Interesting Medical Idea

[Hayabusa Rider]

Repeat after me.
"if it doesn't get better on its own, book another appointment"

I swear every single doctor pulls that just so they can bill you without actually doing anything. You could have obvious signs of the plague and they would tell you to come back in a week.

That's just Canadian docs

 

[Inspector Jihad]

fixing the body isn't like fixing a car. there are variables.

besides, there are strict standards of care for every type of illness. if they're not meeting those standards, then they can get their pants sued off. no doctor wants to be fucked after spending all that time and money in school.

 

[SirStev0]

As a Medical Student I can absolutely guarantee you that no Doc wants to see you any sooner than ever 3 months at most.

No offense but some patients are absolute pains in the ass. We have a huge incentive to make you better... so we don't have to see you. There are millions of other sick people to fill the void. We are never going to run out of sick people.

I know that might sound a tad cynical but it is true. The frequent flyers tend to be some of the worst patients. We tend to not encourage that.
And I am not saying that those people are making it up or lying or just drug seeking. What I am saying is medicine has yet to find a way to diagnosis and treat whatever issue some of these people have and as a Doc there is nothing more frustrating.

Sometimes our society seems to not understand the limits of our medical knowledge. We don't have a pill to fix you. And a great deal of the pills we do have aren't anywhere near perfect. No one seems to truly understand that.

 

[Hayabusa Rider]

As a Medical Student I can absolutely guarantee you that no Doc wants to see you any sooner than ever 3 months at most.

No offense but some patients are absolute pains in the ass. We have a huge incentive to make you better... so we don't have to see you. There are millions of olther sick people to fill the void. We are never going to run out of sick people.

I know that might sound a tad cynical but it is true. The frequent flyers tend to be some of the worst patients. We tend to not encourage that.
And I am not saying that those people are making it up or lying or just drug seeking. What I am saying is medicine has yet to find a way to diagnosis and treat whatever issue some of these people have and as a Doc there is nothing more frustrating.

Sometimes our society seems to not understand the limits of our medical knowledge. We don't have a pill to fix you. And a great deal of the pills we do have aren't anywhere near perfect. No one seems to truly understand that.

The current emphasis is not on health care but a bean counters concept of cost savings which is increasing the volume of patients per unit time. That means two things, one is what you touch on- no time or need for repeats and perversely, higher overall costs. You would understand why that is but I'm not convinced most people who've never provided care want to.

 

[SirStev0]

Repeat after me.
"if it doesn't get better on its own, book another appointment"

I swear every single doctor pulls that just so they can bill you without actually doing anything. You could have obvious signs of the plague and they would tell you to come back in a week.

I've heard that said many of time because for some reason people come running in as soon as they have the sniffles. Even if its Allergy season and even if they get a Cold every Allergy season and even if every time they come in they are told "Fluids, if it doesn't get better come back in".

Yet when they have been bleeding out their ass every day for the last year and losing weight at an alarming rate they tend not to come in and then argue about how they don't think they really need a Colonoscopy.


Some times it amazes me how unrealistic people are about medicine.

Some enlightened fellow already pointed out that Modern American Medicine has become a complicated system of risk management. There are many factors that pushed it that way and I don't really feel like going off topic and gripping about them.

The point is that the public more than anything has been the ones that have absolutely stonewalled preventative medicine. You have to plead and bargain with people to quite smoking and get colonoscopies and trying to get someone to get a flu shot is like pulling teeth.

But the second they actually get the flu... then all of a sudden you want a cure. And you want it now.

People with the mindset like that of the quoted text are the people who have never actually been sick. But don't worry when you are we will be there for you... hoping that you don't try to sue our asses off later down the line.

 

[DrPizza]

Suppose a doctor decides not to administer care that is prudent for a particular illness. His incentive not to do this is to avoid that malpractice lawsuit.

Also, keeping you ill doesn't necessarily make him more money. Let's suppose you're admitted to the hospital and are stuck in the hospital for a month. From laying in a hospital bed that long, it's possible that you might end up with a bed sore. Many insurance companies, medicare/medicaid included, no longer cover hospital acquired problems such as that.
Let's suppose you go to the hospital for some cardiac problem. The doctor doesn't treat you in a way that prevents your readmission. The insurance companies no longer pay for readmissions within 30 days for cardiac problems. That's the hospital's fault & they can only bill for one admission.

 

[MtnMan]

Doctors don't get paid for curing you, they get paid for running tests, and more tests, and referrals, and rewards for writing prescriptions.

 

[moshquerade]

Oh please, I always know when my dentist wants to remodel his bathroom because the drill comes out. D:

Oh please, brush and floss.

 

[TheVrolok]

ATOT never ceases to display how little most (the vast majority?) actually know about medicine, and healthcare as an industry. The ignorance is astounding.

 

[JimW1949]

ATOT never ceases to display how little most (the vast majority?) actually know about medicine, and healthcare as an industry. The ignorance is astounding.

Oh joy, now we have a self professed healthcare guru who claims to know everything there is to know about health care and nobody else knows anything.

OK Mr Guru, if health care is all about getting people well and has nothing to do with money, then tell me something. Why is there so much health insurance fraud? Why are medical clinics billing insurance companies for tests that were not done, for services that were not rendered, and for medications the patient never received? Why is Medicare fraud amounting to billions of dollars a year?

 

[TheVrolok]

Oh joy, now we have a self professed healthcare guru who claims to know everything there is to know about health care and nobody else knows anything.

OK Mr Guru, if health care is all about getting people well and has nothing to do with money, then tell me something. Why is there so much health insurance fraud? Why are medical clinics billing insurance companies for tests that were not done, for services that were not rendered, and for medications the patient never received? Why is Medicare fraud amounting to billions of dollars a year?

Well, my mother has worked in healthcare administration her entire life (including spending time as the COO of an acute care facility), I did my premedical undergraduate work in microbiology and healthcare policy/administration, worked in EMS for years, did some bench research at UPenn, and now am a third year medical student while also completing my Masters in Public Health. Do I have all (many?) of the answers? Absolutely not. Do I have enough of a background to realize how ludicrous certain posters in this thread are? Yes.

You proposed a system of healthcare where you implied that physicians may not treat as effectively as possible (consciously or not) so that they can make more money? That's absolutely insulting, and shows that you have no personal relationship of substance with physicians.

You then suggest that you should only pay when healthy? Please, then, could you tell me how that applies to any number of genetic, congenital, chronic illnesses? How about someone with diabetes? Does having diabetes, in and of itself, constitute being ill even it properly controlled? Or is this patient only ill when his diabetes is uncontrolled (which, by the way, is often the fault of the patient due to poor compliance)?

There are a good number of physicians, nurses, medical students, and other healthcare professionals on this board, so please don't sit there and assume than no one has any idea.

Being frustrated about being sick is one thing, and completely normal, but taking it out/blaming it on physicians is a different thing entirely.

 

[ShawnD1]

That's just Canadian docs

There should be some kind of guarantee when going to a doctor. If you can't fix my problem, you owe me a 3 month prescription of Adderall (not the drug, just the paper saying I can buy it).

 

[SirStev0]

Suppose a doctor decides not to administer care that is prudent for a particular illness. His incentive not to do this is to avoid that malpractice lawsuit.

Also, keeping you ill doesn't necessarily make him more money. Let's suppose you're admitted to the hospital and are stuck in the hospital for a month. From laying in a hospital bed that long, it's possible that you might end up with a bed sore. Many insurance companies, medicare/medicaid included, no longer cover hospital acquired problems such as that.
Let's suppose you go to the hospital for some cardiac problem. The doctor doesn't treat you in a way that prevents your readmission. The insurance companies no longer pay for readmissions within 30 days for cardiac problems. That's the hospital's fault & they can only bill for one admission.

I think that this comes down to a lot of people not understanding how medicine works in this country. Docs are constantly hounded by people to get you out of the hospital.

Every floor has nurses devoted to "chart review" which boils down to making sure that the hospital will get paid. When the patient starts to get to the point that Medicare/Insurance will no longer cover things due to medical necessity we start getting notes on the charts.

As soon as you are "better enough" that insurance doesn't want to pay the hospital wants you out.

Docs come up with all sorts of ways to word things just right to try to help people from being slammed with the bills. If you spend an extra day and we don't give a good enough reason you're getting a nasty bill.

 

[SirStev0]

Doctors don't get paid for curing you, they get paid for running tests, and more tests, and referrals, and rewards for writing prescriptions.

Sweet I'd love to find out when I can start receiving checks and rewards. Cause I have definitely not seen that yet.

 

[JimW1949]

I think that this comes down to a lot of people not understanding how medicine works in this country. Docs are constantly hounded by people to get you out of the hospital.

Every floor has nurses devoted to "chart review" which boils down to making sure that the hospital will get paid. When the patient starts to get to the point that Medicare/Insurance will no longer cover things due to medical necessity we start getting notes on the charts.

As soon as you are "better enough" that insurance doesn't want to pay the hospital wants you out.

Docs come up with all sorts of ways to word things just right to try to help people from being slammed with the bills. If you spend an extra day and we don't give a good enough reason you're getting a nasty bill.

I don't care how many degrees you have, medical healthcare today is more about money than it is about getting patients well. You have , for all practical purposes, said the same thing when you said...see red text above.

Of course the hospital wants you out, the flow of money stops. So in reality, it's not about the patient being well enough to leave, it's about the money stopping so it's time for the patient to hit the road.

I am fully aware that doctors, medical clinics, hospitals and the like, need to get paid for their services, that goes without saying. But why is the first question asked, "Do you have health insurance", or "can you pay for the service?" Why isn't the first question asked, "What is the problem", or "How can we help you?" If healthcare is first and foremost about helping people, then why is money the first thing that comes up? What really troubles me right now is, why am I bothering to ask you more questions after you carefully avoided answering the last ones?

 

[TheVrolok]

I don't care how many degrees you have, medical healthcare today is more about money than it is about getting patients well. You have , for all practical purposes, said the same thing when you said...see red text above.

Your problem is you're blaming/insulting the wrong people. It's the businessmen pushing patients out the door, not physicians; and unfortunately, businessmen have a strong arm with which to control physicians. Physicians frequently do their best to circumvent (which is what SirStev0 was stating) the control of businessmen when they feel it is medically inappropriate.

 

[JimW1949]

Your problem is you're blaming/insulting the wrong people. It's the businessmen pushing patients out the door, not physicians; and unfortunately, businessmen have a strong arm with which to control physicians. Physicians frequently do their best to circumvent (which is what SirStev0 was stating) the control of businessmen when they feel it is medically inappropriate.

So what are you telling me? That healthcare is not a business? Exactly who is running the healthcare system in this country, physicians or insurance companies? You don't have to answer that question, everybody already knows the answer.

Doctors tend to blame the insurance companies, the insurance companies want to blame medical claims fraud, and the patient gets the short end of the stick.

How can anyone not understand our healthcare system is really screwed up and needs to be fixed? More and more I am convinced we need to switch to a single payer healthcare system.

 

[TheVrolok]

So what are you telling me? That healthcare is not a business? Exactly who is running the healthcare system in this country, physicians or insurance companies? You don't have to answer that question, everybody already knows the answer.

Doctors tend to blame the insurance companies, the insurance companies want to blame medical claims fraud, and the patient gets the short end of the stick.

How can anyone not understand our healthcare system is really screwed up and needs to be fixed? More and more I am convinced we need to switch to a single payer healthcare system.

It's not so much "insurance companies" more than it is business in general. The model has shifted, doctors ability to impact the way in which healthcare is delivered has been significantly stifled. If everyone already knows that the "business of medicine" is to blame, why did you come in here claiming that doctors might not want to treat you quickly?

You think the physicians like this end of the deal? They're getting the short end as well. Of course people understand the system is broken, but it's not exactly an easy fix. A lot of the problems are societal, and until the American people stop thinking/acting a certain way, it isn't going to change.

 

[Inspector Jihad]

i'm a 3rd year med student. as soon as i become a doctor all i am going to do is hold back treatment on patients so they don't get better then i can make monies!!!

i'm spending my mid 20s and hundreds of thousands of dollars just so i can make a couple of extra bucks by causing people suffering! its the most logical decision i made.

 

[JimW1949]

If everyone already knows that the "business of medicine" is to blame, why did you come in here claiming that doctors might not want to treat you quickly?

You seem to be implying that I said doctors were terrible people, or that they were to blame for all the evils of the medical profession. I never said that. What I said is that doctors have a financial incentive for their patients to return to the office more than once before they get well. Then I went on to say that maybe we should pay our family doctor when we are well, and stop paying when we are sick. That way the doctor has a financial incentive to get patients healthy as quickly as possible.

Because of that, I have heard all this mumbo-jumbo about how doctors are such wonderful people who would never do anything remotely dishonest. But if doctors, medical clinics and hospitals are so honest, then why is there so much medical insurance fraud/Medicare fraud? According to the US Government, the fraud amounts to billions of dollars per year.

 

[TheVrolok]

i'm a 3rd year med student. as soon as i become a doctor all i am going to do is hold back treatment on patients so they don't get better then i can make monies!!!

i'm spending my mid 20s and hundreds of thousands of dollars just so i can make a couple of extra bucks by causing people suffering! its the most logical decision i made.

You know, I take back everything I've said in this thread .. you've shown me the light.. I can't possibly think of a better way to pay back the nearly half a million I'll owe.

 

[JimW1949]

i'm a 3rd year med student. as soon as i become a doctor all i am going to do is hold back treatment on patients so they don't get better then i can make monies!!!

i'm spending my mid 20s and hundreds of thousands of dollars just so i can make a couple of extra bucks by causing people suffering! its the most logical decision i made.

Tell me something. Why are you attending medical school? Is it because you truly want to help people, or is it because you want to make a lot of money?

 

[TheVrolok]

You seem to be implying that I said doctors were terrible people, or that they were to blame for all the evils of the medical profession. I never said that. What I said is that doctors have a financial incentive for their patients to return to the office more than once before they get well. Then I went on to say that maybe we should pay our family doctor when we are well, and stop paying when we are sick. That way the doctor has a financial incentive to get patients healthy as quickly as possible.

Well, we can just stop here. You do realize that this is not always the case, correct? I know a number of physicians who work in capitation systems where they make MORE money the LESS they see you. Also, there are many contracts with insurance companies that provide incentive (monetarily) for physicians to decrease utilization (unfortunately to the point of underutilization IMHO). Healthcare, and the problems therein, are far more complicated than the oversimplification you've been using.

 

[Inspector Jihad]

You seem to be implying that I said doctors were terrible people, or that they were to blame for all the evils of the medical profession. I never said that. What I said is that doctors have a financial incentive for their patients to return to the office more than once before they get well. Then I went on to say that maybe we should pay our family doctor when we are well, and stop paying when we are sick. That way the doctor has a financial incentive to get patients healthy as quickly as possible.

Because of that, I have heard all this mumbo-jumbo about how doctors are such wonderful people who would never do anything remotely dishonest. But if doctors, medical clinics and hospitals are so honest, then why is there so much medical insurance fraud/Medicare fraud? According to the US Government, the fraud amounts to billions of dollars per year.

you are free to look up the standards of care for whatever illness you had and see if the doctor was doing enough to help. better yet, show it to a lawyer. there are so many road blocks against doctors exploiting the system for money. rather than making ridiculous circumstantial posts, you should spend some time looking into these loony accusations you're making.

 

[JimW1949]

you are free to look up the standards of care for whatever illness you had and see if the doctor was doing enough to help. better yet, show it to a lawyer. there are so many road blocks against doctors exploiting the system for money. rather than making ridiculous circumstantial posts, you should spend some time looking into these loony accusations you're making.

Why do you keep avoiding my question?