the second one before here - http://www.levergunscommunity.org/viewtopic.php?t=86762
So I guess that's technically TWO 'pearls' today.
But if you browse the website of the dutchplus test, there are many videos explaining what can be found - IF you can get the doctor motivated. Obviously I can't be a person's physician unless they physically come to my office and be a patient (I don't do telemedicine except for patients who ALSO are 'regular' patients and do office visits, physicals, etc.), but I can at least help other people be more proactive by giving them things to read and learn about and then they can take the information to THEIR physicians to try to motivate them. Many will actually look into things if the patient does the work for them...

