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Why Did My Patient Leave Me?

cancer.nautil.us

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Re: Why Did My Patient Leave Me?

#251

Post by magic_beans »

giardini wrote: post #203
madengr wrote: post #130

Earlier quoted context omitted.

Dermatologists have a cream for everything. Once in a while I have a horrible itch breakout on the top of my feat; so bad I'll scratch it bloody. In this case, the one pound tub he prescribed does work. Works well for chiggers too.

I asked two friends about my itching woes. Both are gardeners so have dealt with maddening itches. Their response: "I ask my doctor and he gives me a prednisone pill. The itching disappears; 3 days later I'm OK." In the case of the fungus, prednisone would have been a mistake, but I nonetheless sometimes feel I am a target for a form of alternative medicine. Why didn't _I_ get a prednisone pill instead of a tub of co…

What on earth is a chigger.

Re: Why Did My Patient Leave Me?

#252

Post by MagnumOpus »

magic_beans wrote: post #251
giardini wrote: post #203

Earlier quoted context omitted.

I asked two friends about my itching woes. Both are gardeners so have dealt with maddening itches. Their response: "I ask my doctor and he gives me a prednisone pill. The itching disappears; 3 days later I'm OK." In the case of the fungus, prednisone would have been a mistake, but I nonetheless sometimes feel I am a target for a form of alternative medicine. Why didn't _I_ get a prednisone pill instead of a tub of co…

What on earth is a chigger.

The common name for Trombiculidae, a family of mites related to ticks which feed on the skin of mammals and cause skin rashes in the process. Species include the harvest mite native to Europe and the berry bugs native to the southern US, midwest and Mexico.

Re: Why Did My Patient Leave Me?

#253

Post by ziikutv »

abrichr wrote: post #240
ziikutv wrote: post #217

Earlier quoted context omitted.

> This has happened many times to me. It's quite scary once you realize it. Thankfully no one ever told me I was pregnant. I was furious and told them to write my name, age, and gender on top of the leaflet in bold red letters and watched them do it. All subsequent visits started off with me making sure that it was the right chart. Some good doctors ask you name, age before opening the chart. Not this one.. > Care to…

> Doctors need to prevent shit instead of patching shit. Ideally yes. But we as individuals already have the capacity to do this: - Eat well - Exercise - Don't smoke - Don't drink - Wear sunscreen etc.

Yes. I think long term/chronic long term issues can be avoided by following those rules. I do not follow any of them which is my problem.

I think baking in lifestyle design or something that educates kids at an early age might help. Back home in India, I remember there used to be a kid show where they explained how mosquitoes and flies spread diseases and how this happens too often when you eat at the street vendors. I stopped doing that (of course, mileage varies)

Re: Why Did My Patient Leave Me?

#254

Post by lumberingjack »

cmahler7 wrote: post #219
giardini wrote: post #81

In my case, - reluctance to diagnose and treat the ailment instead of the symptoms and - simply refusing to hear what the patient says. I had an oozing rash break out behind my knees. The dermatologist said "That'll go away easily if you put some OTC corticosteroid cream on it." Wrong! The rash flared up within hours and nearly ate the flesh off the back of my knees. I happen to know that this indicates a fungal infe…

no disrespect to doctors but you really don't have to be that smart to become one. It's more about being willing to take out 300k in loans and stay in school until you are 30+ years old.

I'm inclined to agree. I struck up a conversation with a epidemiologist at a party once. He worked for GE designing water filters. I commented on how I just had to find a backpacking filter that could eliminate Viruses .018 micron + in size. Most wilderness medicine professionals now recommend treating water for viruses as well as bacteria and protozoa. Viruses must be eliminated through a purification system or boiling because they are small enough to pass through a filter. He was clueless and had nothing meaningful to add to the conversation and actually told me "that was new info to him."

Re: Why Did My Patient Leave Me?

#255

Post by cortic »

ThomPete wrote: post #245
cortic wrote: post #239

Earlier quoted context omitted.

"Spending even more is whats unsustainable" - nationalized healthcare spends less for the same or better outcome, if your problem is price, then your problem is private healthcare. 'cost center' Vs 'profit center' '[denying treatment] because it can't pay if everyone used it' - This is just false, moneys going into a countries nationalized health system is high return (due to taxes), its also cheaper (due to group un…

I am not sure why you talk about socialist system vs. Laissez-faire. Single payer doesn't mean socialist neither does private mean Laissez-faire. Those kind of oversimplifications doesn't really add anything useful to this discussion. Switzerland has universal healthcare but it's based on private insurance. In other words it's not that simple. In general I find this discussion hard to have because you are assuming so…

There are outliers but most systems fall between two extremes of regulation, the heaviest regulation is basically a socialist system, owned by the people, run as a public service and so directly regulated. the lightest regulated is a private system, in a country that believes in free trade, unimpeded, Laissez-faire. As a general rule, the latter gives you worse outcomes at higher prices and is, from a patient perspective, unsustainable. the former gives you better outcomes at lower prices and scales with the countries needs (along side GDP) and is very sustainable.

Switzerland has very heavy regulations, everyone is covered by a national insurance system like other EU countries, but the very fact that its private companies that carries out the health care show in the stats, they pay almost twice the GDP of the UK for about the same outcomes, same with Germany, which has a similar system, its about 18% of GDP (and their GDP is higher per person).

"I am saying that its able to make money which gives it flexibility" - if this is really what you are trying to say, then you should have started with "Private, profit driven health care is fine for rich people", which i would have agreed with.

"waiting time for operations, to see a specialist" - this is a bad example, how many Americans wait all there lives for an operation, or never see a specialist because of the price. if you factored this in the average waiting times in a private unregulated system would dwarf a socialist waiting list(which by definition includes everyone).

"With regards to drugs" - in England we have 'NICE' which is a public board mandated to approve drugs and procedures on the NHS, with the fist stipulation that the drugs or procedures are shown through proper trials to work. This system is not perfect, but its a hell of a lot better than a private board incentivized to approve any BS treatment on profit basis alone.

"In Denmark if you go to the dermatologist you have to wait 3 week. In the US I went straight in." Try to put your personal feelings aside and look at the stats; http://www.nationmaster.com/country-info/compare/Denmark/Uni...

Re: Why Did My Patient Leave Me?

#256

Post by ThomPete »

cortic wrote: post #255
ThomPete wrote: post #245

Earlier quoted context omitted.

I am not sure why you talk about socialist system vs. Laissez-faire. Single payer doesn't mean socialist neither does private mean Laissez-faire. Those kind of oversimplifications doesn't really add anything useful to this discussion. Switzerland has universal healthcare but it's based on private insurance. In other words it's not that simple. In general I find this discussion hard to have because you are assuming so…

There are outliers but most systems fall between two extremes of regulation, the heaviest regulation is basically a socialist system, owned by the people, run as a public service and so directly regulated. the lightest regulated is a private system, in a country that believes in free trade, unimpeded, Laissez-faire. As a general rule, the latter gives you worse outcomes at higher prices and is, from a patient perspec…

I am sure you don't notice it yourself but you are basically trying to argue through painting things into extremes.

It's either socialist or Laise-Faire, Switzerland is heavly regulated, Public boards are based on rationality, private boards are based on greed alone.

No a taxpayer paid healthcare system does not make it a socialist system anymore than a taxpayer police force or army does. And the US system isn't laissez faire just because it's broken in many ways. Most economies are mixed economies.

So I am not sure what you are trying to prove here. The fact remains that public healthcare has it's own issues regardless of whether you personally think they are better issues to have and any honest dive into those the countries systems will show you that. You can't both have your cake and eat it. Switzerland is heavy regulated you claim (which is wrong) but they pay twice the GDP for about the same outcome. So what is it? A system governed by the state, a system that's private or something in between? With regards to Germany most of their insurance is covered by public healthcare 80% if not more. So why is that?

Furthermore the US is a huge country with hundreds of millions of citizens and millions of illegal immigrants and spread out over a huge area. Based on it's circumstances it's not doing too shabby regardless of the statistics.

It's just not as simply as you would like to paint it in those extreme corners.

There is an interesting discussion around Medicaid vs. private insurance in the US you can read about here:

https://www.forbes.com/sites/sallypipes/2014/08/14/no-really...

My point was never to say one thing was better than the other yet thats what we are really discussing here.

My point was that there are tradeoffs in both systems.

Re: Why Did My Patient Leave Me?

#257

Post by surgeryres »

cmdrfred wrote: post #74
surgeryres wrote: post #65

Earlier quoted context omitted.

So are you going to fly back when the biopsy is positive for your surgery or chemotherapy?

Chemo is often every week or month for a period of time, but the surgery is probably a one off. I'd go for it if I was able.

Surgery might be a "one-off", but cancer surgery can be brutal. People with cancer who need surgery are often nutritionally depleted and surgery takes a big toll. Recovery time in the hospital could be weeks. Rehab, getting you back to where you can wipe your own ass and feed yourself, can take months.

It's not like you would just fly in, get cut and fly back in a week.

You would have to set up some kind of support system for yourself there, which would be very expensive.

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