The Hollow Men of Hims

I don't understand US medical schools in the least. My son is interested in medicine, and I have sat through presentations where the admissions officers describe how they pick the student that has the best sob story from dozens of overqualified candidates. Then the poor jerk that is selected will work 20hr days out of med school in residency and finally patients will wait weeks to months to see them because there are not enough physicians (or they will see someone with a foreign degree). How does any of that make sense? Why not admit a couple more kids, stop causing overtired residents to make mistakes and address the shortage?

The author has yet to reach puberty or move out of his parents' house, so he doesn't yet appreciate the company's products.

Americans can order their own lab tests for pretty cheap as well. In regards to pricing, the overhead for billing is about 1/3rd of the price, though not relevant in the poster's situation. It is part of why some prices here are so inflated though.

If a patient goes to see their doctor at a major hospital, part of that bill goes to pay for uninsured patients in the ER. Hospitals in the US by law have to treat everyone who come to the emergency room, which results in a lot of losses for hospitals that they have to make up for by charging higher prices on other services.

> And you really don't need to hire a driver to get a box of samples to the lab at the end of the day.

Smaller doctor's offices do their labs offsite, in the US just a couple of companies do the majority of blood work, as part of the contract with the lab, a driver comes by and picks up samples. In the great name of outsourcing, I imagine this driver works for a separate company as well, so now there is 2x outsourcing overhead, once for the lab, and again for the transport company. For doctor's offices that cannot justify their own lab, this makes some sense.

FWIW in my city at least, the majority of doctors are affiliated with large hospitals. They either work in a large hospital, in a satellite campus, or have an affiliate relationship (which from what I can tell just means medical records are automatically transferred over).

I go to a "smaller" office, it is a 3 story campus that is the satellite office of a huge hospital nearby. They do some of their own lab work and outsource other stuff. The hospital network is publicly owned and accordingly much nicer to deal with than many of the horror stories I hear online and from friends. (also the prices are reasonable and they always give me a price sheet up front of what everything will cost, which isn't always the case for some doctors...)

> I just checked, the price for a standard blood panel at a local lab is 14€. It's really not a complicated procedure.

Is that a 100% unsubsidized price?

In the US, cash price for a Comprehensive metabolic panel (CMP) is just $50. The same labs that the hospitals outsource to actually offer direct to consumer tests at really reasonable rates.

I just checked my hospitals cash rates:

A yearly checkup for an existing patient is $48.

Lab work is $48 (a $2 discount!)

Urine tests are another $20.

So in summary, OP got ripped off by their doctor's office.

My doctor keeps prescribing it and the pharmacy keeps not filling it. I’m not really sure what’s going wrong, I haven’t taken the time to debug the situation. I shouldn’t need to, and I’ve never needed to with hims.

Finasteride alone won't reverse that much, it stops the path for testosterone becoming DHT (the cause of androgenic alopecia). Taken orally, it stops or slows all hair loss.

Minoxadil increases blood flow and restores the natural growth cycle lengths of weakened follicles. This is applied topically, and promotes hair growth pretty much anywhere - beard, crown, temples. You can take it orally, and it will promote hair growth everywhere (more body hair). However, it can't fix follicles already dormant or scarred over. So if things are already bald, it may not give the results you want.

A word of warning that about 5% of those who take Minoxadil experience a shedding period where it gets worse. Because it restores normal hair follicles growth cycles, this includes the process of pushing out old hairs. This is not permanent and will last, at most, a month. This is why most providers like "Keeps" will try to sell in batches of 3 months.

In 2026, a new drug will finish phase 3 human trials. That one targets (IIRC) stem cells and can restore even advanced hair loss where the follicles are dormant or dead. Very exciting!