4 ms·

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 (sche

by 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.
        amrocha 4y ago
        Look, I've done the research and there's pretty clear benefits to health checkups. You can do your homework if you want to. Here's the thing though, it's pretty obvious that early, regular screening and health checkups with a focus on improving health are a net positive. You go to the doctor, do some blood work, a couple x-rays, and they tell you areas where you could be healthier. Any reasonable person would agree with that. You can come up with arguments for why I'm wrong, and try to put the burden of proof on me, and by doing that you make it such a hassle to try to improve things that I just give up. This is why nothing gets done in North America anymore. There's always a reason not to change things, not to try anything new. That's how you end up with a stagnant society, crumbling healthcare system, outdated infrastructure, school shootings, global warming, housing crisis, etc. I don't know mate, I'm sure you have good intentions but it's hard for me to find a net positive outcome of your position.
  - poulsbohemian 4y ago
    >It makes more sense to target exams based on your risk of having issues. From my perspective, that's exactly the point of these basic preventative labs - how do you even know what you might be at risk for if you haven't established a baseline? As we saw on the thread about cancer earlier today - early detection has had a greater impact than new treatments. I had a doctor who was willing to do basic blood tests and he helped me create a plan of sorts about what I needed in the way of long-term awareness, nutrition, etc. And then he retired. Since then, the doctors that I have spoken with have had an attitude in line with yours, IE: call me when you are sick. But that's a core problem with our health care system - the emphasis is entirely on treating symptoms of the disease rather than on prevention. And this to my thinking is why men in particular are statistically low users of health care - because they give up on playing the game.
- deleted 4y ago
  [deleted]

by amf12 4y ago

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.
        amrocha 4y ago
        Look, I've done the research and there's pretty clear benefits to health checkups. You can do your homework if you want to. Here's the thing though, it's pretty obvious that early, regular screening and health checkups with a focus on improving health are a net positive. You go to the doctor, do some blood work, a couple x-rays, and they tell you areas where you could be healthier. Any reasonable person would agree with that. You can come up with arguments for why I'm wrong, and try to put the burden of proof on me, and by doing that you make it such a hassle to try to improve things that I just give up. This is why nothing gets done in North America anymore. There's always a reason not to change things, not to try anything new. That's how you end up with a stagnant society, crumbling healthcare system, outdated infrastructure, school shootings, global warming, housing crisis, etc. I don't know mate, I'm sure you have good intentions but it's hard for me to find a net positive outcome of your position.
- poulsbohemian 4y ago
  >It makes more sense to target exams based on your risk of having issues. From my perspective, that's exactly the point of these basic preventative labs - how do you even know what you might be at risk for if you haven't established a baseline? As we saw on the thread about cancer earlier today - early detection has had a greater impact than new treatments. I had a doctor who was willing to do basic blood tests and he helped me create a plan of sorts about what I needed in the way of long-term awareness, nutrition, etc. And then he retired. Since then, the doctors that I have spoken with have had an attitude in line with yours, IE: call me when you are sick. But that's a core problem with our health care system - the emphasis is entirely on treating symptoms of the disease rather than on prevention. And this to my thinking is why men in particular are statistically low users of health care - because they give up on playing the game.
deleted 4y ago
[deleted]