Why Did My Patient Leave Me? • Hacker News Board

Re: Why Did My Patient Leave Me?

#61

Post by theoneone » Sat, Apr 15, 2017, 1:32 PM UTC

csydas wrote: post #35

josephorjoe wrote: post #33

The primary reason I have left healthcare providers has been the poor quality of their administrative staff. There are too many qualified doctors in the major metro area I live in to put up with ones where I can't quickly and efficiently make an appointment, can't get an appointment in a timeframe that is useful to me, and where their staff can't seem to successfully process routine insurance claims with major insura…

> Also, randomly billing me for stuff weeks or months after an appointment with cryptic explanations thoroughly pisses me off -- even it if is only $15.00 (going to get a new podiatrist over that one...). This part gets me a lot as well, and having experienced other pay-for healthcare systems, it's extremely frustrating remembering just how much I would pay in the US even when I had fair insurance through my employer…

So 3000$ for a biopsy: ticket to Greece and back to USA : let's say 1000€. Biopsy procedure if it's ultrasound guided around 300€. Lab fee for examining the biopsy:around 200€ max, maybe less. Hotel room for 2-4 days in Thessaloniki 120€-150€ in a decent hotel. Total:1500€ or even less. All these can be done by highly and well educate medical doctors, treatment in private clinics is very good(since you are paying in cash you always get vip treatment) and o course you can enjoy a good vacation. I always said that medical tourism is the future

Re: Why Did My Patient Leave Me?

#62

Post by rincebrain » Sat, Apr 15, 2017, 1:32 PM UTC

jacquesm wrote: post #55

lmns wrote: post #28

So, in this sense, vaccination should be an individual choice? This is something which concerns the individual, but has consequences for society as a whole.

> So, in this sense, vaccination should be an individual choice? Emphatically: YES. Bodily integrity is something that is very high on the list of things that a person should have a say over. Whether they do it because they are mis-informed, dumb, irrational or religious doesn't matter, they still should have the final say over whether or not they get a specific injection or not. There are many things that concern th…

It's not "just" those who haven't been vaccinated at risk, though - vaccines often have both an efficacy rate (the likelihood you develop sufficient immune response) and duration (how long it lasts without repetition).

One of my relatives was vaccinated for pertussis, and yet still came down with it one day. Their parent had a hard time convincing the doctors to even test for it because, in their minds, it was no longer an option.

Even later, it came out that the particular vaccine that my relative had been given had a markedly lower effective duration than had been initially advertised.

So even if other entities make all the "safe" choices (presuming they're not immunocompromised or otherwise unable to be vaccinated), disruptions in herd immunity can have problematic consequences.

Re: Why Did My Patient Leave Me?

#63

Post by ido » Sat, Apr 15, 2017, 1:32 PM UTC

ThomPete wrote: post #32

jacquesm wrote: post #26

Earlier quoted context omitted.

Good point. I'm not too worried about France, they seem to have their priorities straight there, other countries are less stable. Especially in former Eastern European countries there are disasters happening right now, and many Western countries will have to come to terms with the cost of health care and attempting to take commerce out of it. NL had a very good system which got replaced by something much less efficie…

My personal suggestion for a good balanced system is that most people pay most of the cost for normal healthcare costs like going to the doctor for a checkup, most of the cost for one of things like a broken leg but that society pays for more serious and longer term situations like cancer, heart surgeries where you are supposed to stay at the hospital for a longer time. I.e. no one should be bankrupted because they g…

The problem is that people then tend to forgo preventive care & routine checkups if they don't have to (especially poor people), and in the long term end up costing a lot more when they do get treatment once their situation is far worse.

Re: Why Did My Patient Leave Me?

#64

Post by johncolanduoni » Sat, Apr 15, 2017, 1:36 PM UTC

jacquesm wrote: post #55

lmns wrote: post #28

So, in this sense, vaccination should be an individual choice? This is something which concerns the individual, but has consequences for society as a whole.

> So, in this sense, vaccination should be an individual choice? Emphatically: YES. Bodily integrity is something that is very high on the list of things that a person should have a say over. Whether they do it because they are mis-informed, dumb, irrational or religious doesn't matter, they still should have the final say over whether or not they get a specific injection or not. There are many things that concern th…

> Fortunately the anti-vaxxers are a small minority instead of a large majority so the risk is somewhat controllable and fortunately the only people at risk are those that have not been vaccinated yet (a risk that for many diseases is extremely small) so the consequences for society as a whole are manageable.

Loss of herd immunity effects those who have gotten the vaccine as well (especially with vaccines that have more significant failure rates). Choosing to not vaccinate your child and expecting everybody else's children at the public school you send them to to just deal is about more than personal bodily integrity.

Re: Why Did My Patient Leave Me?

#65

Post by surgeryres » Sat, Apr 15, 2017, 1:45 PM UTC

theoneone wrote: post #61

csydas wrote: post #35

Earlier quoted context omitted.

> Also, randomly billing me for stuff weeks or months after an appointment with cryptic explanations thoroughly pisses me off -- even it if is only $15.00 (going to get a new podiatrist over that one...). This part gets me a lot as well, and having experienced other pay-for healthcare systems, it's extremely frustrating remembering just how much I would pay in the US even when I had fair insurance through my employer…

So 3000$ for a biopsy: ticket to Greece and back to USA : let's say 1000€. Biopsy procedure if it's ultrasound guided around 300€. Lab fee for examining the biopsy:around 200€ max, maybe less. Hotel room for 2-4 days in Thessaloniki 120€-150€ in a decent hotel. Total:1500€ or even less. All these can be done by highly and well educate medical doctors, treatment in private clinics is very good(since you are paying in…

So are you going to fly back when the biopsy is positive for your surgery or chemotherapy?

Re: Why Did My Patient Leave Me?

#66

Post by jacquesm » Sat, Apr 15, 2017, 1:46 PM UTC

johncolanduoni wrote: post #64

jacquesm wrote: post #55

Earlier quoted context omitted.

> So, in this sense, vaccination should be an individual choice? Emphatically: YES. Bodily integrity is something that is very high on the list of things that a person should have a say over. Whether they do it because they are mis-informed, dumb, irrational or religious doesn't matter, they still should have the final say over whether or not they get a specific injection or not. There are many things that concern th…

> Fortunately the anti-vaxxers are a small minority instead of a large majority so the risk is somewhat controllable and fortunately the only people at risk are those that have not been vaccinated yet (a risk that for many diseases is extremely small) so the consequences for society as a whole are manageable. Loss of herd immunity effects those who have gotten the vaccine as well (especially with vaccines that have m…

That's true, but it's not an absolute: there is no guarantee anybody will get ill, it's rolling the dice with a somewhat higher chance of someone else getting ill but a much bigger chance of you yourself getting ill.

As an analogue: if you want to categorize the non-vaccinated person as a 'drunk driver' who is not allowed to partake in traffic then you prioritize (rightly, imo) their choice to be drunk over the risk they pose to the lives and health of others because the chances of causing a serious accident are large enough - and we have the evidence to back that up - that we collectively have decided against people having that particular freedom.

So if that's your argument (which I don't know for sure) you definitely have a point.

The counter point (to that convenient strawman :) ) is that the chances of someone getting ill are not as easy to determine and that that someone might have gotten ill anyway. Cause and effect are a lot more distant in that case and much harder to relate to each other.

Re: Why Did My Patient Leave Me?

#67

Post by ThomPete » Sat, Apr 15, 2017, 1:52 PM UTC

ajnin wrote: post #41

ThomPete wrote: post #24

Earlier quoted context omitted.

I do question the sustainability of the french system though and that of many other european systems. Its important to remember that in a state economy where healthcare is free or semi free it's operated as a cost center and thus has budgets that are politically mandated not determined by market demand at least not directly. This leads to a number of limitations on what kind of care patients can get what machines the…

You're right that the budget is tighter, however the healthcare budget is separate from the main state budget, and you can't have a situation where for example you'd allocate less to health to pay for schools or army or something like that. The money still comes from taxes though and there is enormous pressure currently due to the economic situation in Europe, especially from businesses, to lower those taxes. It can…

It's not separate from the reality that they have to decide what kind of ex. treatment they are going to support for how many etc.

Re: Why Did My Patient Leave Me?

#68

Post by losteverything » Sat, Apr 15, 2017, 1:55 PM UTC

brightball wrote: post #52

josephorjoe wrote: post #33

The primary reason I have left healthcare providers has been the poor quality of their administrative staff. There are too many qualified doctors in the major metro area I live in to put up with ones where I can't quickly and efficiently make an appointment, can't get an appointment in a timeframe that is useful to me, and where their staff can't seem to successfully process routine insurance claims with major insura…

If you can justify the expense, MD VIP ( http://www.mdvip.com/ ) is worth exploring. You basically pay an annual fee and in trade, the doctor's office caps their patient load at a certain number. The fee also includes an annual executive physical and work up. The benefit is that with the smaller patient load, you can almost always get an immediate appointment. The doctor will actually get to know you and your history…

Our mdvip experience was different.

We paid the $1500 a year a few times. Got a thorough physical - but Dr. and office dropped the ball on follow up.

So when we didn't renew, we were bombarded by AOL-like contact wondering why we left. (We hardly ever say negative things on questions like this)

But it got worse. We wanted a simple refill on an inhaler and the mdvip Dr refused. We had to rejoin first!!! Pay $1500 for a Rx!!!

Called the former local Dr office and they Rx one emergency refill even after not seeing the practice for years.

We will go back to the mdvip dr again because but only when and if the condition calls for. The Dr may not be good at follow up but we liked his diagnosis skills

Re: Why Did My Patient Leave Me?

#69

Post by ThomPete » Sat, Apr 15, 2017, 1:56 PM UTC

ido wrote: post #63

ThomPete wrote: post #32

Earlier quoted context omitted.

My personal suggestion for a good balanced system is that most people pay most of the cost for normal healthcare costs like going to the doctor for a checkup, most of the cost for one of things like a broken leg but that society pays for more serious and longer term situations like cancer, heart surgeries where you are supposed to stay at the hospital for a longer time. I.e. no one should be bankrupted because they g…

The problem is that people then tend to forgo preventive care & routine checkups if they don't have to (especially poor people), and in the long term end up costing a lot more when they do get treatment once their situation is far worse.

No thats actually not true which Denmark has lots of data to show.

It's 100% free to go to the doctor yet a lot of people don't go for checkups it's not a common thing to do.

Furthermore the situation is even worse for men over 50.

So access to healthcare has very little to do with that.

Re: Why Did My Patient Leave Me?

#70

Post by ThomPete » Sat, Apr 15, 2017, 1:59 PM UTC

jacquesm wrote: post #44

ThomPete wrote: post #32

Earlier quoted context omitted.

My personal suggestion for a good balanced system is that most people pay most of the cost for normal healthcare costs like going to the doctor for a checkup, most of the cost for one of things like a broken leg but that society pays for more serious and longer term situations like cancer, heart surgeries where you are supposed to stay at the hospital for a longer time. I.e. no one should be bankrupted because they g…

Yes, those poor people with recreational broken legs really should pay for their own work. That's only about 25K or so in a bad case without further complications... /s

Please read what I actually wrote instead of just knee-jerk reacting to your own prejudice.

I said MOST people should pay MOST of the bill. Do you really think I am talking about those with least amount of money.