S/o What the f do you all want from doctors?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

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Anonymous wrote:

Anonymous wrote:Doctors are the only highly paid professional that can get away with regularly being late to meetings with their clients. Bankers and lawyers certainly don't make their clients wait well past their appointment times.

We have said over and over on this forum that doctors do not control their schedules these days. They have back to back appointments and sometimes double booked appointments made by administrators. This is why doctors are going concierge and why you all need to go find a practice like this. It should solve all the issues here.

This is like screaming over and over again: "Just be rich and stop complaining!" Especially silly since that is indeed what rich people are already doing.

But it's just a business. Right?

If you can't pay for something, that isn't a business's problem.

I don't believe it is just a business.

You must be new to this thread. That's a new position, at least as being expressed by a non-doctor. Welcome!

Can you please elaborate on what the additional responsibilities or other factors are that make it not just a business? That will help in figuring out how to solve the problem.

I am not new to it. I think many doctors do view it as a business. Part of it is needing to make a living and a profit. I think as a result some patients view it as a business as well, hence the concierge model. I don't think I seriously need to explain to a doctor that literally being able to save/kill someone through proper or improper care makes the job more than a business...

Would you say that this sort of responsibility isn't shared by lawyers or bankers?

It is shared by lawyers depending on their field. Not bankers. I am assuming you are bringing this up because of the scheduling/lateness issue. I am the one who posted the ENT/Derm post. I don't believe that timeliness is necessarily a reflection of the doctor's quality of care at all. A derm who spends 1 min with someone with so many moles is a bad derm. I think what baffles me most in this entire thread is seeing doctors defending bad care.

[Anonymous]

PS: I'm thinking that maybe doctor appointments -- unlike those with bankers or lawyers -- are much more likely to have unexpected things come up that need to be dealt with because of that acuity.

I mean, I'm sure bankers and lawyers deal with unexpected things, but probably not like you are describing. You know, things that can't be put off.

[Anonymous]

Anonymous wrote:

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Anonymous wrote:Everyone is mad at doctors. We should be mad at insurance companies and health systems. We should be mad at the broken free market system and republicans in general.

EMRs, while good in theory and intention, were a disaster to roll out. I’m curious how much time and money is spent implementing, maintaining and using these systems instead of focusing on the patient - a recurring complaint on this thread.

Medicine has become like everything else. Ruined by private equity and other bored, rich AHs who are looking for a new “tech disruption”

EMRs were a disaster to roll out because doctors and practices first did a horrible job picking systems, and then did a horrible job training their staff to use them. They made a self-fulfilling prophecy: they decided EMRs were going to be horrible, so they bought the cheapest EMRs they could find, which were obviously going to be horrible.

You really, really don't want to go back to paper charts.

What I hate is having different doctors on different electronic records portals. I've started picking doctors and specialists who use the same portal so they can all see my medical history and I'm not repeating tests or carrying records between practices. Nationalized health systems tend to do this automatically.

There again I saw someone in her complaining that she didn't want doctors seeing her past ER records.

That's not a red flag at all...

The ableism of this post suggests you've never had a whitecoat misdiagnose you in your <10 minute visit. ER docs are not exactly known for their deep compassion. And if you were in the ER for a mental health crisis, the odds of you getting misdiagnosed in a way that might permanently alter how you're seen by future clinicians is significant.

Universal recordkeeping with patient review and ability to redact and/or dispute input is the solution. Doctors shouldn't be allowed to pass notes about their patients w/o patient consent, and patients should be able to flag and comment on their own charts to dispute accuracy.

I've had several doctors write that they did things they didn't ("counseled re: nutrition" is the usual culprit) and a few leave out things they did say and probably shouldn't have.

Well ER attendings get to deal with all kinds of things. Like people dying on them from a heart attack and triaging some guy with half his brain coming out after a motorcycle wreck.

Anyhow, WTF are you going to the ER for a mental health crisis? You can’t write this stuff if you tried.

Since you’re obviously experienced, I am sure we’d all benefit from your obviously well-informed recommendations about how to correctly be a person, or caregiver of a person, with suicidality in a completely broken health care system.

Do tell.

Not clog up the ER. That’s what. This thread really delivers on the ridiculous expectations. Now we’ve moved on to burdening the ER with mental health crisis. That makes a ton of sense.

It absolutely does if you're not an ableist idiot. Health crisis = ER.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Doctors are the only highly paid professional that can get away with regularly being late to meetings with their clients. Bankers and lawyers certainly don't make their clients wait well past their appointment times.

We have said over and over on this forum that doctors do not control their schedules these days. They have back to back appointments and sometimes double booked appointments made by administrators. This is why doctors are going concierge and why you all need to go find a practice like this. It should solve all the issues here.

This is like screaming over and over again: "Just be rich and stop complaining!" Especially silly since that is indeed what rich people are already doing.

But it's just a business. Right?

If you can't pay for something, that isn't a business's problem.

I don't believe it is just a business.

You must be new to this thread. That's a new position, at least as being expressed by a non-doctor. Welcome!

Can you please elaborate on what the additional responsibilities or other factors are that make it not just a business? That will help in figuring out how to solve the problem.

I am not new to it. I think many doctors do view it as a business. Part of it is needing to make a living and a profit. I think as a result some patients view it as a business as well, hence the concierge model. I don't think I seriously need to explain to a doctor that literally being able to save/kill someone through proper or improper care makes the job more than a business...

Would you say that this sort of responsibility isn't shared by lawyers or bankers?

It is shared by lawyers depending on their field. Not bankers. I am assuming you are bringing this up because of the scheduling/lateness issue. I am the one who posted the ENT/Derm post. I don't believe that timeliness is necessarily a reflection of the doctor's quality of care at all. A derm who spends 1 min with someone with so many moles is a bad derm. I think what baffles me most in this entire thread is seeing doctors defending bad care.

I don't think doctors here are defending bad care. The derm you referred to is unlikely to be hanging out on DCUM, right? Nobody commented on that, and that doctor isn't here. Where is the defense?

You do see doctors here saying that for them to deliver the care people on this thread are criticizing them for not doing, they have to leave the old system and do it on another model.

Did you want a doctor here to agree with you that the derm you saw should spend more than a literal minute doing a skin check on someone with 100s of moles! Sure! I can absolutely say that a derm shouldn't spend a literal minute doing that. I'm also happy to say that a teacher shouldn't take more than three months to enter grades (not you, obviously, PP -- but we aren't just talking about the people on this thread), and that a lawyer shouldn't be billing for time they didn't actually spend (also not you, PP).

What bad care is being defended by a doctor in this thread? Can you quote one of those posts?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Everyone is mad at doctors. We should be mad at insurance companies and health systems. We should be mad at the broken free market system and republicans in general.

EMRs, while good in theory and intention, were a disaster to roll out. I’m curious how much time and money is spent implementing, maintaining and using these systems instead of focusing on the patient - a recurring complaint on this thread.

Medicine has become like everything else. Ruined by private equity and other bored, rich AHs who are looking for a new “tech disruption”

EMRs were a disaster to roll out because doctors and practices first did a horrible job picking systems, and then did a horrible job training their staff to use them. They made a self-fulfilling prophecy: they decided EMRs were going to be horrible, so they bought the cheapest EMRs they could find, which were obviously going to be horrible.

You really, really don't want to go back to paper charts.

What I hate is having different doctors on different electronic records portals. I've started picking doctors and specialists who use the same portal so they can all see my medical history and I'm not repeating tests or carrying records between practices. Nationalized health systems tend to do this automatically.

There again I saw someone in her complaining that she didn't want doctors seeing her past ER records.

That's not a red flag at all...

The ableism of this post suggests you've never had a whitecoat misdiagnose you in your <10 minute visit. ER docs are not exactly known for their deep compassion. And if you were in the ER for a mental health crisis, the odds of you getting misdiagnosed in a way that might permanently alter how you're seen by future clinicians is significant.

Universal recordkeeping with patient review and ability to redact and/or dispute input is the solution. Doctors shouldn't be allowed to pass notes about their patients w/o patient consent, and patients should be able to flag and comment on their own charts to dispute accuracy.

I've had several doctors write that they did things they didn't ("counseled re: nutrition" is the usual culprit) and a few leave out things they did say and probably shouldn't have.

Well ER attendings get to deal with all kinds of things. Like people dying on them from a heart attack and triaging some guy with half his brain coming out after a motorcycle wreck.

Anyhow, WTF are you going to the ER for a mental health crisis? You can’t write this stuff if you tried.

Since you’re obviously experienced, I am sure we’d all benefit from your obviously well-informed recommendations about how to correctly be a person, or caregiver of a person, with suicidality in a completely broken health care system.

Do tell.

Not clog up the ER. That’s what. This thread really delivers on the ridiculous expectations. Now we’ve moved on to burdening the ER with mental health crisis. That makes a ton of sense.

It absolutely does if you're not an ableist idiot. Health crisis = ER.

And ER = medically stabilization. Same for any medical issue. The mandate of an ER isn't to fix the problem, but make sure the person is stable for the immediate moment and can pursue treatment outside of the ER. That is true for mental health as well as physical.

[Anonymous]

Anonymous wrote:I don’t care what they make. Raise it, lower it, whatever.

I want them to prioritize me as the patient over interacting with the EMR, not to be supercilious AHs, and to answer calls/emails with correct information—not patronizing gatekeeping—in fewer than 72 hours.

I would appreciate it if fewer PCPs punted every single illness involving an identifiable body system to a specialist, but this is lower-level.

If they are going to do this, however, I would like them to actually coordinate care.

they need to prioritize illness, not patients. sounds entitled

[Anonymous]

Anonymous wrote:

Anonymous wrote:I don’t care what they make. Raise it, lower it, whatever.

I want them to prioritize me as the patient over interacting with the EMR, not to be supercilious AHs, and to answer calls/emails with correct information—not patronizing gatekeeping—in fewer than 72 hours.

I would appreciate it if fewer PCPs punted every single illness involving an identifiable body system to a specialist, but this is lower-level.

If they are going to do this, however, I would like them to actually coordinate care.

they need to prioritize illness, not patients. sounds entitled

Patients are people, not their condition.

[Anonymous]

How do you prioritize Patient A over Patient B, if not by saying that Patient A's cancer problem has to take priority over Patient B's ingrown toenail problem -- by the condition?

[Anonymous]

Anonymous wrote:How do you prioritize Patient A over Patient B, if not by saying that Patient A's cancer problem has to take priority over Patient B's ingrown toenail problem -- by the condition?

Not sure what you mean here by "take priority". Is this about scheduling surgery? There's usually a schedule and days/mornings for surgery. The two are not happening at the same time so there is no priority issue.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Doctors are the only highly paid professional that can get away with regularly being late to meetings with their clients. Bankers and lawyers certainly don't make their clients wait well past their appointment times.

Exactly! And if a doctor can't structure his work life as well as a banker can, then he should work for himself by starting up a small practice and spend as much (on-time) time as he thinks he needs with each of his patients.

Concierge medicine really is the answer to everything. Concierge doctors aren't regularly being late to meetings with their clients.

A concierge doctor isn't worth it for me. My condition is above her pay grade - the kind of zebra that a doctor might vaguely remember being mentioned for 1 minute in class 20 years ago.

I need a PCP to write one prescription once a year and so I can write on forms that I have a PCP. My specialists manage my condition, which the old PCP failed to diagnose for years until it almost killed me. When she went concierge, I moved on.

I can't imagine what she was going to do at the super duper enhanced annual check up being touted for $2000 a year extra.

[Anonymous]

Why aren't you using Teledoc for a random doc, if it's just one mindless script a year? You can write their name on the form and be done.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Doctors are the only highly paid professional that can get away with regularly being late to meetings with their clients. Bankers and lawyers certainly don't make their clients wait well past their appointment times.

We have said over and over on this forum that doctors do not control their schedules these days. They have back to back appointments and sometimes double booked appointments made by administrators. This is why doctors are going concierge and why you all need to go find a practice like this. It should solve all the issues here.

This is like screaming over and over again: "Just be rich and stop complaining!" Especially silly since that is indeed what rich people are already doing.

But it's just a business. Right?

If you can't pay for something, that isn't a business's problem.

I don't believe it is just a business.

You must be new to this thread. That's a new position, at least as being expressed by a non-doctor. Welcome!

Can you please elaborate on what the additional responsibilities or other factors are that make it not just a business? That will help in figuring out how to solve the problem.

I am not new to it. I think many doctors do view it as a business. Part of it is needing to make a living and a profit. I think as a result some patients view it as a business as well, hence the concierge model. I don't think I seriously need to explain to a doctor that literally being able to save/kill someone through proper or improper care makes the job more than a business...

Would you say that this sort of responsibility isn't shared by lawyers or bankers?

It is shared by lawyers depending on their field. Not bankers. I am assuming you are bringing this up because of the scheduling/lateness issue. I am the one who posted the ENT/Derm post. I don't believe that timeliness is necessarily a reflection of the doctor's quality of care at all. A derm who spends 1 min with someone with so many moles is a bad derm. I think what baffles me most in this entire thread is seeing doctors defending bad care.

I don't think doctors here are defending bad care. The derm you referred to is unlikely to be hanging out on DCUM, right? Nobody commented on that, and that doctor isn't here. Where is the defense?

You do see doctors here saying that for them to deliver the care people on this thread are criticizing them for not doing, they have to leave the old system and do it on another model.

Did you want a doctor here to agree with you that the derm you saw should spend more than a literal minute doing a skin check on someone with 100s of moles! Sure! I can absolutely say that a derm shouldn't spend a literal minute doing that. I'm also happy to say that a teacher shouldn't take more than three months to enter grades (not you, obviously, PP -- but we aren't just talking about the people on this thread), and that a lawyer shouldn't be billing for time they didn't actually spend (also not you, PP).

What bad care is being defended by a doctor in this thread? Can you quote one of those posts?

The original question is clearly posed by someone who resents patients for being patients. How is that indicative of good care? Then the whole thread devolved into doctors being defensive. It doesn't make any sense to me. If you are a good doctor, I am sure you know you are and patients tell you so or show you so by wanting to remain in your practice, writing good reviews...And then there are always some unhappy, rude people, but the big picture remains. So why be defensive? What are you even defending yourself from? No patient on earth has any issue with people providing great care.

[Anonymous]

PS: Nobody is going to check with on your actual relationship with the doctor whose name you write on the form.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Doctors are the only highly paid professional that can get away with regularly being late to meetings with their clients. Bankers and lawyers certainly don't make their clients wait well past their appointment times.

We have said over and over on this forum that doctors do not control their schedules these days. They have back to back appointments and sometimes double booked appointments made by administrators. This is why doctors are going concierge and why you all need to go find a practice like this. It should solve all the issues here.

This is like screaming over and over again: "Just be rich and stop complaining!" Especially silly since that is indeed what rich people are already doing.

But it's just a business. Right?

If you can't pay for something, that isn't a business's problem.

I don't believe it is just a business.

You must be new to this thread. That's a new position, at least as being expressed by a non-doctor. Welcome!

Can you please elaborate on what the additional responsibilities or other factors are that make it not just a business? That will help in figuring out how to solve the problem.

I am not new to it. I think many doctors do view it as a business. Part of it is needing to make a living and a profit. I think as a result some patients view it as a business as well, hence the concierge model. I don't think I seriously need to explain to a doctor that literally being able to save/kill someone through proper or improper care makes the job more than a business...

Would you say that this sort of responsibility isn't shared by lawyers or bankers?

It is shared by lawyers depending on their field. Not bankers. I am assuming you are bringing this up because of the scheduling/lateness issue. I am the one who posted the ENT/Derm post. I don't believe that timeliness is necessarily a reflection of the doctor's quality of care at all. A derm who spends 1 min with someone with so many moles is a bad derm. I think what baffles me most in this entire thread is seeing doctors defending bad care.

I don't think doctors here are defending bad care. The derm you referred to is unlikely to be hanging out on DCUM, right? Nobody commented on that, and that doctor isn't here. Where is the defense?

You do see doctors here saying that for them to deliver the care people on this thread are criticizing them for not doing, they have to leave the old system and do it on another model.

Did you want a doctor here to agree with you that the derm you saw should spend more than a literal minute doing a skin check on someone with 100s of moles! Sure! I can absolutely say that a derm shouldn't spend a literal minute doing that. I'm also happy to say that a teacher shouldn't take more than three months to enter grades (not you, obviously, PP -- but we aren't just talking about the people on this thread), and that a lawyer shouldn't be billing for time they didn't actually spend (also not you, PP).

What bad care is being defended by a doctor in this thread? Can you quote one of those posts?

The original question is clearly posed by someone who resents patients for being patients. How is that indicative of good care? Then the whole thread devolved into doctors being defensive. It doesn't make any sense to me. If you are a good doctor, I am sure you know you are and patients tell you so or show you so by wanting to remain in your practice, writing good reviews...And then there are always some unhappy, rude people, but the big picture remains. So why be defensive? What are you even defending yourself from? No patient on earth has any issue with people providing great care.

You think the OP was delivering medical care in that post?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Doctors are the only highly paid professional that can get away with regularly being late to meetings with their clients. Bankers and lawyers certainly don't make their clients wait well past their appointment times.

We have said over and over on this forum that doctors do not control their schedules these days. They have back to back appointments and sometimes double booked appointments made by administrators. This is why doctors are going concierge and why you all need to go find a practice like this. It should solve all the issues here.

This is like screaming over and over again: "Just be rich and stop complaining!" Especially silly since that is indeed what rich people are already doing.

But it's just a business. Right?

If you can't pay for something, that isn't a business's problem.

Of course not, but they are clearly a disgruntled doctor.

I don't believe it is just a business.

You must be new to this thread. That's a new position, at least as being expressed by a non-doctor. Welcome!

Can you please elaborate on what the additional responsibilities or other factors are that make it not just a business? That will help in figuring out how to solve the problem.

I am not new to it. I think many doctors do view it as a business. Part of it is needing to make a living and a profit. I think as a result some patients view it as a business as well, hence the concierge model. I don't think I seriously need to explain to a doctor that literally being able to save/kill someone through proper or improper care makes the job more than a business...

Would you say that this sort of responsibility isn't shared by lawyers or bankers?

It is shared by lawyers depending on their field. Not bankers. I am assuming you are bringing this up because of the scheduling/lateness issue. I am the one who posted the ENT/Derm post. I don't believe that timeliness is necessarily a reflection of the doctor's quality of care at all. A derm who spends 1 min with someone with so many moles is a bad derm. I think what baffles me most in this entire thread is seeing doctors defending bad care.

I don't think doctors here are defending bad care. The derm you referred to is unlikely to be hanging out on DCUM, right? Nobody commented on that, and that doctor isn't here. Where is the defense?

You do see doctors here saying that for them to deliver the care people on this thread are criticizing them for not doing, they have to leave the old system and do it on another model.

Did you want a doctor here to agree with you that the derm you saw should spend more than a literal minute doing a skin check on someone with 100s of moles! Sure! I can absolutely say that a derm shouldn't spend a literal minute doing that. I'm also happy to say that a teacher shouldn't take more than three months to enter grades (not you, obviously, PP -- but we aren't just talking about the people on this thread), and that a lawyer shouldn't be billing for time they didn't actually spend (also not you, PP).

What bad care is being defended by a doctor in this thread? Can you quote one of those posts?

The original question is clearly posed by someone who resents patients for being patients. How is that indicative of good care? Then the whole thread devolved into doctors being defensive. It doesn't make any sense to me. If you are a good doctor, I am sure you know you are and patients tell you so or show you so by wanting to remain in your practice, writing good reviews...And then there are always some unhappy, rude people, but the big picture remains. So why be defensive? What are you even defending yourself from? No patient on earth has any issue with people providing great care.

You think the OP was delivering medical care in that post?