This is an interesting read. It seems doctors really believe they have a conversation with their patient whereas most patients feel that the doctor just rushes in and gives his standard recommendation without deeper thought and generally doesn't listen to them.
Do doctors go to other doctors when they have a problem? Do they get more respect by other doctors? If they went to a doctor and got the same treatment as their patients typically they should see that something is going wrong.
Why Did My Patient Leave Me?
91–100 of 257 posts
Re: Why Did My Patient Leave Me?
#92Earlier quoted context omitted.
I do question the morality of the US system, and the sustainability of inflated prices it creates. Its also important to remember that in for - profit healthcare, its operated as a profit center and thus has profit margins that are corporately mandated and not determined by need, at least not directly. This leads to a massive inflation of price and decrease of quality of service, medicine, machines etc. Not saying th…
There's no question about it morality - it's immoral. Creating a system where whether you live or die is premised on your income is immoral. Even more so when single-payer systems demonstrably achieve better health outcomes at lower prices. The reality is that that so many people in this country have bought into some kind of Capitalist Calvinism, where the suffering is not only pre-ordained by "market forces," but co…
It's not that simple. Single payer systems also decide who to treat and for what sicknesses, what machines to buy etc.
The reason why the US system is so expensive is because of perverse incentives given to the industry.
As long as you can afford it I would rather be treated in the US system than the French or Danish system.
Re: Why Did My Patient Leave Me?
#93The primary reason I have left healthcare providers has been the poor quality of their administrative staff. There are too many qualified doctors in the major metro area I live in to put up with ones where I can't quickly and efficiently make an appointment, can't get an appointment in a timeframe that is useful to me, and where their staff can't seem to successfully process routine insurance claims with major insura…
I hear you. Previous office I went to I had to wait more than 30 minutes past my appointment time before being seen by the nurse (before being seen by the doctor) which didn't include "arrive 10 minutes before your appointment". Obviously this is annoying. The third time I showed up to the same office I was 10 minutes late to my appointment, and they told me I would have to reschedule or wait about 45 minutes to an h…
What you appear to want is contradictory. Tolerance for people arriving late is incompatible with having appointments start on time, as everything gets backed up.
Re: Why Did My Patient Leave Me?
#94I have luckily been very healthy in my life, but I have always believed that the relationship between a doctor and a patient is a collaboration with the aim being to help the patient make the most appropriate decision for their needs. Too many doctors seem to be of the opinion they know best and the patient should just do as they say - even if they are correct technically it is not their life that is on the line. The…
Not sure the patient is always right but the docs are often wrong. Collaboration probably works best. The docs have more medical knowledge but the patient may know more about their particular condition. I recently went to a dentist with a broken tooth and he wanted to do a root canal not because their was any evidence it was infected but because he thought it might be and why not from his point of view. From mine I'd…
There may also be quotas to fulfill for certain procedures. I often get that impression from dentists when they push for something that doesn't really make sense.
Re: Why Did My Patient Leave Me?
#95Earlier quoted context omitted.
You wrote: > most people pay most of the cost for normal healthcare costs like going to the doctor for a checkup, most of the cost for one of things like a broken leg Most people are poor. Wealthy people are the exception and most people would not be able to pay for even the simplest procedures. They typically can't pay for a new washing machine if their current one breaks down.
Most people in the west aren't poor just like most people aren't wealthy. Most people are in the middle. There is a large number of people who can't afford to buy a washing machine but it's not most people.
> Most people in the west aren't poor just like most people aren't wealthy. Most people are in the middle.
Wrong, income distribution isn't normal, it's bottom-heavy, and most people are well below the mean.
Re: Why Did My Patient Leave Me?
#96Earlier quoted context omitted.
This is not the market fault it's the political system and reimbursement rules which creates perverse incentives. Some hospitals have begun to get reimbursed based on how well the patients gets treated called value based treatment.
I was implying that the US doesn't really have a market.
Compared to Europe it does though. I.e. the us healthcare system does't get most of it's payment through taxation. Thats an important distinctions.
Re: Why Did My Patient Leave Me?
#97It ain't perfect in Canada either.
I remember losing my hairs and getting patches of super smooth bald spots. Super embarrassing for a kid in a bad neighbourhood and bad school.
Went to the doctor she looked at my charts and said I was super low on iron so low that I might even die if it continues to lower. I was given iron pills.
Two months after I went to the doctor again and said my hair patches are not fixed. She looks at my chart again and said... hey you don't have low iron you have perfect iron and I never told you to take any pills.
Then upon investigation it was noted that the staff gave her wrong chart; of a pregnant woman who had a similar "feminized" version of my name.
Edit: Addendum: finally I was sent to a skin specialist who injected me with steroids for months until my patches were fixed. They said I had alopecia.
I was furious what if the said person had cancer and they started chemo on me?
Same doctor once injected my mom with the wrong fluid. To this day we don't know. We filed a complaint but she then resorted to personal attacks in her report and the "college of medicine" or whatever it's called didn't do anything. Till this day my mom has a red/purple bump on her arms.
Finlly, most other docs don't even check me out they listen to symptoms and say it's nothing, it will go away, etc while looking miserable (no doctor should watch House MD lol). Other times they solve the symptoms by tossing prescriptions at me. Said symptoms always keep coming back and I keep getting more of the same prescriptions.
Thanks for the free health"care" Canada.
Re: Why Did My Patient Leave Me?
#98Earlier quoted context omitted.
>the doctor then ordered someone else not in the room to come and get me a glass of water // It seems possible that was a hygiene issue. For example the doctor knew that he'd need then to wash his hands again (possibly twice, once before going to the cupboard, once after), or change his gloves, before continuing with your consultation?
Another alternative that I've run into. Visiting a doctor friend of mine. She needed to deliver some papers to another room and summoned the nurse for that. I joked that why you can't do that yourself (omg) and she replied that the nurses start to complain if you do stuff that's earmarked to them. It might be that it's because they're in a union or it's a company policy. Who knows, I never asked. But the point was th…
It's not necessarily an ego or union thing. It's more of a protocol thing. The nurse needs to know what papers have been signed and generally where the patients are in terms of paperwork. I'm a medical student, and I've been amazed at how efficiently the inefficient system in an outpatient clinic works. There's a very specific protocol that all the assistants, nurses, and doctors adhere to, and any deviation from the protocol seems to halt the entire system. If the doctor in your scenario moved the papers herself, the nurse would be out of the loop. The papers probably signified that your patient visit was almost over, and the nurse needs to be aware of that so she can get the next patient moving.
Re: Why Did My Patient Leave Me?
#99I think it's great for doctors to solicit feedback from departing patients to see if there is anything they could be doing better.
But on a related note: I'm not sure about the value of using patient satisfaction surveys to evaluate physician performance generally. Patients will love doctors who tell them what they want to hear, over-prescribe antibiotics, over-prescribe powerful pain killers, go along with non-vaccination, prescribe homeopathic remedies or similar nonsense.... I think most people are not in a good position to evaluate the quality of care they're getting outside of things like bedside manner, so I wouldn't pay much attention to reviews for doctors.
Re: Why Did My Patient Leave Me?
#100Earlier quoted context omitted.
> Fortunately the anti-vaxxers are a small minority instead of a large majority so the risk is somewhat controllable and fortunately the only people at risk are those that have not been vaccinated yet (a risk that for many diseases is extremely small) so the consequences for society as a whole are manageable. Loss of herd immunity effects those who have gotten the vaccine as well (especially with vaccines that have m…
That's true, but it's not an absolute: there is no guarantee anybody will get ill, it's rolling the dice with a somewhat higher chance of someone else getting ill but a much bigger chance of you yourself getting ill. As an analogue: if you want to categorize the non-vaccinated person as a 'drunk driver' who is not allowed to partake in traffic then you prioritize (rightly, imo) their choice to be drunk over the risk…
> The counter point (to that convenient strawman :) ) is that the chances of someone getting ill are not as easy to determine and that that someone might have gotten ill anyway. Cause and effect are a lot more distant in that case and much harder to relate to each other.
This is wishy-washy logic. There are real evidence/data-based scientific studies that show the specific measurable increase in infections of various diseases based on how many members of the population refuse the available vaccines. There have been flare-ups in California with dozens of people becoming infected (and some dying) when herd immunity is lost. This is not hypothetical; it is simply fact. Similarly, it's hard to say whether any individual pack-a-day smoker will die from lung cancer, but we know that, in aggregate, smoking significantly increases your risks of dying from lung cancer, so to make wishy-washy statements attempting to justify smoking as maybe not unhealthy would similarly fall on deaf ears.
And lastly -- this isn't all theoretical. I want you to watch a video of an infant, too young for vaccination, that has contracted whooping cough thanks to failure of herd immunity (i.e. anti-vaxxers). Even with all the benefits of modern medicine there is a good chance that infants like this one that contract whooping cough will die. This is what enabling anti-vaxxers does: https://www.youtube.com/watch?v=S3oZrMGDMMw