Earlier quoted context omitted.
[flagged]
That’s a horrible thing to say.
It's a morbid joke but 30% of bc residents don't have a family doctor. Maid is being used as a tool to lighten the load on the system.
A fourth of U.S. health visits now delivered by non-physicians
41–50 of 158 posts
Re: A fourth of U.S. health visits now delivered by non-physicians
#42Quick care beats quality care past a certain level of time and money.
Re: A fourth of U.S. health visits now delivered by non-physicians
#43I get annoyed when I send a message to my doctor and it takes 3 back-and-forths to get a message from him, and not the nurse. The nurse's advice tends to be along the lines of what I would find with Google, some semi-relevant copy/pasted advice. I get the sense that they make the messaging system useless so that you have to sign up for appointments/video appointments. They know that for GP appointments, you only pay…
They don't want to solve your problem over a messaging system - and prefer you to come in - the MD can't bill anyone for answering you questions over the phone or even via messaging - which is why they push for an appointment. Not sure what line of work you are in, but are you willing to answer endless emails and or voice mails from customers, all for free? I know I am not - and while you personally may only ask one…
This is a problem they're working on solving, I think. The hospital group I've been using in the Portland area recently announced that patient-initiated messages that take more than a few minutes, and require e.g. digging through a chart, are billable to insurance: https://www.legacyhealth.org/messages
MyHealth is just what this hospital system calls their patient-facing Epic portal.
Re: A fourth of U.S. health visits now delivered by non-physicians
#44I get annoyed when I send a message to my doctor and it takes 3 back-and-forths to get a message from him, and not the nurse. The nurse's advice tends to be along the lines of what I would find with Google, some semi-relevant copy/pasted advice. I get the sense that they make the messaging system useless so that you have to sign up for appointments/video appointments. They know that for GP appointments, you only pay…
They don't want to solve your problem over a messaging system - and prefer you to come in - the MD can't bill anyone for answering you questions over the phone or even via messaging - which is why they push for an appointment. Not sure what line of work you are in, but are you willing to answer endless emails and or voice mails from customers, all for free? I know I am not - and while you personally may only ask one…
> Not sure what line of work you are in, but are you willing to answer endless emails and or voice mails from customers, all for free?
It's common practice to answer emails and take calls from customers and not charge them for it in many industries. If you have 3000 patients, and you spend 3 minutes/patient/year on these interactions, then you spend ~30 minutes a day answering emails or leaving voice mails which is pretty standard.
Re: A fourth of U.S. health visits now delivered by non-physicians
#45Earlier quoted context omitted.
AMA stopped lobbying for that around ten years ago
Which given the 8-10 year pipeline to become a physician, means we have yet to see the effects. It will take years more.
It doesn’t help that doctors and other healthcare professionals are leaving because of burnout. It will only get worse in my opinion.
“Warning signs for the U.S. health system are piling up”
“Nearly half of practicing U.S. physicians are older than 55”
https://www.axios.com/2023/10/26/health-care-doctor-shortage...
Re: A fourth of U.S. health visits now delivered by non-physicians
#46I get annoyed when I send a message to my doctor and it takes 3 back-and-forths to get a message from him, and not the nurse. The nurse's advice tends to be along the lines of what I would find with Google, some semi-relevant copy/pasted advice. I get the sense that they make the messaging system useless so that you have to sign up for appointments/video appointments. They know that for GP appointments, you only pay…
They don't want to solve your problem over a messaging system - and prefer you to come in - the MD can't bill anyone for answering you questions over the phone or even via messaging - which is why they push for an appointment. Not sure what line of work you are in, but are you willing to answer endless emails and or voice mails from customers, all for free? I know I am not - and while you personally may only ask one…
When I have sent a message to my provider it has been because I had a follow up question because the direction given during a visit was unclear once it came time to implement it or there was an issue with a prescription (for instance a particular drug ended up not on my formulary and an alternative needed to be prescribed). The last time I sent a message is because the doctor said he was prescribing a medication and it appeared in my post visit summary but the prescription never was submitted. Even in these cases it can be like pulling teeth to get a response.
"Maybe if insurance companies had a billing model that allowed the MDs for charge for this type of 'support', that made them some money it would be workable - but I can't blame them for not wanting to give out free care this way."
Most primary care physicians today work for a base salary plus incentives. The base salary is the compensation for dealing with this kind of support.
Re: A fourth of U.S. health visits now delivered by non-physicians
#47If you go to urgent care, you most likely won't get a physician. 9/10 visits are urgent care you only see a PA or NP and they can't even really do much. Urgent care seems to also provide really poor results--every time I've gone it's a long wait, the workers seem over-stressed, you barely get any time with the doctor, and usually they just do a strep test or give you a Zithromax pack and hope you'll go away.
If all you need is a strep test or a Z pack, urgent care is a great deal.
Sure, but what about those outlier scenarios? How do I know the NP or PA is actually going to catch those nuances? For example, a few years back I had a sinus infection in the spring and the NP/PA thought it was just allergies and tried to get me to try allergy medication... it was a useless trip. I'd much prefer a physician, but my primary doctor usually is booked out.
Re: A fourth of U.S. health visits now delivered by non-physicians
#48I get annoyed when I send a message to my doctor and it takes 3 back-and-forths to get a message from him, and not the nurse. The nurse's advice tends to be along the lines of what I would find with Google, some semi-relevant copy/pasted advice. I get the sense that they make the messaging system useless so that you have to sign up for appointments/video appointments. They know that for GP appointments, you only pay…
They don't want to solve your problem over a messaging system - and prefer you to come in - the MD can't bill anyone for answering you questions over the phone or even via messaging - which is why they push for an appointment. Not sure what line of work you are in, but are you willing to answer endless emails and or voice mails from customers, all for free? I know I am not - and while you personally may only ask one…
> the MD can't bill anyone for answering you questions over the phone or even via messaging
My patient portal clearly states that the Corporation can bill for questions sent as messages.
The Corporation by the way is a religiously-affiliated non-profit whose CEO earns tens of millions a year. In the past couple of years they have stopped doing vaccinations and blood draws. We go to the drugstore for those now.
So, why stay with them? The alternatives are even worse.
Re: A fourth of U.S. health visits now delivered by non-physicians
#49In a very meaningful way the line between physician and non-physician had been blurring anyway. There's a software called Epic which is used by virtually all large healthcare centers, and while most know it as a database system to store patient history and health records (problems and conditions they've been diagnosed for, lab work results, medicine they're currently taking or have taken in the past), it also has a l…
Only planning for the common case is an insane thing to do in healthcare. We don't train doctors for 12 years so that they are faster or more efficient at diagnosing the common cold, we train them so that they have a wide breadth of knowledge, experience, and skills. People already have difficulty getting satisfying diagnoses from MDs with 12 years of training + Epic, imagine how much worse it would be if the person had no clue illnesses other than what Epic spits out even exist.
Re: A fourth of U.S. health visits now delivered by non-physicians
#50I get annoyed when I send a message to my doctor and it takes 3 back-and-forths to get a message from him, and not the nurse. The nurse's advice tends to be along the lines of what I would find with Google, some semi-relevant copy/pasted advice. I get the sense that they make the messaging system useless so that you have to sign up for appointments/video appointments. They know that for GP appointments, you only pay…
They don't want to solve your problem over a messaging system - and prefer you to come in - the MD can't bill anyone for answering you questions over the phone or even via messaging - which is why they push for an appointment. Not sure what line of work you are in, but are you willing to answer endless emails and or voice mails from customers, all for free? I know I am not - and while you personally may only ask one…
I listen to a veterinarian frequently complain about people trying to skip the exam fee via various methods -- and the owner probably doesn't even know that what they're doing is a problem.
A free diagnosis over the phone is a lost exam fee. A health certificate over the phone -- exam fee. A vaccine appointment that turns into a sick pet and the owner just has some question -- exam fee. Trying to skip an exam before boarding: exam fee.