@gorillapaws Yeah, I know it’s not just primary care. But I’ve just had a really crappy day at the primary care office. :-)
I’ve got a number of questions about this case:
1.) As you pointed out, we don’t know how “abnormal” the protein result was. “Trace” protein in a single urine sample would be very different from 4+ proteinuria.
2.) Apparently the young man hadn’t had a physical exam in the four years since the previous test. Had it been recommended that he have one? @MRSHINYSHOES states “He always felt he was healthy, and with kidney disease the symptoms are so subtle there was no reason (or so he thought) for him to go get a full physical every year. ” If a full physical had been recommended annually, might the urine test have been repeated at follow-up?
3.) What exactly did the new doctors tell @MRSHINYSHOES and the rest of the family? And what was the level of training of the new doctors? We have the quote “The new doctors at the hospital said the test results 4 years ago were so obvious that the original doctor couldn’t have missed them. Therefore the (first) doctor was negligent.” Hindsight is often 20–20, obviously. Did the new doctor mean that the results four years ago were blatantly horrible, or were they at a level that only look bad now because the overall clinical outcome is poor? (E.g. was the protein at a level that could have been a false positive years early, but is “obviously” bad now only in retrospect?) And, frankly, if the current doctor is a young trainee, I’d take his/her opinion with a grain of salt.
If I were the patient in question, I’d want to sit down with the original doctor and go over the results from several years ago. I’d also ask for a copy of the old and new records, and potentially get a second opinion.