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Ask HN: How to leverage my personal wealth to obtain better medical care?

I have a very serious medical condition that is putting me at risk of becoming permanently disabled. It seems that because our society has normalized the idea of having a disability, my health issue is not being treated as seriously as it should be. Given that money is no object, what can I do to get better medical care?

wallflower 7y ago
Informally, if you want a good doctor, the best way is to ask a doctor who you know and trust who they think is a good doctor or to refer you to someone who knows. Not all doctors are the best per the law of normal distribution. If you have not already, consider getting a referral to a concierge doctor from someone in your network. https://www.nytimes.com/2017/06/03/business/economy/high-end-medical-care.amp.html https://www.nytimes.com/2017/06/03/business/economy/high-end...
gingabriska 7y ago
First of all you need to hire some partime med student, maybe some PhD student. And set them into investigatory work of unraveling the current researchers and meeting the doctors who are at the cutting edge treatment for your specific issue. A funded PhD student would love doing that.
andrei_says_ 7y ago
Consider moving to a country with a healthcare system? The US has a healthcare industry, its main purpose is to maximize profit. This leads to a very dangerous distortion of priorities which distortion is institutionalized. Doctors and everyone else have to work within these limitations which puts any patient at a serious disadvantage.
- BlindnessSucks 7y ago
  I have a serious problem and I need concrete advice, not broad generalizations about the politics of healthcare. My health situation is complex, and I have seen some very good doctors, but they can't justify spending the time and effort needed to cure just one patient. I need actionable steps that I can take.
  - andrei_says_ 7y ago
    I appreciate the reply and your correction. Apologies if my entry sounded inappropriate. I was speaking from experience — a friend, EU expat in the US hat to return to his European country to get adequate treatment. But in his case money was a major obstacle in the US. I wish you best outcome and a quick recovery.
- masonic 7y ago
  Nowhere in the OP is his country even mentioned.
DanBC 7y ago
Fly to England for treatment and pay the Overseas Visitor rates which should be 150% of the tariff rates. If however you're in England and the issue is in getting hold of something like Avastin: if money is no object you can go private and get it. Make sure you read the CQC review of the provider, and check the professional registrations of the doctors and nurses.
deleted 7y ago
[deleted]
gshdg 7y ago
This question is a bit vague. What treatments do you want? Do you have information indicating that better treatments or cures exist than what’s being offered to you? What specific obstacles are you encountering in trying to access those treatments?
brador 7y ago
Set a reward for curing your illness equal to your entire wealth stack minus 10%. Use the 10% for marketing the prize and administration costs.
- mars4rp 7y ago
  and what the downsize would be for the doctor? If he could cure him, the doctor gets a fortune, if the treatment didn't work, he goes disabled or worse. I don't want to be that patient! Capitalism doesn't work for everything!
  - brador 7y ago
    Use some of the 10% to pay for independent peer review of interesting solutions.
rajacombinator 7y ago
I understand the general nature of your situation/question, but it’s hard to give meaningful advice without more specifics. Either way, if you say money is no object, what about time? For edge case medical conditions that fall outside the cookie cutter ddx procedure your local doctor is familiar with, doing the research yourself is often the only option. I had to do this for a serious but obscure illness earlier this year. Alternately you can doctor shop and hope to find one who has the interest level and attention to detail to tackle your condition. (Recommendations can help.) But these doctors are few and far between, sadly. Edit: by the way, I don’t think this is an issue that money can solve directly, which is frustrating. If money is truly no object but time is, one option might be to hire a bright college student as a research assistant, as someone else mentioned here.
perilunar 7y ago
If you've already tried the best current treatments, you need to find out who the top researchers in the field are and what experimental treatments they are working on. Read the literature. Find out what clinical trials are in progress and get yourself enrolled in one if possible. e.g. (based on your username): https://www.clinicaltrials.gov/ct2/results?cond=Blindness https://www.clinicaltrials.gov/ct2/results?cond=Blindness Also consider directly funding researchers, research projects, and trials. Research is money constrained — you can fund work that otherwise would not get done.
uberduber 7y ago
If you are not already going to a large academic center in a large city, I would start there. Also depending on your condition and specialty it is fairly regional. For example, most of the good geneticists are on the east coast. In large cities with rich people there are cash only and concierge doctors who will spend the time needed with you because you pay them for it. The going rate now here in Los Angeles seems to be $1000/hr for an appointment, though they do spend time outside of that on your case of that which they don't charge for. If money is truly no object, there are services that you pay money who will do research, have connections to top doctors, and ensure the correct diagnosis. The best known one is Private Health Management. There are some smaller firms often started by people who used to work there that are more affordable. Years ago when I talked to some of these my personal case was around $50-100k which I don't have.

wallflower 7y ago

Informally, if you want a good doctor, the best way is to ask a doctor who you know and trust who they think is a good doctor or to refer you to someone who knows. Not all doctors are the best per the law of normal distribution. If you have not already, consider getting a referral to a concierge doctor from someone in your network. https://www.nytimes.com/2017/06/03/business/economy/high-end-medical-care.amp.html https://www.nytimes.com/2017/06/03/business/economy/high-end...

gingabriska 7y ago

First of all you need to hire some partime med student, maybe some PhD student. And set them into investigatory work of unraveling the current researchers and meeting the doctors who are at the cutting edge treatment for your specific issue. A funded PhD student would love doing that.

andrei_says_ 7y ago

Consider moving to a country with a healthcare system? The US has a healthcare industry, its main purpose is to maximize profit. This leads to a very dangerous distortion of priorities which distortion is institutionalized. Doctors and everyone else have to work within these limitations which puts any patient at a serious disadvantage.

BlindnessSucks 7y ago
I have a serious problem and I need concrete advice, not broad generalizations about the politics of healthcare. My health situation is complex, and I have seen some very good doctors, but they can't justify spending the time and effort needed to cure just one patient. I need actionable steps that I can take.
- andrei_says_ 7y ago
  I appreciate the reply and your correction. Apologies if my entry sounded inappropriate. I was speaking from experience — a friend, EU expat in the US hat to return to his European country to get adequate treatment. But in his case money was a major obstacle in the US. I wish you best outcome and a quick recovery.
masonic 7y ago
Nowhere in the OP is his country even mentioned.

DanBC 7y ago

Fly to England for treatment and pay the Overseas Visitor rates which should be 150% of the tariff rates. If however you're in England and the issue is in getting hold of something like Avastin: if money is no object you can go private and get it. Make sure you read the CQC review of the provider, and check the professional registrations of the doctors and nurses.

deleted 7y ago

[deleted]

gshdg 7y ago

This question is a bit vague. What treatments do you want? Do you have information indicating that better treatments or cures exist than what’s being offered to you? What specific obstacles are you encountering in trying to access those treatments?

brador 7y ago

Set a reward for curing your illness equal to your entire wealth stack minus 10%. Use the 10% for marketing the prize and administration costs.

mars4rp 7y ago
and what the downsize would be for the doctor? If he could cure him, the doctor gets a fortune, if the treatment didn't work, he goes disabled or worse. I don't want to be that patient! Capitalism doesn't work for everything!
- brador 7y ago
  Use some of the 10% to pay for independent peer review of interesting solutions.

rajacombinator 7y ago

I understand the general nature of your situation/question, but it’s hard to give meaningful advice without more specifics. Either way, if you say money is no object, what about time? For edge case medical conditions that fall outside the cookie cutter ddx procedure your local doctor is familiar with, doing the research yourself is often the only option. I had to do this for a serious but obscure illness earlier this year. Alternately you can doctor shop and hope to find one who has the interest level and attention to detail to tackle your condition. (Recommendations can help.) But these doctors are few and far between, sadly. Edit: by the way, I don’t think this is an issue that money can solve directly, which is frustrating. If money is truly no object but time is, one option might be to hire a bright college student as a research assistant, as someone else mentioned here.

perilunar 7y ago

If you've already tried the best current treatments, you need to find out who the top researchers in the field are and what experimental treatments they are working on. Read the literature. Find out what clinical trials are in progress and get yourself enrolled in one if possible. e.g. (based on your username): https://www.clinicaltrials.gov/ct2/results?cond=Blindness https://www.clinicaltrials.gov/ct2/results?cond=Blindness Also consider directly funding researchers, research projects, and trials. Research is money constrained — you can fund work that otherwise would not get done.

uberduber 7y ago

If you are not already going to a large academic center in a large city, I would start there. Also depending on your condition and specialty it is fairly regional. For example, most of the good geneticists are on the east coast. In large cities with rich people there are cash only and concierge doctors who will spend the time needed with you because you pay them for it. The going rate now here in Los Angeles seems to be $1000/hr for an appointment, though they do spend time outside of that on your case of that which they don't charge for. If money is truly no object, there are services that you pay money who will do research, have connections to top doctors, and ensure the correct diagnosis. The best known one is Private Health Management. There are some smaller firms often started by people who used to work there that are more affordable. Years ago when I talked to some of these my personal case was around $50-100k which I don't have.