8 ms·

That ISN'T cool, that's quite dangerous, because if it was indeed broken, that may cause harm. Rule #1 of being a doctor is violated. X-ray imaging on a finger

That ISN'T cool, that's quite dangerous, because if it was indeed broken, that may cause harm. Rule #1 of being a doctor is violated. X-ray imaging on a finger is virtually harmless. Using a tuning fork to vibrate a potentially broken bone and causing a patient to feel pain is not harmless.

thatoneuser 7y ago
I don't see how it could be that dangerous assuming the doc first looked it over and couldn't find anything by hand. How would a tubing fork seriously hurt a small fracture if applied with skill?
leetbulb 7y ago
Sure it's dangerous, but $400 out of pocket for an xray of your finger is also quite ridiculous. If my finger wasn't obviously broken, I'd probably take my chances with a tuning fork, too.
- konschubert 7y ago
  The real problem is that the x-ray costs 400. It doesn’t have to be that way
  - namibj 7y ago
    Here in Germany it's less than 20. I think it was between 10 and 15 € for a finger. This includes an expert's opinion, albeit a succinct one. I wish they'd do technical/industrial things in a similar fashion. Make appointment, bring piece, get xray, wait a few minutes, leave with xray image/dataset. For cheap. Require bagging for contamination reasons.
    - novaRom 7y ago
      Here in Germany we pay highest healthcare insurance costs in the world. If you earn more than 55000 Euro/year, you have to pay 9600 Euro/year for health insurance alone! And you cannot opt out! Together with your spouse you have to pay insane 19200 Euro annually! No wonder it is between 10 and 15 Euro for a finger. In USA if you pay $20000 you will be fully ensured and you will not need to pay anything for your finger check.
      - Gibbon1 7y ago
        > In USA if you pay $20000 you will be fully ensured and you will not need to pay anything for your finger check. Oh my sweet summer child.
      - germanier 7y ago
        > If you earn more than 55000 Euro/year, you have to pay 9600 Euro/year for health insurance alone! Half of which is paid by your employer. If you earn less, you pay less and still get access to the same health care. > Together with your spouse you have to pay insane 19200 Euro annually! Only if they also earn as much. If they don't work, your don't pay anything to insure them. > And you cannot opt out! Employees earning more than 60k and freelancers can opt out of the system. > No wonder it is between 10 and 15 Euro for a finger. With insurance you don't pay anything for getting your finger checked. That was the price without insurance (full bill including consultation would be probably 50€ or so).
        novaRom 7y ago
        > Half of which is paid by your employer Wrong. Your employer covers only 50% of base KV part and excludes PV and other extras. Take 14.6% from 55000 and divide it by 2 to see what your employer covers.
      - username90 7y ago
        Sounds strange, total healthcare spendings in Germany looks like a typical developed country and are much cheaper than USA's: https://data.worldbank.org/indicator/SH.XPD.CHEX.GD.ZS?locations=US-DE-CH-CA-SE-JP https://data.worldbank.org/indicator/SH.XPD.CHEX.GD.ZS?locat...
      - namibj 7y ago
        Oh, sorry, the price is the GOÄ (Gebührenordnung für Ärtzte) price the X-Ray place can bill you/your insurance. This includes the X-Ray consultation. You are send there by your GP if the GP determines you need it checked like that. They write it down, give you a form, and the specialist uses it to bill the insurance (as they don't pay if you just show up at the X-Ray place directly). Also a full hand, including the palm, is less than 10€ more I think. It's really not that expensive (a Finger was the cheapest I remember finding).
cwkoss 7y ago
Putting the patient into medical debt also causes harm
- cwkoss 7y ago
  All pharmaceuticals should be tested against the control of handing the patient the cost of the medication in cash. I bet hundreds of dollars a month would provide depression and anxiety relief for a significant portion of the population.
  - jachee 7y ago
    You clearly don't know anyone suffering from depression and/or anxiety. If you think money relieves anything—regardless of the amount—you're quite mistaken. Robin Williams was a literal multi-millionaire, and if money relieved anything, he'd still be here.
    - stordoff 7y ago
      No, but money worries can exacerbate anxiety. If the drug is marginally effective, the money may provide more (but _far_ from complete) relief. Context: I have a long-term anxiety condition (GAD+OCD).
s1artibartfast 7y ago
This mentality is the problem with current medicine. The doctor is not causing harm, they are mitigating it with a less than optimal method. If the tuning forks analysis has better outcome than no assessment, no harm has been done If a doctor has a treatment with 80% efficacy that costs $1,000, and another with 90% efficacy that costs $100,000, there is nothing immoral about giving the patient the choice. "Doing Harm" would be prescribing treatment that leaves the patient worse off than they started.
Stratoscope 7y ago
As I explained in an update to my original comment, the offer to use the tuning fork came only after an extensive manual exam with range of motion and "does it hurt" tests. I'm sorry I didn't make that clear at first, it was 10 years ago. I don't see what harm the tuning fork would have caused me beyond a moment of pain which would show that it was worth my time to get an X-ray. Feeling a bit of pain is not the worst thing in the world. One time I had a tiny cavity on a lower molar, and my dentist offered to drill and fill it without anesthetic. He said that of course I was welcome to get a shot or two of novocaine as we'd normally done. But the lower jaw takes so much time to recover, and he'd had a small cavity of his own filled without novocaine and it was nice to be immediately back to normal. He also knew that I was fairly tolerant to pain and he probably wouldn't have made the suggestion otherwise. So I took him up on it, and sure enough, it really hurt for a few seconds. But I had a completely normal mouth when I left the office. None of the usual drooling and tongue biting for the rest of the day. I went right out for a nice lunch! So that was another tradeoff I was glad for, and hopefully these decisions are mine to make.
eragone 7y ago
No, this sounds like a great example of shared decision making.

thatoneuser 7y ago

I don't see how it could be that dangerous assuming the doc first looked it over and couldn't find anything by hand. How would a tubing fork seriously hurt a small fracture if applied with skill?

leetbulb 7y ago

Sure it's dangerous, but $400 out of pocket for an xray of your finger is also quite ridiculous. If my finger wasn't obviously broken, I'd probably take my chances with a tuning fork, too.

konschubert 7y ago
The real problem is that the x-ray costs 400. It doesn’t have to be that way
- namibj 7y ago
  Here in Germany it's less than 20. I think it was between 10 and 15 € for a finger. This includes an expert's opinion, albeit a succinct one. I wish they'd do technical/industrial things in a similar fashion. Make appointment, bring piece, get xray, wait a few minutes, leave with xray image/dataset. For cheap. Require bagging for contamination reasons.
  - novaRom 7y ago
    Here in Germany we pay highest healthcare insurance costs in the world. If you earn more than 55000 Euro/year, you have to pay 9600 Euro/year for health insurance alone! And you cannot opt out! Together with your spouse you have to pay insane 19200 Euro annually! No wonder it is between 10 and 15 Euro for a finger. In USA if you pay $20000 you will be fully ensured and you will not need to pay anything for your finger check.
    - Gibbon1 7y ago
      > In USA if you pay $20000 you will be fully ensured and you will not need to pay anything for your finger check. Oh my sweet summer child.
    - germanier 7y ago
      > If you earn more than 55000 Euro/year, you have to pay 9600 Euro/year for health insurance alone! Half of which is paid by your employer. If you earn less, you pay less and still get access to the same health care. > Together with your spouse you have to pay insane 19200 Euro annually! Only if they also earn as much. If they don't work, your don't pay anything to insure them. > And you cannot opt out! Employees earning more than 60k and freelancers can opt out of the system. > No wonder it is between 10 and 15 Euro for a finger. With insurance you don't pay anything for getting your finger checked. That was the price without insurance (full bill including consultation would be probably 50€ or so).
      - novaRom 7y ago
        > Half of which is paid by your employer Wrong. Your employer covers only 50% of base KV part and excludes PV and other extras. Take 14.6% from 55000 and divide it by 2 to see what your employer covers.
    - username90 7y ago
      Sounds strange, total healthcare spendings in Germany looks like a typical developed country and are much cheaper than USA's: https://data.worldbank.org/indicator/SH.XPD.CHEX.GD.ZS?locations=US-DE-CH-CA-SE-JP https://data.worldbank.org/indicator/SH.XPD.CHEX.GD.ZS?locat...
    - namibj 7y ago
      Oh, sorry, the price is the GOÄ (Gebührenordnung für Ärtzte) price the X-Ray place can bill you/your insurance. This includes the X-Ray consultation. You are send there by your GP if the GP determines you need it checked like that. They write it down, give you a form, and the specialist uses it to bill the insurance (as they don't pay if you just show up at the X-Ray place directly). Also a full hand, including the palm, is less than 10€ more I think. It's really not that expensive (a Finger was the cheapest I remember finding).

cwkoss 7y ago

Putting the patient into medical debt also causes harm

cwkoss 7y ago
All pharmaceuticals should be tested against the control of handing the patient the cost of the medication in cash. I bet hundreds of dollars a month would provide depression and anxiety relief for a significant portion of the population.
- jachee 7y ago
  You clearly don't know anyone suffering from depression and/or anxiety. If you think money relieves anything—regardless of the amount—you're quite mistaken. Robin Williams was a literal multi-millionaire, and if money relieved anything, he'd still be here.
  - stordoff 7y ago
    No, but money worries can exacerbate anxiety. If the drug is marginally effective, the money may provide more (but _far_ from complete) relief. Context: I have a long-term anxiety condition (GAD+OCD).

s1artibartfast 7y ago

This mentality is the problem with current medicine. The doctor is not causing harm, they are mitigating it with a less than optimal method. If the tuning forks analysis has better outcome than no assessment, no harm has been done If a doctor has a treatment with 80% efficacy that costs $1,000, and another with 90% efficacy that costs $100,000, there is nothing immoral about giving the patient the choice. "Doing Harm" would be prescribing treatment that leaves the patient worse off than they started.

Stratoscope 7y ago

As I explained in an update to my original comment, the offer to use the tuning fork came only after an extensive manual exam with range of motion and "does it hurt" tests. I'm sorry I didn't make that clear at first, it was 10 years ago. I don't see what harm the tuning fork would have caused me beyond a moment of pain which would show that it was worth my time to get an X-ray. Feeling a bit of pain is not the worst thing in the world. One time I had a tiny cavity on a lower molar, and my dentist offered to drill and fill it without anesthetic. He said that of course I was welcome to get a shot or two of novocaine as we'd normally done. But the lower jaw takes so much time to recover, and he'd had a small cavity of his own filled without novocaine and it was nice to be immediately back to normal. He also knew that I was fairly tolerant to pain and he probably wouldn't have made the suggestion otherwise. So I took him up on it, and sure enough, it really hurt for a few seconds. But I had a completely normal mouth when I left the office. None of the usual drooling and tongue biting for the rest of the day. I went right out for a nice lunch! So that was another tradeoff I was glad for, and hopefully these decisions are mine to make.

eragone 7y ago

No, this sounds like a great example of shared decision making.