Fed up with doctor's incompetence?

[jdbnsn]

curious, tired of stupid doctors serving you health-care?

[Drum Thumper]

No, if I get a stupid doctor I just go get a second opinion. However, I am getting sick of going to the local clinic and getting treated by a damn PA instead of a real doctor.

Truth be told, I'm tired of the arm and leg the doctors are charging. But we have met the enemy, and he is us, now haven't we?

[x88x]

TBH, the last doctor I saw was my parents dentist...almost 3 years ago. :whistler: Hmm, unless you count the optometrist at whatever eye place I went to..

The only times I've been to a doctor for anything besides an eye exam in the past 10 years was once to have my teeth checked, and then one more time a month or so later to have my wisdom teeth taken out taken out (it's the weirdest thing; I'd never had a cavity in my life, then suddenly I have huge ones in all four wisdom teeth...and I've never had a cavity since...). The last time I had anything major happen before that was when I broke my arm in 4th grade. I get a 48-hour flu about once a year, but other than that I never get sick *crosses fingers*, so finding a regular doctor has never made it onto my list of things I need to do.

So...to stop babbling and answer your question, no, I haven't dealt with an incompetent doctor recently that I know of. The optometrist was pretty good (ended up second-guessing her, and ending up back a week later to get what she had originally suggested :P ), and it didn't take a genius to see the giant holes in my wisdom teeth. I can't vouch for the doctor who took them out except that I didn't notice anything afterwards...I don't remember a thing from when I sat down in the chair till several hours after I got home (after apparently offering to drive :facepalm: ) and passed out.

[Kayin]

I deal with incompetents a LOT.

I'm not talking about people who have never seen my condition before. That's actually understandable. I'm talking about the ones who if you don't have a large lump sum of money on the spot refuse to give you proper service. Hippocratic Oath, folks.

I'm now in with a research hospital that has a genetics lab that handles Marfan's cases. The level of treatment (and respect) is light-years ahead of that available to me previously. Now, if I can just get all my issues sorted before I fall apart, that'll be the ticket.

And if I get accused of faking by one more doctor who doesn't KNOW what I have (I mean they haven't heard of my condition, and can't even be arsed to look at my deformed skeletal structure) I WILL hit them.

Jon, you've heard of my condition, think there's any way in hell I'm faking?

[Diamon]

@Kayin I read up on Marfan's syndrome, and yea, it does sound pretty hard to fake a lot of the complications. However it also sounds pretty hard to "prove" that someone has it which is probably the reason you're accused of faking it. The innocent until proven guilty mentality maybe?

My knowledge consists of 10 mins of wiki research though so feel free to discard it :)

[x88x]

Well, Kayin, obviuosly you must be tampering with all the instruments before the doctors can see them. I mean, this is obviously just a huge scheme to make yourself money, after all. It's not like any of these strange diseases actually exist right? It's all a government conspiracy. Yeah, that last one, I like that. :P

Seriously though, that's great you finally found that research hospital.

[d_stilgar]

Well, hmmm . . . incompetence no. MY dad is a doctor and my mom is a very competent and able practice manager. She even quit my dad's office and did freelance Practice Partner training for several years. She came highly recommended and got a lot of business by word of mouth alone. She then got hired by a Practice Partner resaler and made more money and has now quit to implement a really great weight loss program in my dad's office. Because my dad went on it and has lost ~65lbs already the office is getting a ton of patients on this program. I've had 20+ years of dinner conversation around medicine (family practice specifically) and have always been able to ask my dad a question and have it answered well. Anything that I'm unsure of I'll research online and then talk to my dad about some more.

All that is said to say that I'm fairly well informed in a lot of issues (political, monetary) about being a doctor in family practice.

Doctors today have a really tough job. Patients are very well informed (a new phenomena, but good) and have a lot of questions (as they should) about different treatment plans. A doctor's job should be to tell their patients what to do (in b/w instances) or to inform their patients on different treatments and help them come to a decision.

Scenario 1: A patient comes in for a well check, but while he's there brings up something else.
The problem with this is that it takes more time to do a good job, which is what the doctor wants, but limits his ability to see as many patients. This causes him to be late or to schedule fewer patients in a day. The most profitable thing to do is to reschedule to have the patient come in again to talk about the other thing in a week, but this isn't the best medicine.

Why is it more profitable to come in again vs talking to the patient on the spot? Well, for starters a slot in the schedule is built to take the amount of time for the issue scheduled. Something else brought up puts the doctor behind. This is bad patient care for the other patients. But what makes it more profitable to reschedule is how insurance works.

If a patient comes in for a well check the doctor might get something like $65 from the insurance company. The well check has a code that is billed. If something else comes up though, they put a modifier on the insurance bill. This modifier says that something else was done while the patient was there, and will give the doctor more money, but not as much as having the patient come back to talk about it another time.

Because of this, there are doctors who will schedule their patients to come in for a visit every time something comes up. If you want to have a mole removed, get a well check, talk about something bothering your throat, and get some stitches removed, the doctor will have you come back on different days for each of these. This sucks the insurance companies dry which drives up insurance costs, and is bad patient care. Rich doctors are usually the ones that do this sort of thing, and it's bad.

Scenario 2: All Medicare and Medicade patients
A doctor's office is like any business. It has expenses. Medical supplies are horribly overpriced (because doctors are 'rich'). There are receptionists, schedulers, billing specialists, accountants, medical records specialists, nurses, tech guys, and various management positions. There's rent and utilities too. Like all small businesses, the boss gets paid whatever is left over after the net pays the bills and taxes.

Well, let's say 15 minutes of time costs an office $70 to run in expenses. This means that during that 15 minutes something worth more than $70 needs to happen. Well, if your goal is good patient care, Medicade and Medicare patients do not make money. Medicare and Medicade just doesn't pay as much as insurance companies. This means that doctors are doing everything in their power to not get these patients. The problem with Medicare and Medicade is that it's the law. If you have established patients that switch over, you can't turn them away because of their new way of paying. This means that the rest of the patient base with insurance or paying cash is paying the cost to the doctor to see the government patients.

That's bad business and the government is to blame for it.

Scenario 3: Insurance
Why does car insurance work and not medical insurance? Car insurance works because it's compulsory. You have to insure any vehicle you own. There's really no choice about it. Because of this everyone pays in all the time and there is a big enough base to bring the costs down.

Health insurance is not like this. I can think about my wife and I having a baby. We can get insurance a few months before she get's pregnant, have the insurance pay for many many things having to do with her pregnancy, and then cancel the plan a few months after the baby is born and is healthy. We paid in a little and got a lot out. This is crappy for insurance and is a drain on what otherwise is a good idea.

Our idea of insurance has changed from insurance (bailing me out when the unexpected comes) to a health care plan. A question I like to ask people is why they will pay a lot of money out of pocket at the dentist, but get frustrated about a $20 co pay at the doctor's office. Seriously, why? I think the answer has a lot to do with the birth of health benefits from work.

Back in WWII there was a wage freeze in the U.S. Employers couldn't increase wages to attract people to work for them. Because of this they found other incentives, like paying for health care. This became the norm and today we expect it. We expect health care to come at no cost to us even though it costs somebody a lot of time and money. We don't seem to care who that is, as long as it isn't us.

What if employers had offered dental plans during WWII? Would we feel so entitled to dental care as we do for health care? I think so.

Insurance isn't a bad concept, but we need to make it compulsory for it to work. Everyone needs to be required to pay in all the time. This would increase competition and drive costs down. The other side of the coin though is that we need to be prepared a little more to actually pay for the things we value, such as our health. We have no problem spending money on an overpriced iPhone 4 (even though the old models are still ultra nice) because we value it, but then complain about the cost of paying to maintain our own health. Seems hypocritical to me.


I can go into more detail on this if anyone has questions, but I think I've already given more than what was asked for and I'm a bit off topic.

[x88x]

Thanks, d_stilgar, it's always interesting to see these kinds of topics from "the other side", as it were.

[Liquid_Scope_99]

My best friend has just became an RN recently . I have been too see him at work a lot . Its a very small town\hospital .
One thing i have noticed is i have done this myself mind you people basically never ever do what the doctor says typically if it has to do with eating that gripe becasue they never get better like they say the new sugar medicine the doc has me on just dosent work while eating ice Cream:think:

[mDust]

Thanks, d_stilgar, it's always interesting to see these kinds of topics from "the other side", as it were.
Definitely.
I didn't vote as I don't have a doctor and haven't even seen one in years. But I have to say that seeing things from different viewpoints is always good. So, can we get a little backstory on what led up to this poll? ...perhaps coworkers just can't pull their weight, became doctors for all the wrong reasons, or...

I guess I'd understand if it couldn't be discussed...but we could always refer to them as anonymous peers so that it could!:)

EDIT: I didn't even think about it, but this could be about the patients more than the doctors:

people basically never ever do what the doctor says...they say the new sugar medicine the doc has me on just dosent work while eating ice Cream
Are doctors being judged as incompetent by incompetent patients?

[Diamon]

Are doctors being judged as incompetent by incompetent patients?

Most likely since most people ARE incompetent. :whistler:

[blueonblack]

So, can we get a little backstory on what led up to this poll?

This. Given the source of the poll I'm damned curious myself.

[jdbnsn]

Interesting responses, thanks for sharing! And I think some of you saw the point of my query.

[x88x]

Ah, I think I see what you mean. In the computer industry, we call those PEBKAC problems. ;)

[mDust]

PEBKAC
/nod

[Diamon]

Ah, I think I see what you mean. In the computer industry, we call those PEBKAC problems. ;)

It might also be the "ID: 10T" or "Layer 8" error :)

[Luthien]

The doctor that I go to now is great. The one I had before was okay, but I had health problems that she couldn't handle. She admitted it, though, so she gets points for admitting I was too rare for her to help.

[dr.walrus]

Insurance isn't a bad concept, but we need to make it compulsory for it to work. Everyone needs to be required to pay in all the time. This would increase competition and drive costs down.

http://img.photobucket.com/albums/v26/paul_brack/walrus/walrussurgery3.jpg

[d_stilgar]

http://img.photobucket.com/albums/v26/paul_brack/walrus/walrussurgery3.jpg

Owning a car in the US is a choice, but only if you want to have a really limited lifestyle. For 99% of Americans, you have to own a car or you just can't do anything. There's really not a way around it.

There shouldn't be a nationalized health plan. Government employees are all overpaid, and a nationalized health plan would mean having a lot more government employees.

Private business, however, is competitive, which drives down costs quickly. We could get better health care for less money by making health insurance compulsory.

So while I agree that owning a car is a choice and having a body is not, compulsory insurance offers the benefits of a nationalized plan at a lower cost. If you are going to pay for it one way or another, why not have it be cheaper?

The only way I would agree with a nationalized plan is if we did away with OASI 'trust fund' (BS) and replaced it with some plan.

[x88x]

Owning a car in the US is a choice, but only if you want to have a really limited lifestyle. For 99% of Americans, you have to own a car or you just can't do anything. There's really not a way around it.
It all depends on where you live. In cities and areas with well-developed public transportation systems it is entirely possible to live a full life without owning a car. I will grant that in more rural areas it is very much a necessity, but much more than 1% of the US population lives in areas such that, imo, they could not own a car and their lives probably would not change all that much.

I'm not gonna touch the gov't health care because to be perfectly honest I haven't been following it enough to have an intelligent conversation on the topic. On topics like that which I know I can never actually make a difference in, I prefer to crawl into my 'hippie hole' (as a friend of mine coined), and ignore it.

However,

Government employees are all overpaid
That is crap. I will grant that there is a lot of waste in just about all levels of government pretty much anywhere in the world that government is present in any form, but to pull a statement like this just reeks of misinformation. No offence intended. I have known many people throughout my life who were and are government employees, on federal, state, and local levels, and almost all of them were paid like crap. I could go on for pages about why that is the case on different levels, but that would be getting incredibly off topic, so just suffice it to say, ..NO.

ps, there are very few topics that will get a rise out of me, but that is one of them, so sorry if I sound a bit harsh.

[d_stilgar]

No, you have a point on both of those and I was wrong in each. I wouldn't say all government employees are overpaid, but there is a ton of waste. I have friends that work for the government and they told be about days where they would sit around outside doing nothing because they were waiting for paperwork to go through or there was no work to be done. This happens often. The sad thing is that they wish they were working because 8 hours of sitting around takes forever and 8 hours of hard work flies by.

I would expand my concept of overpaid government employees to mean that there are many government jobs that really shouldn't exist. There are too many gov. employees in the first place. We don't need to worry about letting them go either. Just lower the taxes on businesses and those businesses will have plenty of money to hire. It's more complicated than I'm making it out to be. Reducing gov. employees is something that has to be done a little at a time and at a similar pace to reducing taxes or we end up with a lot of people out of work and nobody with money to hire them.

On the car thing. I really do think 99% of the population would have an extremely significant change in lifestyle. While public transportation exists in medium to large cities all over, it only becomes sustainable and competitive with private transportation at 10,000 people per sq mile (Architecture major with urban design focus). Only 19.4 million out of the 312 million people in the US live in cities that dense. That's 6%. Even then, I'm sure a lot of those that drive would have to make big lifestyle changes.

All that aside, the example of auto insurance is just that, an example. It shows that when you have everyone paying into a system that the costs can become affordable, but only because there's competition. The same system run by the government would be horribly expensive or not be as good.

Medicare and Medicaid are already unsustainable. Multiply that out to 100% of the population and we won't have doctors in one generation. There's already a shortage. People just need to lower their expectations a bit. Just because you have a body doesn't mean that you have a right to be healthy indefinitely. You have a right to life, and a right to not have your life ended early. You are not entitled to have your life unnaturally extended no matter what the cost. The breakthroughs we have were paid for by people willing to pay, and were discovered by those that care about making the world a better place and improving the quality of life of those they served. Making money is a side effect of doing what you love and giving others something of value.

Quit looking at it as some sort of moral dilemma or matter of principle. Just look at the money and the results. Private insurance is cheaper and/or provides better results than a nationalized health care system.

I have a moral dilemma when I give 6.25% of my pay check to another person's 'retirement account'. I believe in social security but I don't believe in paying for someone else to retire, but I do. Compulsory health insurance means I must pay for my own health care by law. A nationalized plan means I pay for mine and probably a dozen other people's. I don't even care if the government has plans available, but doctors need the right to deny patients on government insurance just like any other insurance company, and the plans can't be unfair (overly subsidized by taxes, or with too much of the population qualifying) to the private insurance companies in a way that private insurance companies go out of business. The current Obama plan is designed to put private insurance out of business.

Anyway, I'm not trying to get too political here, and I'm not trying to sound anti-government. I just strongly believe that a single payer health care system is a bad answer to the problem. Why put companies out of business and people out of work when you could pass legislature that creates jobs within an existing infrastructure?

[TheGreatSatan]

I haven't been to the doctor in a good 5 years. Hopefully I won't have to till my autopsy