What Happened to Doctors?

[Anonymous]

I just moved to DC and needed a dermatologist. Six months wait.

[Anonymous]

Anonymous wrote:My 14 yo has been having recurring, severe bouts of stomach pain/diarhea for three months after a one-day stomach bug. Ped is out of ideas, referred us to a pediatric gastro. First available appointment with an in network doctor? August 25.

This happened to one of my kids a few years ago, also a young teen at the time. Frequent stomach pain, 5-6 diarhea poops a day, running to the bathroom, weight loss. After the bloodwork, stool testing, visit to the specialist, he was diagnosed with Post-infection IBS. Its a temporary form of IBS that is caused by a bad stomach virus or food poisoning, it knocks your intestinal bacteria out of whack.

Try Culturelle Daily Digestives, take with food. He got better slowly-took almost 6 months to be back to normal- very frustrating.

[Anonymous]

Anonymous wrote:I just moved to DC and needed a dermatologist. Six months wait.

Go on Zocdoc. Plenty of appointments available this month and several available this week.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Let’s be honest: most docs trained in the last few decades don’t know what they are hearing through a stethoscope unless the diagnosis is “death.”

We have a problem here and it’s a lot bigger than in-person visit availability.

You sound crazy.

If that sounds crazy to you, you are revealing yourself as not knowing much about what physicians used to be trained to do, vs what they are trained to do today.

It may be better for you being in that state of not knowing, to be honest; when you do know, this whole situation is much more infuriating to contemplate.

[Anonymous]

Anonymous wrote:

Anonymous wrote:OP, I agree with you. For what we pay in insurance costs and out-of-pocket costs, it feels like we get such poor quality of care. And maybe it's wrong of me, but it feels like such a money grab sometimes. I never know what question at an appointment will get the visit billed differently so there's a $$ co-pay, and it varies with different providers.

I work in healthcare and please be assured, it is a complete money grab.

An unintended consequence of the ACA is that it became prohibitively expensive for doctors to operate private practices, and so they are either shuttering their offices/retiring or selling their services/practices to large healthcare organizations (like the one I work for). Clinical staff is suspicious and resentful of administrative staff, whom they see as out of touch with the day-to-day operations.

My boss, a VP, is candid about the fact that the system is intractably bloated, but everyone at the top gets a piece, so don’t expect any meaningful changes anytime soon. Everyone is in on it, and we all know, and we all get paid, and because this is America no one will stop us.

How can a practice be too expensive for a single doctor to run but somehow make enough to support not only a doctor but also a whole 'nother layer of fat cats?

[Anonymous]

Anonymous wrote:I just moved to DC and needed a dermatologist. Six months wait.

I can get in to see a dermatology PA within a week.

[Anonymous]

Anonymous wrote:I just moved to DC and needed a dermatologist. Six months wait.

Keep letting people in the door and the line gets longer and longer.

[Anonymous]

Anonymous wrote:Long story, but I am very familiar with current med school admissions and the types of people that admissions committees are favoring. Let’s just say that, if you think doctors are bad now, be afraid for the future. Very afraid.

Afraid of doctors with a whole bunch of extracurriculars in addition to a 3.8 undergrad GPA and a 520 MCAT score?

[Anonymous]

Anonymous wrote:

Anonymous wrote:I just moved to DC and needed a dermatologist. Six months wait.

Keep letting people in the door and the line gets longer and longer.

So what, are you seriously suggesting that we should continue to leave tens of millions of Americans without any healthcare when it is beyond their grasp to self finance medical care?

[Anonymous]

So during the pandemic, the economic and business model for healthcare blew up. While ERs, ICUs and some specialties surged beyond capacity others sat idle. People avoided any not urgent so well visits, dentists, eye care, orthopedics, primary care and many specialties are now sitting on a pile of debt and or losses.

It’s very attractive for practice owners to sell out their practice to the larger companies. Ex scape the debt, make a bunch of money, retire or practice on a limited schedule.

Add in boomer retirement and everyone catching up on things that put off during the pandemic and you have a crush.

[Anonymous]

The entire healthcare system is screwed and US healthcare is the worst out of any industrialized country in the world. I've gotten far better care before in Thailand.

I haven't seen a real MD for primary care in like 20+ years because they're impossible to book or get into a practice with as a new patient. It's been NPs the entire time.

PCPs barley follow your health. I really have no idea if I have major health issues. I mean my blood work showed that my cholesterol as a little high and my blood pressure was slightly elevated, but my NP PCP didn't prescribe anything. I haven't gone in 2 years. Am I supposed to even go regularly? I dunno, the PCP doesn't follow up and barely knows my name.

Other times I've had to go to a specialist, and it's been the insurance company denying and denying. Or when I've gone I've gotten zero bills mailed to me the entire time only to find out years later I've been sent to collections for unpaid bills. Wut? How can I even pay a damn bill of you don't even send it to me?

US health scare is an absolute joke. It significantly reduces the quality of life in the country by a massive percentage. Insurance companies shouldn't even exist and they are in charge of determining your healthcare, not doctors. Insurance companies and litigation basically burnout doctors who spend more time with that crap than actually doing medicine.

And no, I refuse that concierge crap. That smacks of privilege, and we simply don't have thousands of dollars laying around to throw away on a country club model just to have access to appropriate healthcare. The whole system is sick.

[Anonymous]

Anonymous wrote:Its become a factory line since obama care kicked in. welcome to a somewhat world of socialized healthcare that docs need to process as many as possible to turn a profit.

also dont forget, inflation has gone nuts but the insurance reimbursement to doctors has stayed constant so they cant afford to hire staff. Its really a sh*t show.

Its about to hit dentistry next.

American healthcare sucked balls loooooong before Obamacare. It has sucked ass all during the Bush years and even under Clinton. Obamacare is a reaction to the problem that has basically existed since the 80s, when US healthcare really started going downhill.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Long story, but I am very familiar with current med school admissions and the types of people that admissions committees are favoring. Let’s just say that, if you think doctors are bad now, be afraid for the future. Very afraid.

Yep. Holistic admissions.

This. Also it’s a terrible ROI. I’m HYP and only the idiots went to med school. Like the ones who clearly got in as recruits and/or legacies for fake sports like fencing and crew.

I work a few hours a day and don’t make significantly less than a specialized physician from the best schools. And I never had to work a 30 hour shift.

[Anonymous]

Anonymous wrote:I’ve noticed a real decline in the quality of care, too. Even for routine visits with a doctor I’ve seen for years, everything just seems rushed and any concerns are dismissed as a natural consequence of aging. It’s very frustrating.

This. I need two hands to count the number of times our doctors have been "wrong" about basic diagnoses. Each a different doctor.

I'm not sure what the problem is but it's a big one.

[Anonymous]

Anonymous wrote:The entire healthcare system is screwed and US healthcare is the worst out of any industrialized country in the world. I've gotten far better care before in Thailand.

I haven't seen a real MD for primary care in like 20+ years because they're impossible to book or get into a practice with as a new patient. It's been NPs the entire time.

PCPs barley follow your health. I really have no idea if I have major health issues. I mean my blood work showed that my cholesterol as a little high and my blood pressure was slightly elevated, but my NP PCP didn't prescribe anything. I haven't gone in 2 years. Am I supposed to even go regularly? I dunno, the PCP doesn't follow up and barely knows my name.

Other times I've had to go to a specialist, and it's been the insurance company denying and denying. Or when I've gone I've gotten zero bills mailed to me the entire time only to find out years later I've been sent to collections for unpaid bills. Wut? How can I even pay a damn bill of you don't even send it to me?

US health scare is an absolute joke. It significantly reduces the quality of life in the country by a massive percentage. Insurance companies shouldn't even exist and they are in charge of determining your healthcare, not doctors. Insurance companies and litigation basically burnout doctors who spend more time with that crap than actually doing medicine.

And no, I refuse that concierge crap. That smacks of privilege, and we simply don't have thousands of dollars laying around to throw away on a country club model just to have access to appropriate healthcare. The whole system is sick.

Sorry to break it to you...you get what you pay for.