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‘Out here, it’s just me’: one doctor for 11,000 square miles

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Re: ‘Out here, it’s just me’: one doctor for 11,000 square miles

#51

Post by dang »

NullPrefix wrote: post #37
elsonrodriguez wrote: post #28

Earlier quoted context omitted.

> If you choose to live in rural US, you are signing up for this kind of lifestyle; you're on your own. Some people don't choose, and other people do choose, but more importantly: your food comes from the rural US and you should keep that in mind before being flippant about their fate.

>your food comes from the rural US and you should keep that in mind before being flippant about their fate My food comes from the supermarket, get your facts straight.

Would you please stop posting unsubstantive comments to HN?

Re: ‘Out here, it’s just me’: one doctor for 11,000 square miles

#52

Post by ses1984 »

marrone12 wrote: post #29
honkycat wrote: post #5

Earlier quoted context omitted.

That is a feature, not a bug. Why would a well-paid, highly regulated profession allow people to come into their turf and undercut them? Not saying this is a GOOD thing. Merely pointing out that the system is working as intended.

There is no "undercutting" in health care. Vast majority of services are already priced out by insurance companies, there just aren't enough people to do all of them.

>...there just aren't enough people to do all of them.

which factors into the economics of prices negotiated between providers and insurance companies.

Re: ‘Out here, it’s just me’: one doctor for 11,000 square miles

#53

Post by charlieflowers »

belltaco wrote: post #3

The decades long wait times for green cards for immigrant doctors is also hurting health care in rural America. https://money.cnn.com/2018/06/08/news/economy/immigrant-doct... https://www.wusa9.com/article/news/local/maryland/communitie... https://time.com/5299488/international-medical-graduates/

Some smart business in a foreign country should start providing tele-medicine to the US for reasonable prices.

We could send blood work overseas cheaper than the piracy prices of labcorp, for that matter.

They could explain it legally as "not medical advice" to skirt any FDA laws, but provide world class health care in reality.

It's a business model that could really work. The "skirt America's dumb self-inflicted crap" business model.

Re: ‘Out here, it’s just me’: one doctor for 11,000 square miles

#54

Post by lazyasciiart »

charlieflowers wrote: post #53
belltaco wrote: post #3

The decades long wait times for green cards for immigrant doctors is also hurting health care in rural America. https://money.cnn.com/2018/06/08/news/economy/immigrant-doct... https://www.wusa9.com/article/news/local/maryland/communitie... https://time.com/5299488/international-medical-graduates/

Some smart business in a foreign country should start providing tele-medicine to the US for reasonable prices. We could send blood work overseas cheaper than the piracy prices of labcorp, for that matter. They could explain it legally as "not medical advice" to skirt any FDA laws, but provide world class health care in reality. It's a business model that could really work. The "skirt America's dumb self-inflicted cra…

That would be illegal because they would need to be licensed as doctors in the state of the patient, nothing to do with the FDA. https://www.ruralhealthinfo.org/toolkits/telehealth/1/barrie...

Re: ‘Out here, it’s just me’: one doctor for 11,000 square miles

#55

Post by hanniabu »

kgermino wrote: post #38
EliRivers wrote: post #17

Earlier quoted context omitted.

I understand a lot of poor people in these regions lack the resources to move to more populated areas. Would you support a federal or state rehousing program to enable that? It's a genuine question; should the US taxpayer pony up so poor people trapped in rural areas can move to population centres and enjoy the benefits thereof?

I absolutely would. One of the best things we can do for poor people - and for the economy as a whole - is getting them physical access to better jobs. If people are trapped in an economically dead area the few grand it would take to support them moving to a more vibrant area is a pittance, especially compared to the cost of bringing jobs and services to rural areas. I'm absolutely opposed to forcing people to move,…

If you instead move a doctor to a rural area it's a much more cost effective solution because that one doctor could treat everyone in the area rather than needing to move everyone in that area out of the rural area. A new doctor in the rural area would also create jobs as they would need at least a receptionist.

Re: ‘Out here, it’s just me’: one doctor for 11,000 square miles

#56

Post by pdub123 »

EliRivers wrote: post #17
castratikron wrote: post #12

The picture at the end of the article says it all, "No services next 74 miles". If you choose to live in rural US, you are signing up for this kind of lifestyle; you're on your own. As long as that's advertised I don't see a real problem. If you need health care then you should live near health care. Don't expect the same level of support in rural MN as you would get in NYC.

I understand a lot of poor people in these regions lack the resources to move to more populated areas. Would you support a federal or state rehousing program to enable that? It's a genuine question; should the US taxpayer pony up so poor people trapped in rural areas can move to population centres and enjoy the benefits thereof?

Eh, I think you exaggerate.

Sure, some people are so disabled they can't travel. For those who are not disabled but are simply poor, here's what they need-- and it doesn't cost much.

- A greyhound bus ticket

- Camping gear: A tent, sleeping bag, inflatable camping mattress

- Clothes

I used to live in a tent. Sure, it's uncomfortable, but it is fully survivable.

While living in a tent in some woods, I pulled myself up by my bootstraps, applied for jobs, visited community centers for showers & food handouts.

Applying for jobs-- How long did it take?

- Blue collar jobs: Took a day to get hired, $13/hr job.

- White collar jobs: Took 3 weeks to get hired $25/hr job.

I've lived in a tent while studying and job hunting 3 times. Now I am quite gainfully employed making over $50/hr.

Should tax payers pony up? Not if you mean people other than the individuals who need to pull themselves up.

Re: ‘Out here, it’s just me’: one doctor for 11,000 square miles

#57

Post by scrumbledober »

SolaceQuantum wrote: post #8
honkycat wrote: post #6

This is happening on my home town. The hospital has been scaling back more and more. What was once a thriving hospital now only has 3 doctors. Not due to demand, but because there are not enough doctors. Doctors do not want to live in a podunk town, no matter how much the hospitals are willing to pay.

Theoretically if the podunk town is willing to pay 5x, 10x, 100x, etc. A doctor would definitely take up that. Hell, I would do software development in a podunk town for a million dollar salary. Maybe even a 750k salary.

I would do software development from a podunk town if I could make the same amount as I do in the bay area.

Re: ‘Out here, it’s just me’: one doctor for 11,000 square miles

#58

Post by lazyasciiart »

It should be illegal for the government to detain people in areas with inadequate access to medical care. If they want to put immigration detention centers (or any prison) in the middle of nowhere, they should be required to pay for a doctor to be there too.

And it isn't a case of 'well migrants cross the border in the middle of nowhere so it's their fault' - almost all immigrants held in this place are transferred from another ICE detention center (https://trac.syr.edu/immigration/detention/201509/WTXDFTX/tr...)

Re: ‘Out here, it’s just me’: one doctor for 11,000 square miles

#59

Post by chimi »

belltaco wrote: post #3

The decades long wait times for green cards for immigrant doctors is also hurting health care in rural America. https://money.cnn.com/2018/06/08/news/economy/immigrant-doct... https://www.wusa9.com/article/news/local/maryland/communitie... https://time.com/5299488/international-medical-graduates/

I believe the American Medical Association (AMA) lobbying congress to shut down medical schools and artificially limit residencies and thus the supply of doctors is a much bigger factor.

A lot of people who are capable and motivated to be doctors for good reasons are shut out because doctors don't want there to be more doctors who will serve to limit their wage growth.

Re: ‘Out here, it’s just me’: one doctor for 11,000 square miles

#60

Post by [deleted] »

novok wrote: post #24
castratikron wrote: post #12

The picture at the end of the article says it all, "No services next 74 miles". If you choose to live in rural US, you are signing up for this kind of lifestyle; you're on your own. As long as that's advertised I don't see a real problem. If you need health care then you should live near health care. Don't expect the same level of support in rural MN as you would get in NYC.

sqrt(11000 miles) ~= 105 miles. If we assume the doctor is referring to a center of a square, then according to pythagoras formula, the longest distance to this doctor is 74 miles. Interesting how it matches like that. When I hear stories about rural lifestyle and people driving for an hour to get to grocery store, it doesn't seem that out of place.

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