Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I went for a bone scan today. This amazing machine that scans over your body and analyzes bone density. I’m sure it costs millions to develop. Wonderful. But it would be nice if I could go to a doctor who would help me with my constant fatigue and low grade headaches. It’s probably not that complicated of a fix - iron? thyroid hormone tweak? Vitamin d? - but doctors don’t seem capable of helping with symptoms like that.

You're assuming there's always a "cure". For things like that, there often isn't. Get in better shape or magically turn 20 years younger.

Weird assumptions. You don’t know my age and I’m very much in shape

NP. If you’re a 30 year old on the DCUM Health board, you’re doing life wrong.

Anonymous wrote:

Anonymous wrote:Our solution has been Kaiser Permanente. I know they get a lot of hate on here, but mostly it's because they refuse to do unnecessary things. Which is frustrating from an individual perspective, but helpful from an overall perspective (helps keep costs down and helps not clog up doctor appts for others). Kaiser already knows absolutely everything about me so I don't have to fill anything out. Their doctors aren't focused on running extra tests because they're salaried and aren't paid for running more stuff.

i think kaiser is great for people who want streamlined, basic, good health care without having to wait a long time for appointments. it is not good for people who want extensive workups, have health anxiety, or who want to see specialists without getting a sign off from their PCP that seeing a specialist is necessary. (for example, a person who wants to see an endocrinologist because they are frequently tired, and their PCP has said that their thyroid workup is normal, their iron is normal, their vitamin D is normal, and that most likely their fatigue is due to some sleep apnea due to large tonsils and their elevated BMI and is recommending a sleep study. the sort of person who is angry at this plan of care, is someone who needs an open access plan so they can see whatever specialist they want. however, that is the reason why it's impossible to get an endocrinology appointment. they're all booked up with people like the above.)

Agreed, but those health anxiety people are the ones driving cost increases and clogging up all the doctor appts.

Anonymous wrote:I feel like I have great dental and eye care, but anything else is ... mediocre. The appointment might be fine, but being able to communicate with my doctors outside of them is so hard I don't even bother most of the time. And the front desk people at my main Dr's office are really hostile. They're forever pushing me to fill out some mental health forms. I know I'm depressed - no need to discuss it with my doctor who only allocates a set amount of time for each patient - we won't solve lifelong depression in 12 minutes.

Dental is becoming terrible in the US. Private equity has bought out all the good practices, saddled them with incredible debt, raised the prices to make them pay for the debt and now those dentists just push $$$ things like onlays and "cavities" that weren't there. I've heard story after story of kids who have 5 cavities, they go for a 2nd opinion and they don't even have 1 cavity. My healthcare is way better than dental.

Anonymous wrote:I feel like I have great dental and eye care, but anything else is ... mediocre. The appointment might be fine, but being able to communicate with my doctors outside of them is so hard I don't even bother most of the time. And the front desk people at my main Dr's office are really hostile. They're forever pushing me to fill out some mental health forms. I know I'm depressed - no need to discuss it with my doctor who only allocates a set amount of time for each patient - we won't solve lifelong depression in 12 minutes.

Honest question, why do you think you should be able to communicate directly with your doctor without paying them for their time? Even if you were willing to pay for a 15 minute phone call, how many hours per day should your doctor allocate towards those phone calls? This obviously means there would be a wait for a phone call appointment too, since so many people want to talk to their doctor on the phone. And of course that means the doctor has fewer office visits now as well. Should doctors work 90 hours a week and take phone calls from patients on weekends and holidays for free? Should they forego taking a lunch break? I sometimes don't understand what people want from us.

If you cut my patient panel down to about a quarter of what it is right now, I'd love to spend more time with patients and personally answer their calls. I would! I could do research on their behalf, I could learn more every day, it would be great. But then to cut costs, we'd no longer be able to offer a ton of stuff. No more in-office labs- no more rapid flu /covid tests, no more rapid strep tests, no more in house bloodwork for simple stuff. No more medical assistants or front desk associates. Probably no more EMR which is expensive too- but this actually isn't allowed, so, scratch that. Even with these cuts, we'd go under.

Anonymous wrote:No, actually, not at all. My daughter's friend was diagnosed with brain cancer and the speed at which he was taken from the ER where it was seen on a scan he got for a headache, back to the OR with a literal world class surgeon operating on him, was astounding. Like, within 8 hours. And guess what? When he got his MRI (every 3-6 months, like clockwork, at a world class medical institution!) and it showed the cancer had come back, he again had surgery within 24 hours and even had an intrathecal catheter placed to get literally the best, newest, most cutting edge treatment to help him survive. And he is still alive, a year later! He would not be, without the system working quickly for him, and the research for these new devices, and the best surgeons wanting to be HERE so the best surgeons are available to operate on him. So no, your complaints about having to fill out paperwork or wait too long for your doctor to come back into the room ring hollow to me. If you have an actual medical emergency, or a rare disease, this is an amazing place to get health care.

Very similarly, this is our take too. My DH cut his finger almost completely off. We had a hand surgeon rushed in from MD (we're VA) and within 2 hours he was in surgery. The whole ordeal only cost us under $500 and dh has full use of his finger now. My parent also had brain surgery scheduled 3 weeks after a tumor was found. And it took 3 weeks because of all the tests and scans that needed to be done before she could be put under. She spent 3 days in the hospital. She was able to book the best surgeon on the entire east coast (2000 miles away from where she lives) for the surgery too, not necessarily the one in her small town. She flew herself up and dad booked a hotel room nearby to support her.

When it's critical, US medical care is amazing.

Anonymous wrote:I'd like to know who isn't?

I'm not, because when there is an emergency, our health care is great. Our vaccines and preventative care are largely free. Our specialists are world class and widely available to anyone, even without a referral in most cases (this is also why you have to wait a while to see them sometimes). Have you tried to get a neuropsych evaluation in canada or the UK? have you tried to get an elective knee replacement in canada or the UK if you are 78 years old? have you tried to get vaccines in pakistan? do we need to go there?)

I feel like I have great dental and eye care, but anything else is ... mediocre. The appointment might be fine, but being able to communicate with my doctors outside of them is so hard I don't even bother most of the time. And the front desk people at my main Dr's office are really hostile. They're forever pushing me to fill out some mental health forms. I know I'm depressed - no need to discuss it with my doctor who only allocates a set amount of time for each patient - we won't solve lifelong depression in 12 minutes.

No, the actual care is great. It's just way too expensive.

Anonymous wrote:Our solution has been Kaiser Permanente. I know they get a lot of hate on here, but mostly it's because they refuse to do unnecessary things. Which is frustrating from an individual perspective, but helpful from an overall perspective (helps keep costs down and helps not clog up doctor appts for others). Kaiser already knows absolutely everything about me so I don't have to fill anything out. Their doctors aren't focused on running extra tests because they're salaried and aren't paid for running more stuff.

i think kaiser is great for people who want streamlined, basic, good health care without having to wait a long time for appointments. it is not good for people who want extensive workups, have health anxiety, or who want to see specialists without getting a sign off from their PCP that seeing a specialist is necessary. (for example, a person who wants to see an endocrinologist because they are frequently tired, and their PCP has said that their thyroid workup is normal, their iron is normal, their vitamin D is normal, and that most likely their fatigue is due to some sleep apnea due to large tonsils and their elevated BMI and is recommending a sleep study. the sort of person who is angry at this plan of care, is someone who needs an open access plan so they can see whatever specialist they want. however, that is the reason why it's impossible to get an endocrinology appointment. they're all booked up with people like the above.)

I'd like to know who isn't?

You can order labwork yourself from Quest or Labcorp.

Our solution has been Kaiser Permanente. I know they get a lot of hate on here, but mostly it's because they refuse to do unnecessary things. Which is frustrating from an individual perspective, but helpful from an overall perspective (helps keep costs down and helps not clog up doctor appts for others). Kaiser already knows absolutely everything about me so I don't have to fill anything out. Their doctors aren't focused on running extra tests because they're salaried and aren't paid for running more stuff.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I went for a bone scan today. This amazing machine that scans over your body and analyzes bone density. I’m sure it costs millions to develop. Wonderful. But it would be nice if I could go to a doctor who would help me with my constant fatigue and low grade headaches. It’s probably not that complicated of a fix - iron? thyroid hormone tweak? Vitamin d? - but doctors don’t seem capable of helping with symptoms like that.

If your insurance is willing to pay for comprehensive top-to-bottom tests to find out why you are having headaches, I am sure docs will be willing to do it.

That’s incorrect. Many headaches are not easily diagnosed by tests.

Probably imaginary

Not imaginary. But if you think there is a "test" out there that says "guess what, the test came back positive for migraine headaches!", you'd be wrong. Headaches are incredibly common. It's life.

Anonymous wrote:I went for a bone scan today. This amazing machine that scans over your body and analyzes bone density. I’m sure it costs millions to develop. Wonderful. But it would be nice if I could go to a doctor who would help me with my constant fatigue and low grade headaches. It’s probably not that complicated of a fix - iron? thyroid hormone tweak? Vitamin d? - but doctors don’t seem capable of helping with symptoms like that.

"While I appreciate the cutting edge, expensive, medical tools available to me that my grandparents never would have dreamed of having access to, what I really want is for my doctor to hand me a bottle of iron and vitD supplements and they WON'T TAKE THE TIME TO SEE ME FOR THIS!"

Anonymous wrote:I went for a bone scan today. This amazing machine that scans over your body and analyzes bone density. I’m sure it costs millions to develop. Wonderful. But it would be nice if I could go to a doctor who would help me with my constant fatigue and low grade headaches. It’s probably not that complicated of a fix - iron? thyroid hormone tweak? Vitamin d? - but doctors don’t seem capable of helping with symptoms like that.

I mean, if you really can't get your doctor to order you a basic bloodwork panel, you can order all of those inexpensive, common tests yourself from labcorp for under 100 dollars.