This really just amounts to part of the Twitter Hype machine.
How twitter helped a technology consultant escape from an evil hospital
81–90 of 90 posts
Re: How twitter helped a technology consultant escape from an evil hospital
#82Earlier quoted context omitted.
The problem with that philosophy is there are thousands of "blockbuster" treatments, everything from a simple filling, to a Tylenol would be miraculous if you steeped back a few hundred years. Finding the right balance between cost and heath is hard, but blaming everything but the blockbusters is the wrong place to start. Two years ago my father went from fine to dead in one week in part because the doctor failed to…
Hmm, You don't specify what missed test killed your father. There are, however, many symptoms where, given the uncertainty of all technology today, giving an operation or a drug prescription to might save X lives whereas NOT taking action would save Y lives, where X and Y are very uncertain. The harder thing, though, the lives that are lost through giving the operation or the drug tend to be even harder to measure -…
http://en.wikipedia.org/wiki/Pulmonary_embolism it's an accute problem and highly treatable. He had a collapsed lung and went to the doctor 4 days before he died. It's a common killer because it masks as other things, but you can do a fairly cheep pretest. Mortality from untreated PE is said to be 26%.
[edit] Anticoagulation is the more common treatment because it has better long term odds. But, that assumes fairly early detection.
Re: How twitter helped a technology consultant escape from an evil hospital
#83My dad's a doctor in a rural environment, and I had a bad back injury including ruptured discs and cracked vertebrae when I was in high school. I can offer some insight on the psychology of the doctors and even a little bit of information on this particular injury. A rural surgeon is going to be professionally offended if their patient calls up an egghead at Harvard from their pre-op hospital bed and then tells him s…
I want to agree with you, but what I am interested in knowing is why the boston doctor was insisting on a mobility test prior to surgery and why the small town folks were insisting on surgery first. The same thing happens in small town India as well where doctors are more interested in keeping you admitted above and beyond the needed duration and doctors in large cities are just better because they have a greater pat…
The article suggests the small town folks were following outdated procedures, while the boston team was following modern procedures.
Re: How twitter helped a technology consultant escape from an evil hospital
#84Earlier quoted context omitted.
The problem with that philosophy is there are thousands of "blockbuster" treatments, everything from a simple filling, to a Tylenol would be miraculous if you steeped back a few hundred years. Finding the right balance between cost and heath is hard, but blaming everything but the blockbusters is the wrong place to start. Two years ago my father went from fine to dead in one week in part because the doctor failed to…
Whether or not you like that philosophy in general, and despite your father's tragedy, it is extremely appropriate for spinal surgery. Spinal surgery costs a lot of money, frequently goes very badly, and even "successes" tend to be temporary and are followed in a few years by being worse off. This is why in the mid-90s the Agency for Health Care Policy Research (AHCPR) looked at the subject and concluded that back su…
You just swapped your argument from the majority of modern medicine to a specific case. Spinal surgery is also a moving target, the risk / reward line keeps shifting as better treatments shows up. Still in a wide range of cases it's a bad idea, for now.
Re: How twitter helped a technology consultant escape from an evil hospital
#85Earlier quoted context omitted.
Well, it's more like the pro is that there is no profit motive to keep her there. The staff would be delighted to get rid of her to a bigger facility elsewhere. I live a kilometre north of a large hospital in Sydney, Australia and we get helicopters coming in all hours of the day and night, presumably doing just that. The "con" would probably be that there would be no facility for spinal surgery in a rural area in th…
Well, it all depends on the 'type' of government healthcare that happens. If hospitals are still privately owned, but the government basically starts it's own 'insurance company' that covers everyone that isn't part of the private insurance company plan (similar to Germany) then it's possible that a rural area could still have spinal surgery experts. Even if the hospitals are all government-owned and run (similar to…
With a government healthcare system, it won't simply be a cost/benefit analysis. There is also the all important question to be answered: "does this create jobs in my congressional district?"
Re: How twitter helped a technology consultant escape from an evil hospital
#86Earlier quoted context omitted.
Whether or not you like that philosophy in general, and despite your father's tragedy, it is extremely appropriate for spinal surgery. Spinal surgery costs a lot of money, frequently goes very badly, and even "successes" tend to be temporary and are followed in a few years by being worse off. This is why in the mid-90s the Agency for Health Care Policy Research (AHCPR) looked at the subject and concluded that back su…
You just swapped your argument from the majority of modern medicine to a specific case. Spinal surgery is also a moving target, the risk / reward line keeps shifting as better treatments shows up. Still in a wide range of cases it's a bad idea, for now.
I just swapped whose argument? Look at the names of the posters in this thread...
In any case the original article was about a woman who went through a nightmare to get a hospital to not perform unwanted, unneeded and dangerous spinal surgery. So to my eyes I was bringing the discussion back to the example under discussion. And pointing out that it has been well known for over a decade that spinal surgery is a generally bad idea to me underscores the horror of what happened to her.
Re: How twitter helped a technology consultant escape from an evil hospital
#87Earlier quoted context omitted.
Ah,is that really a question? My comment on my blog that my health insurance decided it was best to leave me on the ledge to die of exposure was-need I say-tongue in cheek.You must be under the impression the insurance companies are in possession of that awesome perfect blame calculator - parsing an infinite number of scenarios to detemine blame for accidents and disease, then confirm or deny coverage based on their…
I got too say, I would be surprised if an insurance would not cover something like this. This is equivalent to a sports injury. Frankly no one can tell me that jumping off a cliff mountain biking is less dangerous than a bridge jump. I've bridge jumped before (not fifty feet I believe but high) and I wasn't the only one around, I didn't think it was that dangerous at the time but I understand how a bad landing could…
The reason I questioned whether they would cover this is because in the past I've seen exclusion clauses that stated an insurance company would not cover extreme sports related injuries with a standard health insurance policy. The examples I remember for extreme sports were things like base jumping and bungee jumping and parachuting.
I don't pretend to know much about this stuff. I did state that it was just a question I had. If insurance companies routinely cover people who have accidents while doing things significantly more dangerous than your typical day to day activities then that is great... I guess.
The first part of my comment still stands regardless. I wonder how much of the battle was over getting insurance money and how much of it might have been over the doctor's ego.
Re: How twitter helped a technology consultant escape from an evil hospital
#88Earlier quoted context omitted.
You just swapped your argument from the majority of modern medicine to a specific case. Spinal surgery is also a moving target, the risk / reward line keeps shifting as better treatments shows up. Still in a wide range of cases it's a bad idea, for now.
I just swapped whose argument? Look at the names of the posters in this thread... In any case the original article was about a woman who went through a nightmare to get a hospital to not perform unwanted, unneeded and dangerous spinal surgery. So to my eyes I was bringing the discussion back to the example under discussion. And pointing out that it has been well known for over a decade that spinal surgery is a genera…
Ops, sorry.
Re: How twitter helped a technology consultant escape from an evil hospital
#89Earlier quoted context omitted.
I want to agree with you, but what I am interested in knowing is why the boston doctor was insisting on a mobility test prior to surgery and why the small town folks were insisting on surgery first. The same thing happens in small town India as well where doctors are more interested in keeping you admitted above and beyond the needed duration and doctors in large cities are just better because they have a greater pat…
Watching her in the hospital and knowing that she swam to shore and stood up would have made a mobility test irrelevant. Being 40+ with a shattered T12, she made the riskier decision by opting out of the surgery. If you remove the hyperbolic language from her story, it reads like the hospital was being relatively conservative and trying to take the approach with the least risk of paralysis or other spinal cord injury…
She made the riskier decision? What qualifications do you have to claim that?
According to the Harvard neurosurgeon she made the less risky decision. Given the choice between believing a random poster to hacker news and someone with those qualifications, I'm going with the known expert every time. It is just icing on the cake that the expert's opinion fits with what I've been told about the risks of back surgery by multiple doctors, physical therapists, and even a panel appointed by the US government. (Admittedly the last is somewhat out of date.)
Re: How twitter helped a technology consultant escape from an evil hospital
#90Earlier quoted context omitted.
Watching her in the hospital and knowing that she swam to shore and stood up would have made a mobility test irrelevant. Being 40+ with a shattered T12, she made the riskier decision by opting out of the surgery. If you remove the hyperbolic language from her story, it reads like the hospital was being relatively conservative and trying to take the approach with the least risk of paralysis or other spinal cord injury…
She made the riskier decision? What qualifications do you have to claim that? According to the Harvard neurosurgeon she made the less risky decision. Given the choice between believing a random poster to hacker news and someone with those qualifications, I'm going with the known expert every time. It is just icing on the cake that the expert's opinion fits with what I've been told about the risks of back surgery by m…
I read it in the article I linked to in my previous post. But you're obviously more up to date on the facts, so you win.