6 ms·

As an european now living in America: The reason the EU model works is that people treat their problems early. You have a concern - you go to the doctor. NHS

As an european now living in America: The reason the EU model works is that people treat their problems early. You have a concern - you go to the doctor. NHS - with all it's short comes - has the same principle

chrisseaton 10y ago
> You have a concern - you go to the doctor. But the NHS keeps telling us to not go to the doctor! "See a nurse rather than a doctor! See a pharmacist rather than a doctor! Phone a helpline rather than see a doctor! Go to your high street chemist rather than see a doctor! Self-treat rather than see a doctor!".
- andreasklinger 10y ago
  I had subpar experiences in the UK with the NHS but not horrible. Telling people not to go to a doctor is dangerous but i can understand the intend. Eg: (Can only judge with Austria/Germany experience) Pharmacists are extremely highly trained there. They are implicitly used as a simple doctor. We do the same. You feel bit weird you go to the pharmacy just to gauge what it could be and how serious they take it. If serious enough you go to a doctor asap.
  - chrisseaton 10y ago
    > You feel bit weird you go to the pharmacy just to gauge what it could be and how serious they take it. If serious enough you go to a doctor asap. They must be very confident pharmacists. If anyone ever asked me 'do you think I should see a doctor' I would say 'yes' every time. What happens if you get it wrong? Doctors are protected by major institutions, insurance, legal precedents. What about someone working in Boots (UK high street pharmacy chain) who tells you not to bother seeing a doctor and then you die?
    - andreasklinger 10y ago
      1) they are really well trained usually 2) If they are unsure they will tell you. 3) If the judgement is the same as any one else would have done i dont think it could be considered grossly negligent.
    - madaxe_again 10y ago
      Pharmacists, in the UK at least, have to train almost as much as doctors, and have much of the same knowledge.
    - DanBC 10y ago
      We have a bunch of different health advice, from NICE and Public Health England and etc. So if a pharmacist is getting close to that advice they're going to be protected. Admittedly their advice would be "You probably don't need to see a GP for this, but if you're at all worried you should make an appointment".
- ZenoArrow 10y ago
  You're missing the wood for the trees. The 'doctor' part of the statement wasn't the important part, it's that early diagnosis is encouraged. For example, the NHS has the NHS 111 helpline for times when you want medical advice but it isn't something that requires visiting a doctor (they can refer you to a doctor if it is something that requires further investigation). http://www.nhs.uk/NHSEngland/AboutNHSservices/Emergencyandurgentcareservices/Pages/NHS-111.aspx http://www.nhs.uk/NHSEngland/AboutNHSservices/Emergencyandur...
- vertex-four 10y ago
  If you do any of those things and it turns out to be something they can't handle, they send you to a doctor. I've phoned 111 a couple of times, once had an appointment made for me with an emergency dentist, and once been told to wait my illness out (severe stomach pain) as it was unlikely the doctor could do anything for me aside from prescribe painkillers. If I'd seen a doctor the second time, it would've been a waste of the doctor's time.
- petepete 10y ago
  Yes, but look at how many people go to see a doctor with a cold or at the first signs of a sore throat. That, along with missed appointments, are what makes the process so inefficient.
- Angostura 10y ago
  And this is all reasonable advice. If the nurse or helpline or pharmacy can help - great. If not, they will escalate
yummyfajitas 10y ago
The reason the EU model works is that doctors (and other medical professionals) get paid less. A quick google search suggests a US ER doctor or radiologist gets paid more than 3x what a British one does, a family practitioner 2x. http://www.payscale.com/research/UK/People_with_Jobs_as_Physicians_%2F_Doctors/Salary http://www.payscale.com/research/UK/People_with_Jobs_as_Phys... http://www.payscale.com/research/US/People_with_Jobs_as_Physicians_%2F_Doctors/Salary http://www.payscale.com/research/US/People_with_Jobs_as_Phys... "You have a concern - you go to the doctor" is a waste of money. We've done randomized controlled trials to study this question and the result is more money spent with no increase in health. https://www.nber.org/oregon/ https://www.nber.org/oregon/ http://www.rand.org/health/projects/hie.html http://www.rand.org/health/projects/hie.html
- k-mcgrady 10y ago
  >> "The reason the EU model works is that doctors (and other medical professionals) get paid less. A quick google search suggests a US ER doctor or radiologist gets paid more than 3x what a British one does, a family practitioner 2x." I'm not sure if you were posing this as a problem or not but as long as doctors want to work for the NHS it isn't one.
  - arethuza 10y ago
    Going by the standards required to get into medical school in the UK from high school I don't think there is any lack of applicants! Might also be worth comparing the cost of qualifying as a medic in the UK and the US!
  - yummyfajitas 10y ago
    I'm not posing it as a problem. I'm simply pointing out the real reason things work in the UK is that people pay less for the same thing. Tangentially, if anyone proposes UK-style solutions to health care problems in the US without proposing 50-66% wage cuts for doctors/nurses, they are lying to you.
    - andreasklinger 10y ago
adrianratnapala 10y ago
That's the way it works now I live in Germany. It's very cheap an easy to go to the doctor here, and they are keen to do tests that get them early warning problems. This is all a way of clawing money back from the compulsory roughly "Obamacare" style insurers. But it was much worse when in the UK. The providers get funding for you, but once you are registered, it seems actual service is a pure cost to them. My GPs practice in London only allowed same day-appointments and only pretended to allow them over the phone. My cousin there got sicker and sicker for months in because instead of testing her, they just gave her the wrong medicine. In the end she flew to Sri Lanka where she got tested, rediagnosed and operated on within 48 hours.
- DanBC 10y ago
  > My GPs practice in London only allowed same day-appointments and only pretended to allow them over the phone Some GPs are bad, and in general GPs are under a lot of pressure, but you can change your GP surgery at any time, for any reason. And let's not forget that your "NHS GP" is not employed by the NHS, but is employed by a private company that does work for the NHS. GPs are shit because of the fucking awful semi-privatisation they've been forced through.

chrisseaton 10y ago

> You have a concern - you go to the doctor. But the NHS keeps telling us to not go to the doctor! "See a nurse rather than a doctor! See a pharmacist rather than a doctor! Phone a helpline rather than see a doctor! Go to your high street chemist rather than see a doctor! Self-treat rather than see a doctor!".

andreasklinger 10y ago
I had subpar experiences in the UK with the NHS but not horrible. Telling people not to go to a doctor is dangerous but i can understand the intend. Eg: (Can only judge with Austria/Germany experience) Pharmacists are extremely highly trained there. They are implicitly used as a simple doctor. We do the same. You feel bit weird you go to the pharmacy just to gauge what it could be and how serious they take it. If serious enough you go to a doctor asap.
- chrisseaton 10y ago
  > You feel bit weird you go to the pharmacy just to gauge what it could be and how serious they take it. If serious enough you go to a doctor asap. They must be very confident pharmacists. If anyone ever asked me 'do you think I should see a doctor' I would say 'yes' every time. What happens if you get it wrong? Doctors are protected by major institutions, insurance, legal precedents. What about someone working in Boots (UK high street pharmacy chain) who tells you not to bother seeing a doctor and then you die?
  - andreasklinger 10y ago
    1) they are really well trained usually 2) If they are unsure they will tell you. 3) If the judgement is the same as any one else would have done i dont think it could be considered grossly negligent.
  - madaxe_again 10y ago
    Pharmacists, in the UK at least, have to train almost as much as doctors, and have much of the same knowledge.
  - DanBC 10y ago
    We have a bunch of different health advice, from NICE and Public Health England and etc. So if a pharmacist is getting close to that advice they're going to be protected. Admittedly their advice would be "You probably don't need to see a GP for this, but if you're at all worried you should make an appointment".
ZenoArrow 10y ago
You're missing the wood for the trees. The 'doctor' part of the statement wasn't the important part, it's that early diagnosis is encouraged. For example, the NHS has the NHS 111 helpline for times when you want medical advice but it isn't something that requires visiting a doctor (they can refer you to a doctor if it is something that requires further investigation). http://www.nhs.uk/NHSEngland/AboutNHSservices/Emergencyandurgentcareservices/Pages/NHS-111.aspx http://www.nhs.uk/NHSEngland/AboutNHSservices/Emergencyandur...
vertex-four 10y ago
If you do any of those things and it turns out to be something they can't handle, they send you to a doctor. I've phoned 111 a couple of times, once had an appointment made for me with an emergency dentist, and once been told to wait my illness out (severe stomach pain) as it was unlikely the doctor could do anything for me aside from prescribe painkillers. If I'd seen a doctor the second time, it would've been a waste of the doctor's time.
petepete 10y ago
Yes, but look at how many people go to see a doctor with a cold or at the first signs of a sore throat. That, along with missed appointments, are what makes the process so inefficient.
Angostura 10y ago
And this is all reasonable advice. If the nurse or helpline or pharmacy can help - great. If not, they will escalate

yummyfajitas 10y ago

The reason the EU model works is that doctors (and other medical professionals) get paid less. A quick google search suggests a US ER doctor or radiologist gets paid more than 3x what a British one does, a family practitioner 2x. http://www.payscale.com/research/UK/People_with_Jobs_as_Physicians_%2F_Doctors/Salary http://www.payscale.com/research/UK/People_with_Jobs_as_Phys... http://www.payscale.com/research/US/People_with_Jobs_as_Physicians_%2F_Doctors/Salary http://www.payscale.com/research/US/People_with_Jobs_as_Phys... "You have a concern - you go to the doctor" is a waste of money. We've done randomized controlled trials to study this question and the result is more money spent with no increase in health. https://www.nber.org/oregon/ https://www.nber.org/oregon/ http://www.rand.org/health/projects/hie.html http://www.rand.org/health/projects/hie.html

k-mcgrady 10y ago
>> "The reason the EU model works is that doctors (and other medical professionals) get paid less. A quick google search suggests a US ER doctor or radiologist gets paid more than 3x what a British one does, a family practitioner 2x." I'm not sure if you were posing this as a problem or not but as long as doctors want to work for the NHS it isn't one.
- arethuza 10y ago
  Going by the standards required to get into medical school in the UK from high school I don't think there is any lack of applicants! Might also be worth comparing the cost of qualifying as a medic in the UK and the US!
- yummyfajitas 10y ago
  I'm not posing it as a problem. I'm simply pointing out the real reason things work in the UK is that people pay less for the same thing. Tangentially, if anyone proposes UK-style solutions to health care problems in the US without proposing 50-66% wage cuts for doctors/nurses, they are lying to you.
  - andreasklinger 10y ago

adrianratnapala 10y ago

That's the way it works now I live in Germany. It's very cheap an easy to go to the doctor here, and they are keen to do tests that get them early warning problems. This is all a way of clawing money back from the compulsory roughly "Obamacare" style insurers. But it was much worse when in the UK. The providers get funding for you, but once you are registered, it seems actual service is a pure cost to them. My GPs practice in London only allowed same day-appointments and only pretended to allow them over the phone. My cousin there got sicker and sicker for months in because instead of testing her, they just gave her the wrong medicine. In the end she flew to Sri Lanka where she got tested, rediagnosed and operated on within 48 hours.

DanBC 10y ago
> My GPs practice in London only allowed same day-appointments and only pretended to allow them over the phone Some GPs are bad, and in general GPs are under a lot of pressure, but you can change your GP surgery at any time, for any reason. And let's not forget that your "NHS GP" is not employed by the NHS, but is employed by a private company that does work for the NHS. GPs are shit because of the fucking awful semi-privatisation they've been forced through.