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> the doctors need to be payed more USA here, I think we need to pay them less. It's basically become a game of how little can they do and how much can they c
by bluedino 2y ago
> the doctors need to be payed more
USA here, I think we need to pay them less. It's basically become a game of how little can they do and how much can they charge. Many already don't care about your symptoms, or bother to do any research. They just prescribe stuff as it's pushed. If they aren't already, I'm sure your doctor will soon just be entering your symptoms into ChatGPT.
- llamaimperative 2y agoOne reason doctors have so little time for each patient is because 1) demand is through the roof due to artificial constraints on doctor supply, 2) they spend tons of their time dealing with insurance paperwork, and 3) they don't actually get paid that much which means they need tons of volume to stay in business. (2) and (3) are related since "dealing with insurance companies" == arguing for reimbursement from those companies, which means they're losing time arguing and losing money when they lose those arguments. You know it's okay simply not to have an opinion on something if you can't spend more than 5 minutes or so thinking about it.
- bluedino 2y agoDoctors don't deal with insurance companies and billing. They have people for that.
- llamaimperative 2y ago1) Yes they do, especially at smaller practices (another reason for the mass extinction of independent medical practices) 2) When they do have other people for it (which yes, is very often to your point), they're paying those people 3) When you pay other people, you need to make more money to pay them with 4) To make more money, you need more volume 5) To get more volume, you need to spend less time with each patient You've changed nothing about the core dynamic of the system, just interjected with a meaningless and not-even-totally-true detail.
- axus 2y agoWhat I noticed is that to not lose money, they need lots of brief visits. Do the checkup, come in later to review the test results, then schedule a follow-up to decide on a referral (or not). Everything after the first visit could have been done with a (voice-only) phone call. Maybe video visits were supposed to make it easier to generate billing with less driving, but it didn't work out that way. Ultimately I went with an HMO, where the doctors can provide the same minimal amount of care but not jump through hoops to do it.
- lurking15 2y agoI don't disagree per se, but it seems from reading the article that they're bemoaning the shortage of qualified doctors and how they're all spent cause they have to work within the confines of centrally planned subsidy prices. Really they should be charging as high as possible directly to consumers until doctors are attracted into the profession. Cut out the middleman, there is no reason that routine expenses like a sick visit that gets routine labwork or medication need to be insured. It'd be better to reroute the software developers that construct complex systems to SERVE ADS and addict people to scrolling.
- earthling8118 2y agoPay them more, sure. But also let's get rid of the artificial limit on how many we can have. They're not being used effectively and we're all worse off for it.
- lurking15 2y agoNo disagreement from me regarding that.
- brendoelfrendo 2y agoThis is already happening, with more and more primary care responsibilities being pushed to physician assistants and nurse practitioners. At your modern urgent care or "doc in a box" primary care clinic, you may never see the doctor, who mostly exists to lend legitimacy to the practice. Not to say that I don't appreciate the hard work that PAs and NPs do, and I think they are certainly qualified to handle most medical issues in their fields, just that the medical industry is trending towards a less personal experience run by lower paid workers and I can't imagine that leading to better health outcomes for the average person.
- bluedino 2y agoAnd I think that is just fine. There's a large amount of things you don't actually need to see a doctor for. Especially things like looking up your nose and prescribing a Z-pak.
- brendoelfrendo 2y agoSure, but while "looking up your nose and prescribing a Z-pak" is sufficient for some medical interactions, if I don't actually need a Z-pak but the only medical staff I have access to is someone who shrugs and prescribes me one anyway because they only allotted 15 minutes for my appointment, then we have a problem. These medical solutions only really work as supplementary to, not in replacement of, more personal primary care providers and specialists.
- fallingknife 2y agoI wish doctors would enter my symptoms in ChatGPT. In my experience they have the opposite problem. They think they know everything and when they hear something they don't understand they just brush it off as nothing. Twice in my life doctors have completely screwed up a diagnosis and later upon doing research it turns out my symptoms were basically a dead ringer for the condition it turned out to be. If the doc had just taken a few minutes to Google it, he would have found it. I don't walk into a doctors office today without doing research first.
- consteval 2y agoThe insurance company sets the appointment times, not the doctor. They didn't decide on 15 minutes themselves.