Physicians’ attitudes about caring for people with disabilities • Hacker News Board

Re: Physicians’ attitudes about caring for people with disabilities

#31

Post by User23 » Sun, Oct 30, 2022, 3:11 PM UTC

lotsofpulp wrote: post #27

parkerhiggins wrote: post #18

Earlier quoted context omitted.

Spot on. It becomes more clear when you ask who pays medical professionals salaries? Insurance companies do. Insurance companies are medical professionals’ bosses. The customer receiving treatment has no influence on the standard of care.

Most customers could not afford the treatment at the standard of care they want anyway, hence the reason they purchase via insurance.

Interestingly this wasn’t the case in living memory in the USA. The insurance cartels have effectively greatly increased prices while commensurately lowering the standard of care.

Re: Physicians’ attitudes about caring for people with disabilities

#32

Post by kayodelycaon » Sun, Oct 30, 2022, 3:12 PM UTC

Test0129 wrote: post #20

kayodelycaon wrote: post #16

Earlier quoted context omitted.

What’s an example of an unnecessary thing?

I dunno, that's the point. Since it only technically requires "reasonable accommodation" it's up to interpretation. "Reasonable accommodation" has been used by ambulance chasers to sink businesses. I'm sure a set of absolutes could be codified. I'm getting downvoted to death for having an opinion again so I'm just gonna leave the topic.

Reasonable accommodation isn’t significantly onerous in the vast majority of cases. You don’t have to provide the accommodation a person wants. For example…

- Ordering via phone could be an acceptable accommodation for an inaccessible website. (Just don’t place the person on hold for half an hour.)

- Pen and paper can be used for communication when verbal communication isn’t possible.

- If someone is blind, you may be able to read things for them.

I’ll often get people still objecting to this level of accommodation because it is still inconvenient.

Re: Physicians’ attitudes about caring for people with disabilities

#33

Post by User23 » Sun, Oct 30, 2022, 3:13 PM UTC

arkades wrote: post #22

Test0129 wrote: post #17

Earlier quoted context omitted.

> Worse, I need to confirm the doctor kept in mind _all_ of this in my treatment plan, because I've had awful reactions when they haven't. I'm not disabled but do have some chronic stuff. A couple decades ago I started carrying my medical record (well...the synopsis) to the doctors office for this reason. Especially when you end up in a clinic rather than a real private practice you're often not guaranteed to even se…

That’s not what the doc gets paid. That’s the pretend amount that the insurer and doc have agreed upon, before their agreed upon discount. Source: doctor.

You as the doctor actually explicitly signed off on the real price? Not some administrator somewhere? Did you have any real input, or is your relationship to the insurer more like a driver’s relationship to Uber?

Re: Physicians’ attitudes about caring for people with disabilities

#34

Post by kelseyfrog » Sun, Oct 30, 2022, 3:13 PM UTC

lotsofpulp wrote: post #29

Test0129 wrote: post #20

Earlier quoted context omitted.

I dunno, that's the point. Since it only technically requires "reasonable accommodation" it's up to interpretation. "Reasonable accommodation" has been used by ambulance chasers to sink businesses. I'm sure a set of absolutes could be codified. I'm getting downvoted to death for having an opinion again so I'm just gonna leave the topic.

The ADA should have been the government providing disabled people with sufficient cash to purchase the services or products they need to address their disability, or the government can provide it directly. But by diffusing the responsibility across businesses, the government can say they helped people without spending any money or taking responsibility to help people. For example, why would a doctor need to arrange f…

How does a disabled person purchase a ramp or handrail for the building they are trying to enter?

Re: Physicians’ attitudes about caring for people with disabilities

#35

Post by hn_throwaway_99 » Sun, Oct 30, 2022, 3:13 PM UTC

photochemsyn wrote: post #19

This is yet another argument for the transition of American health care from a primarily private for-profit operation to a socialized medicine model. Compare to the British NHS, which takes this issue into consideration and devotes resources to it: https://www.england.nhs.uk/2017/09/nhs-england-launches-prac... Yes, you can still get privatized health care if you want to pay for it in Britain, you can hire a nurse an…

This was the thing that was so baffling to me about this study. I read the interview quotes, but then was baffled by the study's conclusion where they focused on things like "attitudes" and "structural barriers" (I kinda hate that term because it's easily interpreted in different ways).

Meanwhile I'm screaming "Duh, it's money!". Meaning that:

1. The study, for some reason seems reluctant to come out and say "treating those with disabilities costs more". Which seems pretty patently obvious when you read many parts of the rest of the study: they talk about needing more specialized equipment, needing to take additional time, etc.

2. Thus, in a private care system where reimbursements aren't changed for treating people with disabilities, there are tons of embedded incentives to not want to deal with those with disabilities.

The only was to get rid of these unwanted incentives is to fundamentally change the for-profit nature of American health care. Good luck with that.

Re: Physicians’ attitudes about caring for people with disabilities

#36

Post by wholinator2 » Sun, Oct 30, 2022, 3:16 PM UTC

thepasswordis wrote: post #30

I really wish I could just (safely) order whatever medications, tests, and treatments I want online. Let me consult a doctor if I need one, but also: don't gatekeep treatment from me because the doctor is having a bad day, doesn't like me, etc. I have a severe , debilitating anxiety disorder. It's extremely frustrating, and sometimes I will have to leave classes I'm teaching, social functions, etc. for no apparent re…

You can just keep the pills. If you're really that strong about avoiding addiction why do you feel the need to throw them away?

Re: Physicians’ attitudes about caring for people with disabilities

#37

Post by knaekhoved » Sun, Oct 30, 2022, 3:17 PM UTC

thepasswordis wrote: post #30

I really wish I could just (safely) order whatever medications, tests, and treatments I want online. Let me consult a doctor if I need one, but also: don't gatekeep treatment from me because the doctor is having a bad day, doesn't like me, etc. I have a severe , debilitating anxiety disorder. It's extremely frustrating, and sometimes I will have to leave classes I'm teaching, social functions, etc. for no apparent re…

You can order xanax on the darkweb, FYI.

I mostly agree with you - the problem is that doctors are trained to deal with the lowest common denominator of patient: an addictive idiot who would kill themselves with benzos or opiates, given the chance. 90% of doctors are absolutely not equipped to deal with high-agency, high-intelligence patients. I've had a few doctors that were smart enough to work with me on experimentation or nonstandard treatment, but they are few and far between.

Re: Physicians’ attitudes about caring for people with disabilities

#38

Post by hotpotamus » Sun, Oct 30, 2022, 3:17 PM UTC

thepasswordis wrote: post #30

I really wish I could just (safely) order whatever medications, tests, and treatments I want online. Let me consult a doctor if I need one, but also: don't gatekeep treatment from me because the doctor is having a bad day, doesn't like me, etc. I have a severe , debilitating anxiety disorder. It's extremely frustrating, and sometimes I will have to leave classes I'm teaching, social functions, etc. for no apparent re…

You can order unscheduled drugs from pharmacies in India like alldaychemist.com. That means no benzodiazepines, but there are drugs with off-label anxiolytic indications like hydroxyzine, propranolol, or clonidine to name a few. I don't disagree with you regarding our medical system.

Re: Physicians’ attitudes about caring for people with disabilities

#39

Post by kingkawn » Sun, Oct 30, 2022, 3:17 PM UTC

User23 wrote: post #31

lotsofpulp wrote: post #27

Earlier quoted context omitted.

Most customers could not afford the treatment at the standard of care they want anyway, hence the reason they purchase via insurance.

Interestingly this wasn’t the case in living memory in the USA. The insurance cartels have effectively greatly increased prices while commensurately lowering the standard of care.

Medical institutions have been kept onboard with massive increases in revenue that subsequently led to expansions of the institutions that are now dependent on that higher revenue to exist.

Re: Physicians’ attitudes about caring for people with disabilities

#40

Post by chiefgeek » Sun, Oct 30, 2022, 3:19 PM UTC

thepasswordis wrote: post #30

I really wish I could just (safely) order whatever medications, tests, and treatments I want online. Let me consult a doctor if I need one, but also: don't gatekeep treatment from me because the doctor is having a bad day, doesn't like me, etc. I have a severe , debilitating anxiety disorder. It's extremely frustrating, and sometimes I will have to leave classes I'm teaching, social functions, etc. for no apparent re…

Sorry to hear about the suffering you endure with your condition. Have you investigated any somatic work? How about psychedelics? Over the past 10+ years, I've gotten myself off a 200mg dose of Zoloft, along with Wellbutrin and Adderall through a combination of the above. I've seen others heal similarly.