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Why Did My Patient Leave Me?

cancer.nautil.us

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Re: Why Did My Patient Leave Me?

#151

Post by salesguy222 »

jjordan wrote: post #138
salesguy222 wrote: post #132

Earlier quoted context omitted.

Which have you tried? :) p.s: anyone that downvotes this, you should really allow HN to be a place with a small dosage of humor sometimes!!

If I want to scroll through pages and pages of joke threads, I'll go to reddit. HN is special in its high signal to noise ratio.

Some of the most profound observations in this world were made by accident, or through jokes. Some of the most effective speakers routinely incorporate humor into their presentations, including John Carmack.

If you really feel this site needs more technical manuals, nobody will stop you.

But if you think humor is less important than the debate about Italian vs French bread that is on the front page right now, then I wish you luck in your very dull life

Re: Why Did My Patient Leave Me?

#152

Post by mhneu »

CydeWeys wrote: post #114

I abandoned an orthopedist last year because I felt that he was using hard-sell tactics on me to get me to agree to surgery for my broken ankle. Basically, he had a surgery slot open in a few days and it seemed like he wanted to book it, with increasing discounts (including exploding offers!) on the surgery as I kept demurring. He was a referral from the urgent care clinic that I went to immediately following the acc…

Things I have learned about orthopedists: - they have only one tool and it is surgery. If you don't need surgery, you need to see a physical therapist. PTs know far more about soft tissue injuries and rehab than orthopedists.

- orthopedists make money from each surgery they do. Many orthos are honest, but some areas of US have orthos who run joint replacement factories to maximize profit. In the past few months I've gotten two junk mailings from orthos advertising joint replacement. If doctors are advertising, you know their financial incentives are wrong.

Re: Why Did My Patient Leave Me?

#153

Post by jwilk »

salesguy222 wrote: post #132
giardini wrote: post #116

Earlier quoted context omitted.

The fungus or the steroid cream?

Which have you tried? :) p.s: anyone that downvotes this, you should really allow HN to be a place with a small dosage of humor sometimes!!

From the HN guidelines:

Please resist commenting about being downvoted. It never does any good, and it makes boring reading.

Re: Why Did My Patient Leave Me?

#154

Post by lkbm »

jacquesm wrote: post #55
lmns wrote: post #28

So, in this sense, vaccination should be an individual choice? This is something which concerns the individual, but has consequences for society as a whole.

> So, in this sense, vaccination should be an individual choice? Emphatically: YES. Bodily integrity is something that is very high on the list of things that a person should have a say over. Whether they do it because they are mis-informed, dumb, irrational or religious doesn't matter, they still should have the final say over whether or not they get a specific injection or not. There are many things that concern th…

> and fortunately the only people at risk are those that have not been vaccinated yet

No, vaccines are not 100% effective. For example, the H3N3 vaccine was 90% effective[1]. So the only people at risk are those not yet vaccinated...and an additional 10% of the people who did get the vaccine.

Also, as noted in another reply, many, many people can't get vaccinated and rely on those of us who can to not be spreading the disease around. You can't vaccinate a newborn, for example.

There's a lot of value in bodily autonomy, and it's definitely questionable to mandate vaccines, but that has to be weighed against the costs, and that requires understanding and honestly acknowledging the costs.

[1] https://en.wikipedia.org/wiki/Vaccine_efficacy

Re: Why Did My Patient Leave Me?

#155

Post by salesguy222 »

jwilk wrote: post #153
salesguy222 wrote: post #132

Earlier quoted context omitted.

Which have you tried? :) p.s: anyone that downvotes this, you should really allow HN to be a place with a small dosage of humor sometimes!!

From the HN guidelines: Please resist commenting about being downvoted. It never does any good, and it makes boring reading.

That is a bullshit rule and I would rather be banned and crucified than even attempt to be

that

fucking

complacent

Re: Why Did My Patient Leave Me?

#156

Post by mhneu »

CydeWeys wrote: post #114

I abandoned an orthopedist last year because I felt that he was using hard-sell tactics on me to get me to agree to surgery for my broken ankle. Basically, he had a surgery slot open in a few days and it seemed like he wanted to book it, with increasing discounts (including exploding offers!) on the surgery as I kept demurring. He was a referral from the urgent care clinic that I went to immediately following the acc…

For example on surgery advertising in a non-rich area of the US:

http://www.scrantonhipandknee.com

Landing page is all about how great hip and knee replacements are.

Re: Why Did My Patient Leave Me?

#157

Post by barrkel »

ThomPete wrote: post #86
jacquesm wrote: post #72

Earlier 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 are in the middle

Of the income or wealth distribution - not a hope, it's Pareto all the way. You've got a really warped view of the world there.

Re: Why Did My Patient Leave Me?

#158

Post by ThomPete »

mhneu wrote: post #133
ThomPete wrote: post #90

Earlier quoted context omitted.

And the french started cutting benefits already in 2014 to make sure that didn't happen.

Right. So you're saying the French single payer system works, with political modification as needed over time. The issue that might make single payer difficult in America is we don't trust our political system to manage good programs, because the GOP is committed to destroying government (to benefit the super rich) rather than trying to get things done.

No I am saying what I said originally that there are issues with the single payer system as it's based on tax money and thus can't make it's own money.

Re: Why Did My Patient Leave Me?

#159

Post by muninn_ »

foldr wrote: post #93
muninn_ wrote: post #58

Earlier quoted context omitted.

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.

So the thing is that it's not like I wait 30 minutes then see the nurse and then immediately see the doctor. It's wait 30 minutes, wait 5 minutes for the nurse, wait 20 minutes for the doctor and then she is like rushing through her appointment with me. I spend over an hour for 5-10 minutes worth of doctor time.

Re: Why Did My Patient Leave Me?

#160

Post by arkades »

josephorjoe wrote: post #33

The 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…

The problem is:

Doctor Revenue = Number of Hours Worked / Yr / Duration of Average Visit * reimbursement for average visit

That's capped, and everyone is squeezing down on it constantly. Every bit of healthcare reform in the last couple decades has been unfunded mandates (aka, increased overhead) coupled to ongoing reductions in reimbursement rates. For that matter, as is usually the case when price ceilings are implemented, demand > supply, and docs are booked to capacity in most places.

This creates a problem when it comes to hiring staff. Better staff comes directly out of your pocket, and it doesn't translate into higher revenue: it's just a cost. Er... most businesses don't throw money out of the window if they can avoid it.

The exception is billing staff (some of whom are better than others at maximizing your revenue from insurers), and if you plan on moving into a luxury all-cash niche, in which you can demand market rates for better service.

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