3 ms·

As a patient, I wish I could utilize healthcare (eg: access to a doctor) without all the intermediary parties. But like software development (where we specializ

As a patient, I wish I could utilize healthcare (eg: access to a doctor) without all the intermediary parties. But like software development (where we specialize in front/back end), it's a group effort, and no one doctor can be the answer to everything. Plus you need special equipment. You need prescriptions. It's a problem perfectly designed to middle-feeders to get their cut, since the problem demands so many different stakeholders with their own specialties.

amf12 4y ago
Last year I had the misfortune of having to visit doctors for non-hospital related condition. It is a miserable experience. I got charged a lot for simple (scheduled for 15-30m, but ended early) follow up appointments, finding a specialist who had an appointment in a reasonable amount of time (<3 months). A specialist who had an appointment wasn't in-network, so I had to spend out of pocket, because, out-of-network has a different deductible, expensive prescriptions. I was lucky that I had a good insurance plan, but still, trying to navigate the system when I wasn't unable to was the absolute worst experience.
- 88913527 4y ago
  I called a dozen offices seeking a primary physician (didn't have one) and all of them were booked solid in 2020-2021. I did eventually find one. Note that these offices aren't urgent care or ER centers, I just wanted an annual physical (a reasonable thing that the medical system largely recommends to everyone) and even that was nigh impossible. And my annual physical found an anomaly! So clearly that practice is based in some sort of empirical value. I went back for a 2nd test, it was nothing.
  - Scoundreller 4y ago
    > wanted an annual physical (a reasonable thing that the medical system largely recommends to everyone) Which medical system recommends that? And why? My jurisdiction stopped paying for those because they don't have any evidence of net benefit. It makes more sense to target exams based on your risk of having issues. https://www.ncbi.nlm.nih.gov/books/NBK82767/ https://www.ncbi.nlm.nih.gov/books/NBK82767/ https://time.com/5095920/annual-physical-exam/ https://time.com/5095920/annual-physical-exam/ https://www.ncbi.nlm.nih.gov/books/NBK82767/ https://www.ncbi.nlm.nih.gov/books/NBK82767/
    - deleted 4y ago
      [deleted]
    - donw 4y ago
      They are required by law in Japan. Germany too, I believe.
      - sbierwagen 4y ago
        Congrats to doctors in Japan and Germany for getting an eternal jobs program into national law.
        amrocha 4y ago
        Are you trying to spin this into a bad thing? A universal program to catch diseases early and provide adequate health care to all citizens of a country? Is actually bad????
        pja 4y ago
        Scanning a mostly healthy population for issues is going to mean that you end up with at least some false positives. Those people are going to get expensive follow on investigations & maybe treatments, with all the psychological stress that entails & it will all have been for nothing. In a few cases long term harm will be done to people who never needed treatment. Medicine is often uncertain & going looking for problems can end up being a good way to create new problems where there weren’t any before. If you propose a universal program to catch diseases early then you need to demonstrate two things: 1) there are people with these diseases that are currently not being picked up and 2) the false positive rate & harm caused is less than the existing harm being caused by missed opportunities to treat real issues. By way of example, many health services have abandoned screening programs for prostate cancer via PSA tests - the harm done was judged to outweigh any observed benefits. Even in those places that are still screening there will be an age cutoff as, below a given age, the costs are thought to outweigh any possible benefits.
        4y ago
  - deleted 4y ago
    [deleted]

amf12 4y ago

Last year I had the misfortune of having to visit doctors for non-hospital related condition. It is a miserable experience. I got charged a lot for simple (scheduled for 15-30m, but ended early) follow up appointments, finding a specialist who had an appointment in a reasonable amount of time (<3 months). A specialist who had an appointment wasn't in-network, so I had to spend out of pocket, because, out-of-network has a different deductible, expensive prescriptions. I was lucky that I had a good insurance plan, but still, trying to navigate the system when I wasn't unable to was the absolute worst experience.

88913527 4y ago
I called a dozen offices seeking a primary physician (didn't have one) and all of them were booked solid in 2020-2021. I did eventually find one. Note that these offices aren't urgent care or ER centers, I just wanted an annual physical (a reasonable thing that the medical system largely recommends to everyone) and even that was nigh impossible. And my annual physical found an anomaly! So clearly that practice is based in some sort of empirical value. I went back for a 2nd test, it was nothing.
- Scoundreller 4y ago
  > wanted an annual physical (a reasonable thing that the medical system largely recommends to everyone) Which medical system recommends that? And why? My jurisdiction stopped paying for those because they don't have any evidence of net benefit. It makes more sense to target exams based on your risk of having issues. https://www.ncbi.nlm.nih.gov/books/NBK82767/ https://www.ncbi.nlm.nih.gov/books/NBK82767/ https://time.com/5095920/annual-physical-exam/ https://time.com/5095920/annual-physical-exam/ https://www.ncbi.nlm.nih.gov/books/NBK82767/ https://www.ncbi.nlm.nih.gov/books/NBK82767/
  - deleted 4y ago
    [deleted]
  - donw 4y ago
    They are required by law in Japan. Germany too, I believe.
    - sbierwagen 4y ago
      Congrats to doctors in Japan and Germany for getting an eternal jobs program into national law.
      - amrocha 4y ago
        Are you trying to spin this into a bad thing? A universal program to catch diseases early and provide adequate health care to all citizens of a country? Is actually bad????
        pja 4y ago
        Scanning a mostly healthy population for issues is going to mean that you end up with at least some false positives. Those people are going to get expensive follow on investigations & maybe treatments, with all the psychological stress that entails & it will all have been for nothing. In a few cases long term harm will be done to people who never needed treatment. Medicine is often uncertain & going looking for problems can end up being a good way to create new problems where there weren’t any before. If you propose a universal program to catch diseases early then you need to demonstrate two things: 1) there are people with these diseases that are currently not being picked up and 2) the false positive rate & harm caused is less than the existing harm being caused by missed opportunities to treat real issues. By way of example, many health services have abandoned screening programs for prostate cancer via PSA tests - the harm done was judged to outweigh any observed benefits. Even in those places that are still screening there will be an age cutoff as, below a given age, the costs are thought to outweigh any possible benefits.
        4y ago
- deleted 4y ago
  [deleted]