How twitter helped a technology consultant escape from an evil hospital • Hacker News Board

Re: How twitter helped a technology consultant escape from an evil hospital

#61

Post by catch23 » Mon, Sep 14, 2009, 2:10 AM UTC

fnid wrote: post #6

It never occurred to me that carrying high-level heath insurance would mark me as a candidate for unnecessary surgery. Perhaps this is exactly why health care costs have gone up so dramatically. We have insurance, so the doctors take advantage of it -- needlessly. We very well could be spending a lot less money for the same amount of health care. I think the solution to the health care problem is for someone to start…

A friend of mine who works for Qualcomm in san diego says this happened to him as well. He went to the dentist to have all 4 wisdom teeth removed. They asked him to schedule it over 4 separate days rather than doing it all at once, just so that they could charge the maximum allowable amount per day to the insurance company -- they actually explained that to him!

Re: How twitter helped a technology consultant escape from an evil hospital

#62

Post by joe_the_user » Mon, Sep 14, 2009, 2:36 AM UTC

Retric wrote: post #48

kmavm wrote: post #12

Earlier quoted context omitted.

This is essentially the thesis of Arnold Kling's "Crisis of Abundance": http://www.amazon.com/Crisis-Abundance-Rethinking-Health-Car... Except for a few blockbuster interventions (antibiotics for bacterial infection, orthopedics, reading glasses), the expected return of many health care interventions is negative; they cost so much, and have the potential to do so much harm, for such uncertain good, that we're better…

The problem with that philosophy is there are thousands of "blockbuster" treatments, everything from a simple filling, to a Tylenol would be miraculous if you steeped back a few hundred years. Finding the right balance between cost and heath is hard, but blaming everything but the blockbusters is the wrong place to start. Two years ago my father went from fine to dead in one week in part because the doctor failed to…

Hmm,

You don't specify what missed test killed your father.

There are, however, many symptoms where, given the uncertainty of all technology today, giving an operation or a drug prescription to might save X lives whereas NOT taking action would save Y lives, where X and Y are very uncertain.

The harder thing, though, the lives that are lost through giving the operation or the drug tend to be even harder to measure - people die through being prescribed 4,5,6...X drugs up to the point that interaction fry them without any one drug being "to blame". People die from complications of many surgeries, yet if the surgery is possibly necessary, people don't think to blame the decision to operate (the New Yorker figure that surgical accidents kill more than auto accidents is remarkable - auto accidents were once the 4th leading cause of death in the US). And there is a hidden if you test everyone for everything. False positives can kill people - false positives do kill many people today.

And as the New Yorker article mentions, physician incentives to make tests (or in other circumstances, to avoid them) can make a big difference.

Re: How twitter helped a technology consultant escape from an evil hospital

#63

Post by DannoHung » Mon, Sep 14, 2009, 3:53 AM UTC

gruseom wrote: post #15

DannoHung wrote: post #10

And the ultimate lesson of all of this: If your friend jumps off a bridge, are you going to jump off of a bridge too?

Although your comment looks like a vacuous redditesque one-liner, I'll respond: I've jumped from similar heights under similar circumstances, i.e. a spot favored by locals, surrounded by people happily jumping and swimming. It's only in hindsight that what she did was an obviously bad move, and even then it sounds like a slightly different angle would have made it harmless. This aspect is hardly "the ultimate lesson…

I wasn't really trying to be funny; it's advice my Mother gave me, repeatedly. I think it's sound, regardless of the issue with the hospital.

Here, let me repackage it for you so it's less topical: if people are doing something that you think is dangerous, don't do it just because they did it.

Re: How twitter helped a technology consultant escape from an evil hospital

#64

Post by desu » Mon, Sep 14, 2009, 4:00 AM UTC

pyre wrote: post #52

benatkin wrote: post #33

Since that time, people on both sides of the health care debate have listened to my story and pointed out it supports their views, both pro and con. Unsurprising. I think this is more about patients' rights than healthcare funding, though.

Yea. I can see people on both sides saying crap about this. Pro: This wouldn't happen with government healthcare because there would be standards in place (i.e. the 'mobility test' would be standard everywhere not just in 'cutting edge' facilities) Con: In government-run healthcare, she would have been forced to stay in that hospital so as to minimize the costs of treating her (i.e. no expensive transport from PA to…

Well, it's more like the pro is that there is no profit motive to keep her there. The staff would be delighted to get rid of her to a bigger facility elsewhere. I live a kilometre north of a large hospital in Sydney, Australia and we get helicopters coming in all hours of the day and night, presumably doing just that.

The "con" would probably be that there would be no facility for spinal surgery in a rural area in the first place. She would not be able to choose to be treated there and she's getting on one of those helicopters.

Re: How twitter helped a technology consultant escape from an evil hospital

#65

Post by benatkin » Mon, Sep 14, 2009, 4:10 AM UTC

desu wrote: post #64

pyre wrote: post #52

Earlier quoted context omitted.

Yea. I can see people on both sides saying crap about this. Pro: This wouldn't happen with government healthcare because there would be standards in place (i.e. the 'mobility test' would be standard everywhere not just in 'cutting edge' facilities) Con: In government-run healthcare, she would have been forced to stay in that hospital so as to minimize the costs of treating her (i.e. no expensive transport from PA to…

Well, it's more like the pro is that there is no profit motive to keep her there. The staff would be delighted to get rid of her to a bigger facility elsewhere. I live a kilometre north of a large hospital in Sydney, Australia and we get helicopters coming in all hours of the day and night, presumably doing just that. The "con" would probably be that there would be no facility for spinal surgery in a rural area in th…

Interesting. Yeah, it does sound like if either group has their way, it very likely could have a side effect of preventing this particular scenario from happening again.

Re: How twitter helped a technology consultant escape from an evil hospital

#66

Post by param » Mon, Sep 14, 2009, 4:59 AM UTC

rdouble wrote: post #45

My dad's a doctor in a rural environment, and I had a bad back injury including ruptured discs and cracked vertebrae when I was in high school. I can offer some insight on the psychology of the doctors and even a little bit of information on this particular injury. A rural surgeon is going to be professionally offended if their patient calls up an egghead at Harvard from their pre-op hospital bed and then tells him s…

I want to agree with you, but what I am interested in knowing is why the boston doctor was insisting on a mobility test prior to surgery and why the small town folks were insisting on surgery first.

The same thing happens in small town India as well where doctors are more interested in keeping you admitted above and beyond the needed duration and doctors in large cities are just better because they have a greater patient load to be well versed with complex surgeries if needed.

Re: How twitter helped a technology consultant escape from an evil hospital

#67

Post by Kadin » Mon, Sep 14, 2009, 5:00 AM UTC

marze wrote: post #49

This seems like a situation where knowing a certain phrase might help. I don't know what that phrase might, but a lawyer or someone else familiar with the medical industry might. Something like "I will not authorize you to perform this procedure and have notified my physician and lawyer of this, if you perform anything that I have not authorized will result in an expensive lawsuit" or something. Anyone know what the…

You can always -- provided you are sane, sober, and alert -- decline treatment or even just check yourself out of the hospital "against medical advice." Generally this involves signing some forms releasing the hospital from all responsibility for you. And then you can just walk out.

Hospital personnel will try to strongly discourage you from doing this -- not because they're evil, but because in most situations it's a really, really bad idea. But if you just keep saying "no, I don't want treatment, I want to leave, give me the forms to sign out AMA," and you're not clearly nuts or high on morphine or otherwise impaired, you can pretty much just leave.

However, unless you have a very specific reason for believing that the treatment protocol at work isn't correct or best for you, it's generally a bad idea.

Re: How twitter helped a technology consultant escape from an evil hospital

#68

Post by davidw » Mon, Sep 14, 2009, 5:03 AM UTC

pyre wrote: post #53

davidw wrote: post #32

Earlier quoted context omitted.

About 15 years ago, the dentist I went to said dire things about the immense pain my wisdom teeth were going to cause in my immediate future. I told him I'd make an appointment right away when that happened, even though his advice was to intervene as soon as possible to 'avoid any future problems'. I still have all of them and aside from the occasional twinge, they are just fine.

It's not necessarily about money though. To my knowledge, most people have problems with their wisdom teeth coming in wrong and screwing up their other teeth. If this is the majority case, then going on the offensive and taking care of them early can make sense rather than waiting to have issues. Sometimes these cases end up sounding to me like the people who try to decry the state laws requiring you to wear a seatbe…

You'd have to go to statistics to make any sort of real determination, of course (anecdotes, data, etc...), but it's definitely not something where I'm trying to make the facts fit a conclusion - it happened that way and it made me suspicious of at least one dentist.

Re: How twitter helped a technology consultant escape from an evil hospital

#69

Post by nkassis » Mon, Sep 14, 2009, 5:05 AM UTC

SarahCortes wrote: post #42

DEinspanjer wrote: post #36

I wonder if the treatment was really all about the "really great health insurance" and not just the doctors at the hospital deciding that they knew better than another doctor many hours away that had not seen the patient or the pictures of her spine. Upon reading the description of how the accident took place, my first thought was, "Really, is her insurance going to pay for that!?" And according to the last comment o…

Ah,is that really a question? My comment on my blog that my health insurance decided it was best to leave me on the ledge to die of exposure was-need I say-tongue in cheek.You must be under the impression the insurance companies are in possession of that awesome perfect blame calculator - parsing an infinite number of scenarios to detemine blame for accidents and disease, then confirm or deny coverage based on their…

I got too say, I would be surprised if an insurance would not cover something like this. This is equivalent to a sports injury. Frankly no one can tell me that jumping off a cliff mountain biking is less dangerous than a bridge jump. I've bridge jumped before (not fifty feet I believe but high) and I wasn't the only one around, I didn't think it was that dangerous at the time but I understand how a bad landing could cause such an injury. Hell Olympic divers have really bad landings doing 33 feet dive and don't die.

Re: How twitter helped a technology consultant escape from an evil hospital

#70

Post by davidw » Mon, Sep 14, 2009, 5:06 AM UTC

DannoHung wrote: post #63

gruseom wrote: post #15

Earlier quoted context omitted.

Although your comment looks like a vacuous redditesque one-liner, I'll respond: I've jumped from similar heights under similar circumstances, i.e. a spot favored by locals, surrounded by people happily jumping and swimming. It's only in hindsight that what she did was an obviously bad move, and even then it sounds like a slightly different angle would have made it harmless. This aspect is hardly "the ultimate lesson…

I wasn't really trying to be funny; it's advice my Mother gave me, repeatedly. I think it's sound, regardless of the issue with the hospital. Here, let me repackage it for you so it's less topical: if people are doing something that you think is dangerous, don't do it just because they did it.

It's like that Paul B article: what's the worst that could happen, and what's the best possible outcome. IMO, the best possible outcome from jumping off a bridge is not really worth the worst possible outcome.