Kind of long...hopefully it won't bore you to tears! I didn't want to highjack the other threads regarding tooth aches and bird flu, so I started my own. I guess this is kind of a medical rant; nothing serious, but things that I hopefully remember the next time I need a doctor. DW and I (especially my wife) are pretty much anti-medical establishment. While we don't completely shun doctors, we see them very, very infrequently. DW probably hasn't seen a doctor for almost six years. My oldest DD had the second doctor visit of her lifetime (6 YOA in January), for what we thought could have been appendicitus or a twisted bowel, but what turned out to be severe constipation. Our younger two DDs (3 and 1) have never seen a doctor. I just had my first doctor visit in almost five years, I think. I thought I had a partially torn rotator cuff in my left shoulder, which due to the nature of my job, I thought I could easily injure more seriously. In my daughter's case, we felt the doctor did a good job, but I definitely sensed that he was CYA'ing and feeling us out. He ordered an x-ray and a blood test. He could clearly see from the x-ray that she was severely constipated, but wanted to hear back about the blood test. The test showed elevated white blood cell count, which he said could indicate appendicitus. The options ranged from keeping her overnight (not a chance) or trying an enema. We chose the enema, which worked like a charm, and he made us promise to return if DD showed any signs of getting worse or developing a fever. While I am overall satisifed, it seems that he could have gone with the x-ray first, then if it did not shed any light on things, ordered the blood test. This would have saved some money, although not for me since I have insurance, but it's the principal of the thing. In my case, I saw a nurse practitioner, since I walked in and wanted to be seen right away and she had an opening. I am not kidding when I say that the examination was about five minutes in length, during which time she diagnosed me with a possibly partially torn rotator cuff, ordered an x-ray and physical therapy. She told me that another possibility might be arthritis and that either way, the x-ray would show this and physical therapy would still be warranted, so I should get an appointment to have a Physical Therapist (PT) "evaluate and treat". To her credit, she did take time to answer my questions. She told me that she would call with the x-ray results later that afternoon or first thing the next morning. I made an appointment with physical therapy (PT) for the next afternoon, and they told me that the PT would want to know what the x-ray results were. I met with the PT and without the benfit of the x-ray, he told me that he believed that I had an impingement and bicep tendonitis. He told me that he was going to do some medicated ultrasound and show me some exercises to strengthen the muscles in my shoulder. At one point, he asked if I had ever been injected with hydrocortisone. I told him that I was concerned about using it, since I've read that it can contribute to diabetes and I have a family history of adult diabetes. He told me he just wanted to know if I was allergic to it and what he was using was not hydrocortisone. I started the ultrasound treatments, which helped the pain, but later found out that the medicated part was dexamethasone, which is a hydrocortisoid(sp?). Now, I did not insist he stop using it, which I should have done if I felt that strongly about it, but so much for my concerns. I was also conflicted since I felt better. Additionally, he told me that an x-ray technically won't show a torn rotator cuff, but will show some abnormalities in the joint, which might indicate a torn rotator cuff. The x-ray results, which I got hours later, showed everything was normal. What exatly was the point of the x-ray? The PT wants to see me for 4-6 weeks, 2-3 times a week, but I think I am going to nip that one in the bud. It's basically $40, a visit and the only purpose (other than the exercises, which many I can do at home) is pain control. I cancelled my last appointment due to work conflicts and told the PT's receptionist that I was going to wait a week and see what happens. Several days now and my shoulder feels much better. I haven't taken anything for it and if it never feels any better than it does now, I could live with that. I have also ordered an anti-inflammatory herbal mix and will give that a try when needed. I guess my complaints are small compared to some, but they are indicators of the problem with our medical system. Why did I need to see a doctor when a PT figured out what was wrong on his own? Why did I need an x-ray, if the doctor was going to have the PT "evaluate" me anyway? Are the risks of using a hydrocortisoid warranted if I can handle the pain without it? It's not helping me to heal and coulkd be causing other worse problems. Anyway...time to wake up, I'm done!