I was talking with a seventy-year-old woman the other day who told me of the urinary problems she was having. Her doctor is a general practitioner who says she "specializes in kidney diseases." Training in nephrology or kidney problems takes several more years than that of a general doctor who may practice medicine after a one year internship. The woman told me that she got up in the morning and urinated a great amount of bright red blood. The doctor did check a urine and said that it was probably a bladder infection. A CT scan was done showing no apparent abnomalities and an antibiotic was ordered. It was questionable if a urine culture was done and there was no follow-up urinalysis or urine culture, At no time was it suggested that a urologist be seen.
General practitioners may be outstanding doctors but when a serious problem occurs a specialist needs to be called in. No doctor can be an expert on everything. Of course in many HMOs, of a patient is referred to a specialist that decreases the referring doctor's salary. Money does come far too often into what is the best care for a patient. Far too many women have chronic bladder infections that are not adequately treated by their general doctors. A good urologist needs to do an examination, order any necessary tests, and follow these patients. Unfortunately, a good urologist seems to be hard to find these days. My own experience tells me that!