4 ms·

I’ve had issues like this even for non chronic things. Repeated visits for an obvious or easy to determine diagnosis. Unwillingness to order certain blood tests

I’ve had issues like this even for non chronic things. Repeated visits for an obvious or easy to determine diagnosis. Unwillingness to order certain blood tests or whatever. Sometimes it is because of health insurance rules, which is itself a problem since it forces me to deal with the big inconvenience and expense of several visits, but other times it is because of the doctor’s arbitrary unwillingness. One example that frustrated me recently was an issue that could be one of three things, each of which could be confirmed via a DNA test. The hospital’s genetics department was unwilling to just go ahead with the three different tests (they aren’t tested as part of a general DNA screen so it is three specific tests instead) even though it’s the fastest and least invasive way to diagnose. Instead they want an invasive surgical confirmation first, which is far more expensive and time consuming. They shared no good reason when I challenged this - just vague patronizing language that reiterated their unwillingness. In general I’m frustrated that patients can’t just order the exact tests they want. Why do I need a doctor’s consent for various blood draws? I should be able to pick from a menu and pay for whatever I want.

nradov 2y ago
Clinical reference labs allow patients to order many tests themselves through services like LabCorp onDemand or Questhealth. You can even order your own full genome sequence through specialized services such as Nebula Genomics. Those services might not be reimbursed by your health plan but they are available if you want them.
Der_Einzige 2y ago
This is why you do medical tourism to a country like Thailand. Deregulated medical systems mean that you can meet doctors who are empowered to give you any drug you want for like, 1 USD. If you get travelers sickness (half caused by gut bacteria), you can quickly get low level antibiotics which purges this and gets you back on your feet in a day or two. Not in America though, because the risk of “superbugs” means that everyone should struggle and be in serious avoidable pain. Imagine how livid I was when I got peptic ulcers and my idiot doctor tried to tell me it was “stress”. I reported his ass to my states medical board and linked the other examples of doctors through history who understood the bacterial cause of ulcers and were sanctioned by their own medical boards for using the right treatment before it was accepted. Don’t just accept their bullshit. Fight them every step of the way when you know you’re right.
- pjc50 2y ago
  The stupid thing is that the worry about antibiotic overprescription is only applied to humans in the US. Whereas cows are given them with basically no oversight, making the resistance situation worse for humans. https://education.nationalgeographic.org/resource/antibiotic-resistance-beefing/ https://education.nationalgeographic.org/resource/antibiotic... (EU regulation restricts this somewhat, I think)
- ericjmorey 2y ago
  MRSA isn't bullshit. Your argument makes no sense.
  - Der_Einzige 2y ago
    Front line antibiotics don’t cause serious risk of the development of MRSA. I’m talking amoxicillin man!
reureu 2y ago
> In general I’m frustrated that patients can’t just order the exact tests they want. See jasonhealth.com (for Quest) or ownyourlabs.com (for Labcorp). The main issue is that you can't bill insurance without a provider's order, but a lot of tests are cheaper when not billed through insurance.
- jerlam 2y ago
  I did this recently and it was so easy I felt like I was cheating somehow. For me to get an appointment with and talk to my doctor to try to convince them to prescribe the test cost, not including the actual draw and test results themselves, would have cost several times more than paying for the test myself. It's similar to how getting my prescription with insurance costs three times more than getting it from Cost Plus Drugs.
AStonesThrow 2y ago
Recently I learned of "fail first" or "step therapy" policies by insurance carriers. This means that you've gotta try ineffective therapies that are cheaper until you can go for the real thing. Policies and procedures also tie the hands of diagnostics. Dr. House and Doc Martin could never exist in real life because a gauntlet must be run. Call your ISP for tech support when you know the diagnosis. They'll read you the script, and you'd better follow the script or you won't get a resolution. Restart your devices, destroy some data, bypass your firewall and AV, reset all your preferences to default. Why should your PCP be any different?

nradov 2y ago

Clinical reference labs allow patients to order many tests themselves through services like LabCorp onDemand or Questhealth. You can even order your own full genome sequence through specialized services such as Nebula Genomics. Those services might not be reimbursed by your health plan but they are available if you want them.

Der_Einzige 2y ago

This is why you do medical tourism to a country like Thailand. Deregulated medical systems mean that you can meet doctors who are empowered to give you any drug you want for like, 1 USD. If you get travelers sickness (half caused by gut bacteria), you can quickly get low level antibiotics which purges this and gets you back on your feet in a day or two. Not in America though, because the risk of “superbugs” means that everyone should struggle and be in serious avoidable pain. Imagine how livid I was when I got peptic ulcers and my idiot doctor tried to tell me it was “stress”. I reported his ass to my states medical board and linked the other examples of doctors through history who understood the bacterial cause of ulcers and were sanctioned by their own medical boards for using the right treatment before it was accepted. Don’t just accept their bullshit. Fight them every step of the way when you know you’re right.

pjc50 2y ago
The stupid thing is that the worry about antibiotic overprescription is only applied to humans in the US. Whereas cows are given them with basically no oversight, making the resistance situation worse for humans. https://education.nationalgeographic.org/resource/antibiotic-resistance-beefing/ https://education.nationalgeographic.org/resource/antibiotic... (EU regulation restricts this somewhat, I think)
ericjmorey 2y ago
MRSA isn't bullshit. Your argument makes no sense.
- Der_Einzige 2y ago
  Front line antibiotics don’t cause serious risk of the development of MRSA. I’m talking amoxicillin man!

reureu 2y ago

> In general I’m frustrated that patients can’t just order the exact tests they want. See jasonhealth.com (for Quest) or ownyourlabs.com (for Labcorp). The main issue is that you can't bill insurance without a provider's order, but a lot of tests are cheaper when not billed through insurance.

jerlam 2y ago
I did this recently and it was so easy I felt like I was cheating somehow. For me to get an appointment with and talk to my doctor to try to convince them to prescribe the test cost, not including the actual draw and test results themselves, would have cost several times more than paying for the test myself. It's similar to how getting my prescription with insurance costs three times more than getting it from Cost Plus Drugs.

AStonesThrow 2y ago

Recently I learned of "fail first" or "step therapy" policies by insurance carriers. This means that you've gotta try ineffective therapies that are cheaper until you can go for the real thing. Policies and procedures also tie the hands of diagnostics. Dr. House and Doc Martin could never exist in real life because a gauntlet must be run. Call your ISP for tech support when you know the diagnosis. They'll read you the script, and you'd better follow the script or you won't get a resolution. Restart your devices, destroy some data, bypass your firewall and AV, reset all your preferences to default. Why should your PCP be any different?