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Her Various Symptoms Seemed Unrelated, Then One Doctor Put It All Together

nytimes.com

41–50 of 118 posts

Re: Her Various Symptoms Seemed Unrelated, Then One Doctor Put It All Together

#42

TLDR: It was Schnitzler Syndrome, a rare autoimmune disease. Clickbait titles and suspense-novel narrative structures in articles like this really annoy me for some reason. Just get to the point.

This is from New York Times Magazine.

Think something like GQ, Vanity Fair, Rolling Stone.

It's not meant to be a news article, it's a story.

Re: Her Various Symptoms Seemed Unrelated, Then One Doctor Put It All Together

#43
post #7

Earlier quoted context omitted.

Unfortunately, no. Your doctor is contractually bound to the insurer’s fee structure; they can’t take an extra penny off of you. You’d have to go to someone that doesn’t take your insurance at all (or just don’t tell them you have that insurance). The side effect of all this, honestly, is that doctors stop learning how to turn off 7-minute-mode. When it comes to very serious problems, it pays to go to a practice that…

Almost makes the red envelope culture in Chinese hospitals seems appealing.

Not at all.

Having to slip the doc and the anaethetist a red envelope and hoping it's the enough that they'll take proper care of you is not a good system to live under.

Re: Her Various Symptoms Seemed Unrelated, Then One Doctor Put It All Together

#44
post #40

Earlier quoted context omitted.

Almost makes the red envelope culture in Chinese hospitals seems appealing.

https://en.wikipedia.org/wiki/Red_envelope I’d never heard of this before.

On the situation in hospitals specifically:

https://www.seattletimes.com/opinion/the-red-envelope-capita...

Re: Her Various Symptoms Seemed Unrelated, Then One Doctor Put It All Together

#45
post #40

Earlier quoted context omitted.

Almost makes the red envelope culture in Chinese hospitals seems appealing.

https://en.wikipedia.org/wiki/Red_envelope I’d never heard of this before.

Lol, that's exactly life in Eastern Europe/ex-USSR. There's socialized medicine, but if you want better service, you have to bring a gift (whisky, chocolate, money, the latter is always desirable). Not just hand cash over, that's disrespectful nowadays.

Re: Her Various Symptoms Seemed Unrelated, Then One Doctor Put It All Together

#46
post #7
post #4

Earlier quoted context omitted.

Is there a way to actually request a specific doctor have some time dedicated to figuring your case out at your expense? i.e. "Please do more troubleshooting for me above what insurance pays." I like your idea - but I fear the industry might have already ruled it out. -edit- Granted, I've done this in my own life by going to specialists at their own offices/outside of a hospital or medical group.

Unfortunately, no. Your doctor is contractually bound to the insurer’s fee structure; they can’t take an extra penny off of you. You’d have to go to someone that doesn’t take your insurance at all (or just don’t tell them you have that insurance). The side effect of all this, honestly, is that doctors stop learning how to turn off 7-minute-mode. When it comes to very serious problems, it pays to go to a practice that…

You're right that it's difficult for physicians to "turn it off". The contractual requirements you reference, however, are basically unenforced. The only way a physician will get "caught" charging more than agreed is if the patient calls the insurer to complain. Presumably you wouldn't do that to her after she saved your life.

Re: Her Various Symptoms Seemed Unrelated, Then One Doctor Put It All Together

#47
post #8
post #5

Earlier quoted context omitted.

Why doctor? It's the most expensive part of your healthcare. But it can be trainee/researcher/AI. Which could be absolutely out of expensive healthcare system. Service which you could buy for additional cost from company which has good guess/prediction ratio based on input parameters from doctor. Service which could be in any part of the world.

What? The doctor’s visit is the cheapest part of healthcare. Procedures cost far more, and pharm far more again. Perhaps you’re outside of the US, though I can’t think of a country where this isn’t true.

Don't forget diagnostic scans and tests. Those are quite expensive. However GP is proposing a service that doesn't actually exist now: paying a medical expert to spend a lot of time considering a challenging case. It would have obvious benefits, so we shouldn't dismiss it out of hand just because it would be too cheap.

Re: Her Various Symptoms Seemed Unrelated, Then One Doctor Put It All Together

#48
It does make one wonder how broken the system is. Consider how often we hope this is the norm, and yet it is held up as something exceptional:

———————

“When I see people suffering and I know that if I took the time and effort, I could figure it out,” he told me, “then I have to do something.” He looks for unexplained pathological findings — in this case, the high level of IgM.

Re: Her Various Symptoms Seemed Unrelated, Then One Doctor Put It All Together

#49
post #30

Schnitzler syndrome, whilst rare, is well known to dermatologists and is in the differential diagnosis of chronic urticaria (hives). Not to take away from the resident that made the diagnosis but if the patient had been seen by a dermatologist I would be surprised if this would have been missed.

Article said a dermatologist was consulted early on and who failed to make the connection. Doesn’t support your ascertion.

Are you "ascerting" that dermatologists never make mistakes?

Re: Her Various Symptoms Seemed Unrelated, Then One Doctor Put It All Together

#50
post #4
post #2

> As for Huls, he is finishing up his fellowship at the hospital this summer. Wherever he ends up, he is certain he will find new cases to challenge his curiosity, cases he hopes to solve. No, he won’t, because only early stage residents are given the freedom from economic realities to spend hours digging and thinking through records. Docs aren’t paid for their time, nor even for results - and their employers (read:…

Is there a way to actually request a specific doctor have some time dedicated to figuring your case out at your expense? i.e. "Please do more troubleshooting for me above what insurance pays." I like your idea - but I fear the industry might have already ruled it out. -edit- Granted, I've done this in my own life by going to specialists at their own offices/outside of a hospital or medical group.

Isn't this what concierge doctors offer?
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