Dear Dr. Paster: My friend was recently diagnosed with diabetes. It took her a while to find a doctor who takes her insurance: medical assistance. The problem is her doctor discourages her from asking questions. He usually cuts her off before she has even finished her sentence. Any thoughts on how to approach this? – M.J., Oklahoma City
Dear M.J.: As my mother used to say, “Bad manners are not acceptable in our house.” That certainly applies here.
Many stressed doctors think the “olden days” were better. I disagree. I came to my small town of Oregon back in 1978, joining two doctors who started their practice in 1949. They were on call every other night for almost 30 years.
They didn’t have the electronic medical records we have today, stressful for some docs. But they were rarely with their family, rarely taking the extended family vacations most doctors enjoy today. The “good old days” were humbug.
It’s right that your friend’s doctor should spend more time with her, but the converse side is that the doctor only has so much time to spend with each patient. The average doctor visit today is 13 minutes. Two decades ago, it was 18 minutes. The long 30-minute visit is a rarity today – and was a rarity years ago.
I suggest your friend bring to each appointment a list of questions she would like to have answered. If the doctor can’t get to all of the issues, your friend should make a follow-up appointment to discuss the rest of them. If we don’t have feedback, we can’t change.
But the elephant in the room is medical assistance – it pays far less than other insurance plans, and that might be part of the problem. A doctor cannot survive on MA alone; having a mix of different insurance plans is what makes a medical practice financially viable (unless it’s a federally qualified clinic). So finding another doctor to take her case might be more difficult than trying to correct his behavior.
Dear Doc: I really enjoy your radio program and your laughter! Tom Clark is a great sidekick to have – he never lets you get away with anything.
My question is about UHT milk, ultrahigh-temperature pasteurized milk. My fresh mozzarella recipe turned into a lovely ricotta because I used the wrong milk. Is UHT safe? And what’s the difference between UHT and regular milk? – K from Neenah, Wis.
Dear K: UHT pasteurization is done at 275 degrees Fahrenheit for one to two seconds, a higher temperature than regular pasteurization. The result is a shelf life of six to nine months. Calcium and calories are the same, but some vitamins such as folate are greatly reduced.
In some countries such as Spain, Belgium and Israel, UHT milk is the norm. The reason your milk didn’t curdle into mozzarella is that the high temperature breaks down enzymes needed to create that curdling process.
There’s a trade-off here: Some nutritional value gives way for a longer shelf life. Since we live in Wisconsin where “regular” milk is plentiful, I’d ditch the UHT and stick to the other. Besides, I think it tastes better.
Dr. Zorba Paster hosts a radio program at 3 p.m. Saturdays on WBFO-FM 88.7; email him at firstname.lastname@example.org.