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A fourth of U.S. health visits now delivered by non-physicians

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141–150 of 158 posts

Re: A fourth of U.S. health visits now delivered by non-physicians

#141

If 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.

Anecdote that isn't remotely data: I went to an urgent care facility the first time I had a migraine aura without headache. I described it to the receptionist as a "visual hallucination", since it was a flashing checkerboard pattern that obviously wasn't real. The receptionist _ran_ to the back to get a doctor. The doctor, in an exam room, very careful, and with significant compassion, explained that they don't have…

Possibly similar situation…but probably due to something else other than miscommunications.

I had insurance partnered with my university. I went to the uni clinic due to a headache and fever so I could get some ibuprofen. They had no capacity to perform any tests and told me I needed to goto the hospital. They ordered an ambulance and said I needed to sign a waiver if I refused them. I had no idea what the impact would be to my insurance so I went along with it. At the hospital ER they hooked me up to IV immediately and then said I needed a spinal tap to check for meningitis because they couldn't explain the fever. I asked to leave, but nobody came to unhook me from the IV or bring my belongings back. They then guided me to another room after an hour or so with 5 people in it. I asked to leave immediately, and they said I could have a life threatening case and I needed to sign a waiver if I left. Apparently they were bringing another doctor from another hospital as emergency to do the test. This time I called my family for advice and signed the form but they were very pushy. The headache and fever were gone the next day. This experience has scarred me from going to U.S. healthcare to this day.

Re: A fourth of U.S. health visits now delivered by non-physicians

#142
post #124
post #71

Earlier quoted context omitted.

Epic very much is poised to take over and every week it appears a new large healthcare center makes the switch to it. I think the hard lesson everyone must learn eventually is that they have to take control of/become deeply involved with their healthcare as much as possible, because dragons are everywhere. For the average person acute care is not needed when they're thinking of reaching out to the doctor, and they sh…

Can you really just download epic? Like it’s free? I thought it was super specialized and you had to have some kind of business relationship to get access to it. I tried to find it online but didn’t see anything.

Epic is basically enterprise-grade software. And every hospital, forget health care systems, is an enterprise. Which makes it very difficult to break that moat.

Re: A fourth of U.S. health visits now delivered by non-physicians

#143
post #7

canadian anecdote: i havent seen my GP ever . He just oversees resident (student doctors). Ive had chronic health issues for 3 years now without much relief, despite having been to the doctors office 20+ in that time. Most of the time they deflect me from specialist care.

Honestly, if you have the time, just go abroad to India or Thailand and get a full body check up. Don't leave your medical conditions untreated. Considering the restrictions around getting medications in the US, these hospitals night already have ways for you to prescribe you stuff. Just stick to the reputed ones like Apollo or Narayana Hrudalaya in India or Bumrungrad in Thailand. Or if you can splurge the cash, go for non-resident treatment at an American hospital (which is arguably cheaper than the insurance-covered prices).

Re: A fourth of U.S. health visits now delivered by non-physicians

#144

Earlier quoted context omitted.

Why do you include your undergraduate degree as part of your medical training? I've asked dozens of doctors (and lawyers) about the relevance of their college/undergraduate education to their day-to-day work and none have said it was critical, most have said it was not relevant, and some have had completely non-medical majors (music and physics). Of course, maybe it's different for you, which is why I ask.

It could be more of explaining the total duration and cost of how long they went to college. If it's required to have an undergrad I believe one can mention it, even if the undergraduate isn't required. Like in Belgium you need to have a masters for certain government jobs, but it's not relevant in which field.

+1. In Mexico there's a "Medicine" major, which is longer than other majors, but not as long as doing a 4 year undergrad degree followed by a 4 years of med-school. I've always found interesting and a little pointless that even if you know you want to be a doctor you have to go through the extra steps of two degrees/schools.

Re: A fourth of U.S. health visits now delivered by non-physicians

#145
post #84

Earlier quoted context omitted.

No way a typical question takes 3 minutes to answer; just by time you read the message, pull up the chart, read the chart, make the call, talk with the patient and then document the outcome of the call back into the chart, you are in it for 15 minutes at least … not to mention the context-switching time you need as you move from one task to the next. And I disagree that it is ‘common’ in other industries - ever try t…

Doctors do entire appointments in 10-15 minutes. I think they can rip through messages sub 3 minutes.

sounds like you should go to medical school and prove the industry wrong then.

Re: A fourth of U.S. health visits now delivered by non-physicians

#146

Earlier quoted context omitted.

> On the other hand, a lot of what I do doesn't require 12 years of training What, besides surgery, really requires 12 years of training? I've found I have a greater success rate with self diagnosis and treatment than I have with seeing my physician, and I've found a very good internist. An hour spent with ChatGPT and Google and I always find a couple options that fit what I'm experiencing as well as detailed descrip…

A recent occurrence I will share related to this was having to convince my doctor that I had Lyme disease. I Googled the symptoms, saw the trademark bullseye, and of course concluded that I had Lyme disease. It was right where I got the tick bite, 8 weeks later. My doctor refused to believe me. He told me to see a dermatologist about it, thinking it was some skin rash, even though it was exactly where the tick had bi…

On the other hand I got a rash and tried to google diagnose and got in completely wrong whereas the doctor figured it in seconds (shingles). Probably best to try both approaches.

Re: A fourth of U.S. health visits now delivered by non-physicians

#148
post #145

Earlier quoted context omitted.

Doctors do entire appointments in 10-15 minutes. I think they can rip through messages sub 3 minutes.

sounds like you should go to medical school and prove the industry wrong then.

DO you actually have any reason to believe doctors spend more than 2 minutes on each message? I know a few doctors quite well and I've seen them go through the messages. They do not spend much time on each one at all.

Re: A fourth of U.S. health visits now delivered by non-physicians

#149
post #28

MD here. I'm of two minds about this. On the one hand, obviously there's a bit of defensiveness since I went through 12 years of school and training to be an independent physician (4 years college, 4 years medical school, 4 years residency) and I've definitely seen subpar care from other "providers" (not a fan of the term) with less training. The wide variety of different "providers" is also confusing to patients who…

The current choices are 1) Uniterested, slapdash care from an MD with 12+ years of training and no ability to listen or empathize but eager to make the money s/he went into medicine to make 2) The same from an assistant of some kind who uses ever-degrading search engines to look up not-your-problem and give you potentially dangerous suggestions The future will undoubtedly be worse. As someone mentioned below, we'll p…

The future is here:

https://www.youtube.com/watch?v=hmUVo0xVAqE

The film Idiocracy reviewed:

https://www.imdb.com/title/tt0387808/

Re: A fourth of U.S. health visits now delivered by non-physicians

#150

Earlier quoted context omitted.

Why do you include your undergraduate degree as part of your medical training? I've asked dozens of doctors (and lawyers) about the relevance of their college/undergraduate education to their day-to-day work and none have said it was critical, most have said it was not relevant, and some have had completely non-medical majors (music and physics). Of course, maybe it's different for you, which is why I ask.

> Why do you include your undergraduate degree as part of your medical training? Was the comment edited after you posted this? Because I don't see them saying this was part of their training at all. They wrote "12 years of school and training", and this is the school part.

You caught something I didn't. The first paragraph states "12 years of school and training". The second paragraph has the same phrase, but without "school". I was focused on the second paragraph without realizing it was likely referencing the first one.
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