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Physicians’ attitudes about caring for people with disabilities

healthaffairs.org

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Re: Physicians’ attitudes about caring for people with disabilities

#91

Post by lotsofpulp »

gamblor956 wrote: post #78
VancouverMan wrote: post #47

Earlier quoted context omitted.

And those pricing distortions are due to significant government-imposed regulations and restrictions that tightly limit the supply of doctors and medical services, even in the face of increasing demand.

That's false, but why let the truth get in the way? The limitation on doctors in the U.S. is based on the available funding for residents. The government supplies the money because private institutions largely are unwilling to do so.

Is it true that unsubsidized residencies would not be profitable? If so, I would not expect private institutions to opt to lose money.

https://www.reddit.com/r/medicine/comments/a0pufi/comment/ea...

Re: Physicians’ attitudes about caring for people with disabilities

#92

Post by threatofrain »

eska wrote: post #46
octokatt wrote: post #11

N=1, but I can confirm the experience of being disabled and getting medical care is mutually frustrating. Taylorism and one-size-fits-all fails hard. Appointment times are standardized, despite patients not being standard. I know I'm going to take extra time. I have multiple chronic conditions, getting treatment is a mess. But I can't arbitrarily ask for more time during booking; it's all automated now. Worse, I need…

* I'm making them go over time* Saying this as a non-disabled person, please don’t think of it/word it this way. It’s not you, it’s the disability, and you’re not responsible for it. If you take some time because of it I would gladly accommodate you as a service provider and show understanding as the next patient in line.

If people prioritized their values this way then store owners would also fail to serve disabled people.

Re: Physicians’ attitudes about caring for people with disabilities

#93

Post by pg_bot »

octokatt wrote: post #11

N=1, but I can confirm the experience of being disabled and getting medical care is mutually frustrating. Taylorism and one-size-fits-all fails hard. Appointment times are standardized, despite patients not being standard. I know I'm going to take extra time. I have multiple chronic conditions, getting treatment is a mess. But I can't arbitrarily ask for more time during booking; it's all automated now. Worse, I need…

You might want to seek out a direct primary care clinic.

Re: Physicians’ attitudes about caring for people with disabilities

#94

Post by bradleyjg »

Our entire framework of accommodation is a mistake. If we wish for people—disabled, pregnant, whatever—to be subsidized we should collectively bear the costs. We shouldn’t insist that whoever they randomly come across be forced to eat those costs. That’s both unjust and a recipe for resentment, reluctant service, and hidden avoidance.

Re: Physicians’ attitudes about caring for people with disabilities

#95

Post by Calavar »

amalcon wrote: post #87
wholinator2 wrote: post #36

Earlier quoted context omitted.

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?

For medication like this, the doctor will usually prescribe a specific number of pills at a specific dosage. The number will rarely exceed what you ask for, and asking for large numbers of pills is treated (not unreasonably) as a sign of drug seeking.

This is true in general, but as a doctor, I've never written a prescription for only 3 Xanax pills. Usually more like 10 to 30 depending on the situation. The only time I write for a single digit number of pills is for antibiotics, where I know ahead of time exactly how many pills they will need.

Re: Physicians’ attitudes about caring for people with disabilities

#96

Post by tux3 »

amalcon wrote: post #87
wholinator2 wrote: post #36

Earlier quoted context omitted.

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?

For medication like this, the doctor will usually prescribe a specific number of pills at a specific dosage. The number will rarely exceed what you ask for, and asking for large numbers of pills is treated (not unreasonably) as a sign of drug seeking.

>and asking for large numbers of pills is treated (not unreasonably) as a sign of drug seeking.

Something that keeps tripping me up with the label of drug seeking, is that in this situation the person is correctly drug seeking in a situation they've previously had a specific problem diagnosed and have had positive experiences with a therapeutic. They simply need to subject themselves to the ritual, follow doctor's orders, and not look like they are drug-seeking to successfully drug-seek the therapeutic.

What bother me is the implicit confusion between seeking drugs to treat a specific problem, versus not. Confusion creates damage both ways, with an insufficiently individualized approach people subject to drug addictions may not be sufficiently protected (many are still successful finding someone who will fuel their addiction), while people not subject to drug addiction receive substandard care.

Re: Physicians’ attitudes about caring for people with disabilities

#97

Post by dennis_jeeves1 »

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…

>I HATE the medical system.

A teeny nitpick, it's never the system, its always collectively the people, and common people at that. I have toyed with the idea of getting a medical degree but it's a lot of time, effort and money, to get over the issues you correctly pointed out, but it appears that searching and finding a doc that is disgruntled with the 'system' and who might be co-operative with things that I need is higher.

Re: Physicians’ attitudes about caring for people with disabilities

#98

Post by TylerE »

csdvrx wrote: post #61
orbital223 wrote: post #55

Earlier quoted context omitted.

Most medicine has expiration dates. If he needs it only every 3-5 years, it's unlikely the pills will still be usable.

> it's unlikely the pills will still be usable Pills (and chemicals) are not SSL certificates: they don't cease to work at the expiration date + 1 second.

And in the US at least, FDA requires a max expiration date or one year, despite many being shelf stable for probably decades.

I know I read somewhere about morphine pills from WW2 medkits being found to still be useful 60+ years later - like say 30-50% of stated dose.

Re: Physicians’ attitudes about caring for people with disabilities

#99

Post by bombcar »

johannbok wrote: post #77
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.

This is partly true. In no small part because they tend to control the bulk (or all) of our patient supply. In part because people have gotten the idea that insurance equals care, and vice versa - so people tend not to think about high-impact moments where it pays to go cash. For instance, I specialize in neuromodulation for highly-treatment-resistance psychiatry. I'm very good at what I do; my mentor is (IMO) better…

Many people do not realize how cheap it can be to do direct-consultations; and it can't hurt to ask.

Even a doctor pulling down $1m a year is only about $500 an hour, and that could be entirely worth it to get their time and dedicated.

Re: Physicians’ attitudes about caring for people with disabilities

#100

Post by bombcar »

csdvrx wrote: post #61
orbital223 wrote: post #55

Earlier quoted context omitted.

Most medicine has expiration dates. If he needs it only every 3-5 years, it's unlikely the pills will still be usable.

> it's unlikely the pills will still be usable Pills (and chemicals) are not SSL certificates: they don't cease to work at the expiration date + 1 second.

The US government tested a bunch of old World War II medication they found laying around, and it had something outrageous like 98% efficacy or whatever.

Maybe a liquid medicine would go bad but I suspect pills are forever.

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