The old guidelines, back in 2001, basically said that if your LDL cholesterol was too high, you should get medication, and you should keep getting more medication until the level was below 130. If your doctor is using that calculator every time…I will eat my hat. At that time, the guidelines were totally biased, and based on an entirely foolish thought process (the statistical details are complicated, but basically the thought process was as if a doctor said "hey, once someone gets pneumonia, they do better with antibiotics - let's make everyone take antibiotics all the time, so that no one will get pneumonia". No joke).
And that became clear when the new(er) guidelines came out in 2013 and said what the science had always been saying - that cholesterol medicines should only be given to people who had a high risk of heart disease for multiple reasons, and that doctors should calculate each patient's risk of heart disease and only prescribe medications if their risk was above a certain percentage (what percentage is still not clear, some say 8%, some say 15%). And the new guidelines even made a calculator available.
If your doctor is actually using that calculator every time they prescribe cholesterol medicine, He just has barely enough time to write you a dangerous, ineffective, addictive prescription before he walks out of the room. I will eat my hat. But he should be. But he isn't. And you can find out - just ask. Ask "what's my risk of heart disease according to the AHA?" Get a percentage. If it's less than 8%, you shouldn't be on cholesterol medicine, you should be doing other things to lower your risk of disease.
How? You'd probably better ask a concierge doctor, or else you might just get a prescription for ambien, which actually ruins your sleep quality, doesn't improve the amount of sleep, gives you an addiction, and increases your risk of death, according to a study in the BMJ.
Still trust your regular doctor? The thing is, if he's making time to read the medical literature, he might even know some of these things. But he doesn't have time (or the energy) to put that knowledge to work for your health. He doesn't have time to calculate every patient's heart disease risk. He doesn't have time to e-mail you information about how to sleep better (let alone create a 15 minute video lecture). He's not familiar with biohacking, or other cutting edge ideas. He just has barely enough time to write you a dangerous, ineffective, addictive prescription before he walks out of the room.
53.7% of doctors get this wrong by ordering imaging tests for low back pain within 6 weeks, despite many guidelines stating this is usually incorrect (unless there are specific "red flags"). Some of those orders were appropriate, but most were not. Here is the amazing part - there was a national campaign, starting in 2010, to "educate" doctors that they should order these tests only when necessary (and to teach them when it was truly necessary). Three years later, guess what happened? Nothing. Nada. The doctors did not change at all. They knew it was wrong, there was a national campaign from the American Board of Internal Medicine to tell them what they should be doing instead, and there was absolutely no change in what they did.
Your doctor probably doesn't treat a cold (aka sinusitis) correctly. In the same study mentioned above, 84% of primary care doctors were not following the national guidelines for correct treatment of sinus inflammation. 84% of primary care doctors were not following the national guidelines. After the 3-year national awareness campaign, with the CDC strongly recommending not to use antibiotics, but instead to prescribe chicken soup and more sleep, doctors didn't change AT ALL. Still, 84% of doctors were doing it WRONG, and prescribing antibiotics. Mostly because they didn't have time to talk to patients about the right and wrong reasons to use antibiotics, and what ELSE patients could do to feel better.
The same story can be told with flu, ear infections, aspirin, leg swelling, etc. etc. etc. The wrong treatments are given over and over and over, without careful diagnosis, because the doctor doesn't have time or knowledge (or both).
Spend time googling things instead of e-mailing your doctor when you have a question.
Why you leave your doctor's appointments and still aren't sure you should follow your doctor's advice.
Why you have to make lists and do research before your appointment, Most people have (sadly) come to accept that this is ok. It's not. so you can have an "efficient" conversation, otherwise you won't get all your questions answered, and you'll have to "come back in 2 weeks".
Why you don't feel certain that your doctor is actively focused on preventing future health problems, and you feel even less assured that he has the time to do the necessary research to manage your current health problems in the best possible way.
Why, even though you know that many times symptoms may pass, you can't tell the difference between whether your doctor really thinks that your symptoms may get better on their own, or whether he just doesn't have the time or energy to think about it deeply.
Why you feel like your doctor blindly prescribes medications and sends you on your way without a second thought, when you know that many times medications can be unnecessary or even harmful, and there may be something else you could do that would be safer and more effective.
Most people have (sadly) come to accept that this is ok. It's not. It's never been ok, and will never be ok, and it doesn't reflect the deepest core values of medicine - it's just not what the patient-physician relationship should be about.
When you experience concierge medicine, you'll never look at your doctor the same way again. It's like having a doctor be what you thought doctors were supposed to be when you were a kid. Someone who knows what they're talking about. Who listens. Who cares. Who takes the time to do the right thing. Who's smart enough to know what the right thing is. And who's humble enough to tell you when there may be no right answer.