4 ms·

You have to wonder where we fucked up because clearly it wasn't like that even 30 years ago. A few generation ago you had family doctors who knew pretty much ev

You have to wonder where we fucked up because clearly it wasn't like that even 30 years ago. A few generation ago you had family doctors who knew pretty much everything about you from your birth to their retirement (or death even). Even I had that as a kid, and I'm not 40 yet. Now we have 10 minutes online consultations with random doctors we'll never see again. Last time I went to mine they refused a preventative blood check, the reason? "it's too expensive and you're healthy anyways". I went to a private lab and paid for it, it ended up costing less than 10 euros, meanwhile I pay 500+ a month for health insurance.

sarchertech 2y ago
In the US you can blame private equity for that. Buying up practices and pushing them to turn a profit by maximizing patient load and minimizing interaction times etc... We have far more doctors per capita than we did in 1960.
- bell-cot 2y ago
  > In the US you can blame private equity for that... Only partly. Where I'm living (SE Michigan), one of the two huge local hospitals is owned & operated by a major research university. The other one by a major Catholic non-profit. My (older) family & friends have been on the receiving end of lots of "the system cares only about itself, and many of the individual doctors obviously feel the same" horrors at both of those hospitals. And it's been that way for decades, minimum.
  - sarchertech 2y ago
    Yeah it's possible for a non-profit to cause some of the same problems. But I guarantee you PE is still involved in that health system to a major extent. Many if not most of the doctors are going to be employees of private groups that the University hospital contracts out to.
    - bell-cot 2y ago
      I get the sense that you're only interested in finding PE anywhere near "the scene of the crime". Not the causality for bungled cases. 30 years ago, when there was vastly less PE in the medical field, those hospitals had the same problems. If Dr. Fubar was socially adroit with his fellow MD's, then it really didn't matter that he was a disaster for his patients.
      - sarchertech 2y ago
        The subthread was about people not having a single family physician. And private equity consolidating physician practices is a very well documented contributor to that. Bungled cases can have all sorts of causes, and I never said private equity was the cause of all of them. I never said private equity was the cost of any bungled cases despite the fact that they surely are. What I said you can blame private equity on is this > A few generation ago you had family doctors who knew pretty much everything about you from your birth to their retirement (or death even). Even I had that as a kid, and I'm not 40 yet. But to be fair. It's not just PE, it's consolidation in general, which can be lead by large non-profit hospital groups as well.
urbandw311er 2y ago
In the UK, the answer is that the NHS is simply overwhelmed. There are too many people and not enough doctors so the whole system has been whittled down to the point where it is stateless and transactional. And still another net 600,000 people come here every year and we wonder why it’s getting worse!
- pjc50 2y ago
  > still another net 600,000 people .. many of whom are NHS employees, since we don't train enough locally. https://www.nhsconfed.org/articles/immigration-harming-nhs https://www.nhsconfed.org/articles/immigration-harming-nhs "Recent NHS data shows that across all NHS staff in England (1.4 million), more than 17 per cent (264,815) are from overseas. Percentages for nurses are much higher – nearly 27 per cent of NHS nurses are from outside the UK (99,856 of the 372,605 nurses and health visitors recorded). Further, the workforce plan is supported by the government, for example, having set a target to recruit between 51,000 and 57,000 international nurses by 2023/24"
- RobotToaster 2y ago
  Yet they still artificially limit the number of medical school places available to UK applicants, to a number far below what we need.
  - Shortness8 2y ago
    This is not the case. Medical school places are up over a third since 2017. We import the amount of doctors we graduate every year, but we haven't meaningfully increased the amount of specialists and GP's we train in over a decade. There is no shortage of doctors. There is a shortage of consultants/GPs.
apwell23 2y ago
Has it been proven that getting "preventative blood check" is of any actual benefit if you have no other symptoms? Blood tests are not for curiosity or entertainment.
- lm28469 2y ago
  By that logic preventative anything is useless, the whole point is to know if what I'm doing right now is going in the right direction or not. Better catch diabetes or cholesterol when it's not a problem yet, when the symptoms are bad enough for you to notice by yourself you're already in deep shit.
  - apwell23 2y ago
    its not useless if its studied that it prevents diabetes or cholesterol.

sarchertech 2y ago

In the US you can blame private equity for that. Buying up practices and pushing them to turn a profit by maximizing patient load and minimizing interaction times etc... We have far more doctors per capita than we did in 1960.

bell-cot 2y ago
> In the US you can blame private equity for that... Only partly. Where I'm living (SE Michigan), one of the two huge local hospitals is owned & operated by a major research university. The other one by a major Catholic non-profit. My (older) family & friends have been on the receiving end of lots of "the system cares only about itself, and many of the individual doctors obviously feel the same" horrors at both of those hospitals. And it's been that way for decades, minimum.
- sarchertech 2y ago
  Yeah it's possible for a non-profit to cause some of the same problems. But I guarantee you PE is still involved in that health system to a major extent. Many if not most of the doctors are going to be employees of private groups that the University hospital contracts out to.
  - bell-cot 2y ago
    I get the sense that you're only interested in finding PE anywhere near "the scene of the crime". Not the causality for bungled cases. 30 years ago, when there was vastly less PE in the medical field, those hospitals had the same problems. If Dr. Fubar was socially adroit with his fellow MD's, then it really didn't matter that he was a disaster for his patients.
    - sarchertech 2y ago
      The subthread was about people not having a single family physician. And private equity consolidating physician practices is a very well documented contributor to that. Bungled cases can have all sorts of causes, and I never said private equity was the cause of all of them. I never said private equity was the cost of any bungled cases despite the fact that they surely are. What I said you can blame private equity on is this > A few generation ago you had family doctors who knew pretty much everything about you from your birth to their retirement (or death even). Even I had that as a kid, and I'm not 40 yet. But to be fair. It's not just PE, it's consolidation in general, which can be lead by large non-profit hospital groups as well.

urbandw311er 2y ago

In the UK, the answer is that the NHS is simply overwhelmed. There are too many people and not enough doctors so the whole system has been whittled down to the point where it is stateless and transactional. And still another net 600,000 people come here every year and we wonder why it’s getting worse!

pjc50 2y ago
> still another net 600,000 people .. many of whom are NHS employees, since we don't train enough locally. https://www.nhsconfed.org/articles/immigration-harming-nhs https://www.nhsconfed.org/articles/immigration-harming-nhs "Recent NHS data shows that across all NHS staff in England (1.4 million), more than 17 per cent (264,815) are from overseas. Percentages for nurses are much higher – nearly 27 per cent of NHS nurses are from outside the UK (99,856 of the 372,605 nurses and health visitors recorded). Further, the workforce plan is supported by the government, for example, having set a target to recruit between 51,000 and 57,000 international nurses by 2023/24"
RobotToaster 2y ago
Yet they still artificially limit the number of medical school places available to UK applicants, to a number far below what we need.
- Shortness8 2y ago
  This is not the case. Medical school places are up over a third since 2017. We import the amount of doctors we graduate every year, but we haven't meaningfully increased the amount of specialists and GP's we train in over a decade. There is no shortage of doctors. There is a shortage of consultants/GPs.

apwell23 2y ago

Has it been proven that getting "preventative blood check" is of any actual benefit if you have no other symptoms? Blood tests are not for curiosity or entertainment.

lm28469 2y ago
By that logic preventative anything is useless, the whole point is to know if what I'm doing right now is going in the right direction or not. Better catch diabetes or cholesterol when it's not a problem yet, when the symptoms are bad enough for you to notice by yourself you're already in deep shit.
- apwell23 2y ago
  its not useless if its studied that it prevents diabetes or cholesterol.