hello. Need advice about my 20 year old son who has had a gradual weight loss of 20 lbs this last year. He has indeed gone through some major life stresses, death of his grandpa, sister in the military about to go to Iraq, college challenges, sister has melanoma. He doesn't do drugs or is not a trouble maker. He has tried countless protein shakes, and remedies from health food stores.

He just can't seem to shake his high metabolism. He is 6'2 and weighs 150. Pulse is never over 54. His body fat index results are below body fat norm. BP usually in normal ranges.
Good kid. Denies depression, but I think differently. Question is, where is the best place to take him. Eats okay for a college kid. Are there metabolic specialists I should take him to? Or a general internist. Doesn't have a pediatrician anymore (too old now). Thank you. Worried mom of Russell. Email: KP-atpdh@care2.com thank you for any advice you can give

Part of the problem is that it's hard to tell who is agood doctor - especially for FPs, pediatricians and internists. When we do a good job, nothing happens. Patients think they wasted their money.

Patients are more impressed when you remove a cerumen impaction that by anything we do to help them live longer. It's the PCP's lot in life and we accept that.

But it would be nice if the rest of the world accepted that as well. Measuring how many of my male patients got a PSA drawn last year does not tell anyone how good (or bad) a doctor I am.

After twenty-years practicing medicine and teaching medical students, I've come to the conclusion that quality health care has little to do with the tests we order or the medications we prescribe. The best physicians I have encountered are those with the ability, and willingness to listen.

Ours is a rather simple profession. 95%, if not more, of the people we see will tell us what their problem is. All we have to do is listen. Unfortuately, it takes time to listen, something poorly reimbursed by our health care system. Perhaps, this is why so many physician are leaving primary care medicine and fewer medical students are expressing interest in it.