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I worked for a mature healthcare company and much of our marketing centered around healthcare provider surveys of doctors and nurses. The results were unsettlin

I worked for a mature healthcare company and much of our marketing centered around healthcare provider surveys of doctors and nurses. The results were unsettling. Extremely high rates of burnout, typically due to administrative overhead. Horrifying medical error rates. Doctors should be compensated for the amount of time to send an email. Every other industry is capable of restructuring support to satisfy demand. It's up to the healthcare providers to manage this channel properly as any other would. The real question is: what would it take for the healthcare industry to restructure itself to actually function?

pydry 3y ago
>The real question is: what would it take for the healthcare industry to restructure itself to actually function? Strike the words "over 65" from the medicare bill.
- tonymet 3y ago
  that's a poor excuse. We can provide much better care for the elderly. the bulk of the operating cost growth in the past generation has been from administration.
- dragonwriter 3y ago
  > Strike the words "over 65" from the medicare bill. If you mean "universal single-payer", its worth noting that Medicare is very much not single payer and striking the population restriction for Medicare would not produce universal single payer (or even a single comprehensive plan for each individual, unless they are opting for privately-provided, publicly subsidized main insurance -- otherwise hospital [Part A], outpatient [Part B], and prescription drug [Part D] are separate insurance systems, and only the first two are public.) Medicare is a particularly complicated implementation of partially publicly subsidized private insurance with an (incomplete) public option.
- Projectiboga 3y ago
  Medicare only covers 80% and the providers are specifically prohibited from waiving that copay. Yes we need single payer but the Trojan horse of expanding Medicare to lower the age incrementally is just PR it is a way for insurers to reduce the average age of their insured cohort.
resource_waste 3y ago
[dead]
mherkender 3y ago
Maybe it wouldn't fix everything but I'd like to see a great increase on the cap of the number of medical residencies supported by the government. The AMA and doctors in general shouldn't be artificially limiting the number of doctors. I'd like to see the other usual suspects addressed too but it seems like the doctor shortage is a big part of the problem.
- ejb999 3y ago
  Do you think if there are more doctors, they are going to be more willing to provide free services? I don't - doctors want to get paid for their services - insurance companies (in general) don't pay for doctors to respond to emails - having more doctors doesn't solve this problem. Not saying we don't need more doctors, but seems unrelated to to the problem being discussed.
  - triceratops 3y ago
    If there are more doctors they won't need to choose between working unpaid overtime or charging an overtime rate. Patient workloads could be adjusted that doctors could respond to messages during their regular work hours.
- tonymet 3y ago
  i agree this is a big problem. but as long as you have 10+ admins for every doctor , costs will be through the roof.
  - thereticent 3y ago
    This is one of the major issues underlying the perversity of US healthcare. That and high-level executive churn incentivizing "innovative" initiatives and policy changes just so the executive makes their mark and leaves for the next rung elsewhere.
__MatrixMan__ 3y ago
> what would it take for the healthcare industry to restructure itself to actually function? I can't quote it precisely, but here's a gist from The Glass Bead Game: > Intelligence can find its own way, the teacher's job is to address stupidity. Overlooking the crudeness here, I think it's a good idea, and translates to medicine. Most of us are not qualified to define good care, but we know bad care when we see it. One example of bad care is when you don't discover how expensive a treatment will be until 3 months after it has occurred. Another might be cases where medical professionals are expected to work insane long shifts with insufficient sleep time in between. Whatever the examples are, let's make a list of them. Build consensus around the worst offenders, and then start revoking counts-as-medical-insurance tax status from the insurers who fund the bad behavior. If you want pre-tax-medical-insurance dollars, you must: - be able to turn a "what if" treatment scenario into a dollar amount in less than 10 minutes - not have organizations be in-network which create unsustainable working conditions for medical personnel - [other example of bad care goes here] ...and we add to that list over time. Markets don't do design, they do evolution. We have to kill off the ones we don't like if we want more of the ones we like.
- tonymet 3y ago
  We dont even recognize bad care. People are overweight and suffering from chronic disease , but since they are “alive “ and taking meds we still call that a good outcome
  - ejb999 3y ago
    sadly, a lot of patients consider that good care - around me, doctors stopped weighing patients, and don't ever discuss lifestyle changes or dietary changes (patients by and large don't want to hear it) - they just give the patients the pills they want to offset the poor lifestyle choices.
    - __MatrixMan__ 3y ago
      On the flip side: It's so frustrating to go in search of guidance re: lifestyle changes and they don't wanna hear it, instead all that do is recommend drugs. Maybe we need to remove gatekeeping access to drugs from the primary care physician's job so that they can focus on the other parts.

pydry 3y ago

>The real question is: what would it take for the healthcare industry to restructure itself to actually function? Strike the words "over 65" from the medicare bill.

tonymet 3y ago
that's a poor excuse. We can provide much better care for the elderly. the bulk of the operating cost growth in the past generation has been from administration.
dragonwriter 3y ago
> Strike the words "over 65" from the medicare bill. If you mean "universal single-payer", its worth noting that Medicare is very much not single payer and striking the population restriction for Medicare would not produce universal single payer (or even a single comprehensive plan for each individual, unless they are opting for privately-provided, publicly subsidized main insurance -- otherwise hospital [Part A], outpatient [Part B], and prescription drug [Part D] are separate insurance systems, and only the first two are public.) Medicare is a particularly complicated implementation of partially publicly subsidized private insurance with an (incomplete) public option.
Projectiboga 3y ago
Medicare only covers 80% and the providers are specifically prohibited from waiving that copay. Yes we need single payer but the Trojan horse of expanding Medicare to lower the age incrementally is just PR it is a way for insurers to reduce the average age of their insured cohort.

resource_waste 3y ago

[dead]

mherkender 3y ago

Maybe it wouldn't fix everything but I'd like to see a great increase on the cap of the number of medical residencies supported by the government. The AMA and doctors in general shouldn't be artificially limiting the number of doctors. I'd like to see the other usual suspects addressed too but it seems like the doctor shortage is a big part of the problem.

ejb999 3y ago
Do you think if there are more doctors, they are going to be more willing to provide free services? I don't - doctors want to get paid for their services - insurance companies (in general) don't pay for doctors to respond to emails - having more doctors doesn't solve this problem. Not saying we don't need more doctors, but seems unrelated to to the problem being discussed.
- triceratops 3y ago
  If there are more doctors they won't need to choose between working unpaid overtime or charging an overtime rate. Patient workloads could be adjusted that doctors could respond to messages during their regular work hours.
tonymet 3y ago
i agree this is a big problem. but as long as you have 10+ admins for every doctor , costs will be through the roof.
- thereticent 3y ago
  This is one of the major issues underlying the perversity of US healthcare. That and high-level executive churn incentivizing "innovative" initiatives and policy changes just so the executive makes their mark and leaves for the next rung elsewhere.

__MatrixMan__ 3y ago

> what would it take for the healthcare industry to restructure itself to actually function? I can't quote it precisely, but here's a gist from The Glass Bead Game: > Intelligence can find its own way, the teacher's job is to address stupidity. Overlooking the crudeness here, I think it's a good idea, and translates to medicine. Most of us are not qualified to define good care, but we know bad care when we see it. One example of bad care is when you don't discover how expensive a treatment will be until 3 months after it has occurred. Another might be cases where medical professionals are expected to work insane long shifts with insufficient sleep time in between. Whatever the examples are, let's make a list of them. Build consensus around the worst offenders, and then start revoking counts-as-medical-insurance tax status from the insurers who fund the bad behavior. If you want pre-tax-medical-insurance dollars, you must: - be able to turn a "what if" treatment scenario into a dollar amount in less than 10 minutes - not have organizations be in-network which create unsustainable working conditions for medical personnel - [other example of bad care goes here] ...and we add to that list over time. Markets don't do design, they do evolution. We have to kill off the ones we don't like if we want more of the ones we like.

tonymet 3y ago
We dont even recognize bad care. People are overweight and suffering from chronic disease , but since they are “alive “ and taking meds we still call that a good outcome
- ejb999 3y ago
  sadly, a lot of patients consider that good care - around me, doctors stopped weighing patients, and don't ever discuss lifestyle changes or dietary changes (patients by and large don't want to hear it) - they just give the patients the pills they want to offset the poor lifestyle choices.
  - __MatrixMan__ 3y ago
    On the flip side: It's so frustrating to go in search of guidance re: lifestyle changes and they don't wanna hear it, instead all that do is recommend drugs. Maybe we need to remove gatekeeping access to drugs from the primary care physician's job so that they can focus on the other parts.