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Why Did My Patient Leave Me?

cancer.nautil.us

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Re: Why Did My Patient Leave Me?

#241

Post by AdieuToLogic »

cmahler7 wrote: post #219
giardini wrote: post #81

In my case, - reluctance to diagnose and treat the ailment instead of the symptoms and - simply refusing to hear what the patient says. I had an oozing rash break out behind my knees. The dermatologist said "That'll go away easily if you put some OTC corticosteroid cream on it." Wrong! The rash flared up within hours and nearly ate the flesh off the back of my knees. I happen to know that this indicates a fungal infe…

no disrespect to doctors but you really don't have to be that smart to become one. It's more about being willing to take out 300k in loans and stay in school until you are 30+ years old.

  no disrespect to doctors but you really don't
  have to be that smart to become one.
Keep that statement in mind the next time someone trivializes the time and effort you have invested into your profession. If you have neither a profession nor invested any significant effort into one, then please accept my apology for assuming such.

Re: Why Did My Patient Leave Me?

#242

Post by lovich »

AdieuToLogic wrote: post #241
cmahler7 wrote: post #219

Earlier quoted context omitted.

no disrespect to doctors but you really don't have to be that smart to become one. It's more about being willing to take out 300k in loans and stay in school until you are 30+ years old.

no disrespect to doctors but you really don't have to be that smart to become one. Keep that statement in mind the next time someone trivializes the time and effort you have invested into your profession. If you have neither a profession nor invested any significant effort into one, then please accept my apology for assuming such.

Assuming he's a software engineer given that this is hacker news, you really don't have to be that smart to get _a job_. Being the best or even good at it requires intelligence, but its not difficult to get a job you cant due when you have hiring managers who don't understand the work or if you can get certification just by spending a lot of time and money.

For the software engineer example again, if just being able to do the job proved your intelligence, then no one would ever have to go through the marathon interviews to prove that they are competent

Re: Why Did My Patient Leave Me?

#243

Post by michaelt »

maxxxxx wrote: post #91

This is an interesting read. It seems doctors really believe they have a conversation with their patient whereas most patients feel that the doctor just rushes in and gives his standard recommendation without deeper thought and generally doesn't listen to them. Do doctors go to other doctors when they have a problem? Do they get more respect by other doctors? If they went to a doctor and got the same treatment as the…

The extent to which a patient has a 'relationship' with a doctor undoubtedly depends on the patient.

As a healthy 30 year old, I've never met my doctor. But my 85 year old neighbour who is in and out of hospital all the time has a doctor who knows her children's names and everything.

Re: Why Did My Patient Leave Me?

#244

Post by ThomPete »

mistersquid wrote: post #227
ThomPete wrote: post #187

Earlier quoted context omitted.

I am saying that because then they start paying for when they go to get treated or for checkups which allow for more money being possible to use on more serious situations. I am not sure where you get that I want less people to go to the doctor. I just want to be able to pay for the situations you can't afford by asking for money in situations where most people can. And yes if you don't have any money then you should…

That makes better sense, but covering costs of extraordinary care isn't an issue in state-provided health insurance (single payer), nor is it an issue with private healthcare insurance. With single payer, taxes cover the cost of care for everyone. With private insurance, the costs for more expensive care is covered by the premiums of healthier individuals, which is sort of like what you suggest but does not financial…

It actually is an issue in both systems which is why in state-provided systems there are limits to what kind of treatments at what stages etc and in privet insurance systems there are limits to coverage.

The main premise of this discussion is that it's not possible to pay enough for healthcare. I.e. even if you taxed people 100% there still would be things they couldn't get because it has to be available to everyone and there are always new treatments being developed, new machines, new drugs.

Whether you find it humane or not is based on what you consider the end-game of healthcare.

Re: Why Did My Patient Leave Me?

#245

Post by ThomPete »

cortic wrote: post #239
ThomPete wrote: post #194

Earlier quoted context omitted.

Spending even more is whats unsustainable you can't keep spending more and more money in a single payer system as it will either affect other areas or you will have to tax the citizens even more. There is a limit to that. If you get more and more treatments available and what people consider being part of healthcare and you are running a cost center then your system gets more and more expensive. No enough here is mea…

"Spending even more is whats unsustainable" - nationalized healthcare spends less for the same or better outcome, if your problem is price, then your problem is private healthcare. 'cost center' Vs 'profit center' '[denying treatment] because it can't pay if everyone used it' - This is just false, moneys going into a countries nationalized health system is high return (due to taxes), its also cheaper (due to group un…

I am not sure why you talk about socialist system vs. Laissez-faire. Single payer doesn't mean socialist neither does private mean Laissez-faire. Those kind of oversimplifications doesn't really add anything useful to this discussion.

Switzerland has universal healthcare but it's based on private insurance. In other words it's not that simple.

In general I find this discussion hard to have because you are assuming so many things about what I say or mean, that simply aren't true.

I am not saying that a profit center is cheaper than a cost center I am saying that its able to make money which gives it flexibility.

The incentives that drives the US healthcare system are pretty shitty but they aren't incentives which are unique to a private system. On top of that in the public healthcare systems you see more and more new public management to hold down cost, which itself is expensive. But it's not something that's set in stone. It's not a property of the system it can be changed.

Changing the US healthcare system to patient outcomes incentives would do a lot to fix the incentives and there is an active program trying to do that.

And no it's not false that there are limits to a public healthcare system. Believe me I have lived in one and it doesn't only get realized by not doing certain treatments it also reflect in waiting time for operations, to see a specialist etc.

In Denmark if you go to the dermatologist you have to wait 3 week. In the US I went straight in.

In Denmark my biopsy had to be done at the hospital. In the US they made it right away at the dermatologist the same day.

With regards to drugs it's actually based on the cost, the rarity of the decease etc. I think it's in the UK where they have a list in order to prioritize.

Re: Why Did My Patient Leave Me?

#246

Post by goldenkey »

tasty_freeze wrote: post #236
comicjk wrote: post #205

Earlier quoted context omitted.

Prednisone pills are substantially more dangerous than cortisone cream, no? The one time I've taken prednisone, I had pretty severe mood swings, which is just one of a dozen notable side effects.

I work with a guy who was given prednisone to treat some problem or other. It wasn't some high dose, and he didn't take it for long, but he was unlucky. The capillaries feeding the network around his hip sockets essentially all died, and he started having a lot of pain walking, then started using a cane (he was in his late 40s). A couple years later he had a double hip replacement.

Prednisone won't cause that. Its a very safe anti inflammatory.

Re: Why Did My Patient Leave Me?

#247

Post by maxerickson »

goldenkey wrote: post #246
tasty_freeze wrote: post #236

Earlier quoted context omitted.

I work with a guy who was given prednisone to treat some problem or other. It wasn't some high dose, and he didn't take it for long, but he was unlucky. The capillaries feeding the network around his hip sockets essentially all died, and he started having a lot of pain walking, then started using a cane (he was in his late 40s). A couple years later he had a double hip replacement.

Prednisone won't cause that. Its a very safe anti inflammatory.

Not really.

http://www.mayoclinic.org/steroids/art-20045692?pg=2

Re: Why Did My Patient Leave Me?

#248

Post by goldenkey »

maxerickson wrote: post #247
goldenkey wrote: post #246

Earlier quoted context omitted.

Prednisone won't cause that. Its a very safe anti inflammatory.

Not really. http://www.mayoclinic.org/steroids/art-20045692?pg=2

Its pretty safe. Those are side effects of larger and consistent doses. You dont go from having veins to dying veins in a day from a prednisone dose.

Re: Why Did My Patient Leave Me?

#249

Post by maxerickson »

goldenkey wrote: post #248
maxerickson wrote: post #247

Earlier quoted context omitted.

Not really. http://www.mayoclinic.org/steroids/art-20045692?pg=2

Its pretty safe. Those are side effects of larger and consistent doses. You dont go from having veins to dying veins in a day from a prednisone dose.

There's a difference between "very safe" and being reasonably safe in smaller doses over a short term.

Re: Why Did My Patient Leave Me?

#250

Post by 77pt77 »

ziikutv wrote: post #217
77pt77 wrote: post #111

Earlier quoted context omitted.

> Then upon investigation it was noted that the staff gave her wrong chart; of a pregnant woman who had a similar "feminized" version of my name. This has happened many times to me. It's quite scary once you realize it. Thankfully no one ever told me I was pregnant. > We filed a complaint but she then resorted to personal attacks in her report Care to go into more detail? I'm really interested in knowing how these de…

> This has happened many times to me. It's quite scary once you realize it. Thankfully no one ever told me I was pregnant. I was furious and told them to write my name, age, and gender on top of the leaflet in bold red letters and watched them do it. All subsequent visits started off with me making sure that it was the right chart. Some good doctors ask you name, age before opening the chart. Not this one.. > Care to…

> She came back and saw my mom looking and accused her of attempting to harm herself and tampering.

Classic. When in doubt discredit them by making them look crazy. Coupled with being an authority figure and credibility that comes with it this is an effective technique.

> Doctors need to prevent shit instead of patching shit.

Medicine is very good at treating acute and traumatic things. Long term conditions, not really.

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