"Medicine is quickly becoming overwhelmingly corporate"
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So as to not derail the "breakthrough" thread.
Jolly's comment about where medicine is going pointed out something that I find rather troubling.
Mrs. George and I have moved all of our care from our local suburban hospital to the university where I used to work. The difference in travel time is only about 15 minutes each way, and we thought having a "base" where everything is connected is a good thing.
Indeed the integration of systems and services is remarkable. For the patient, everything is easy, fast and transparent. It's really efficient and...corporate.
But, here's the problem: Patients are ignorant.
And I mean that in this way: When I worked in private practice, it didn't take me long to find out who the good docs were, and who the bad docs were. Face it, bad docs exist, and it's only because of my connections that I could tell which was which. Taken a step further, when you go to a good doc, and you need a referral to a different specialty, he'll probably refer you to another good doc.
When I worked at the university, the same thing applied. Believe me, there were some really mediocre surgeons who worked there. Either they were just bad, or they were so bad that they let their house staff do a lot of the work. I saw more than one guy bailed out of a tough situation by his resident.
But, that's all changed now.
When Mrs. George started to have eye troubles, we logged into MyChart and tried to make an appointment. She was assigned to a random opthamologist. I had no clue if this guy was a good one or a bad one, and it worried me that we were just throwing darts at the ophthalmology board, getting whomever the computer picked.
I'm fortunate to have some connections (still) in the anesthesia department that I could ask, "Hey, who's a good eye doc for the Missus." My friend recommended a young talented (and pretty) eye surgeon who did Mrs. George really good. We are pleased, of course, but for the random person, this could not have happened.
Continuing along those lines, when we went to make a 6 month followup appointment, the scheduler scheduled an appointment with a different doc, one whom we had never seen! This might be good and efficient, but I don't think it's good care.
It used to be that you doc would say, "Let me refer you to Dr. Aqua. He's a good guy, but stay away from his sister, LOL."
Now, the doc says, let me refer you to nephrology. And you'll get some guy the computer picks out based on availability etc.
Frankly, it scares me. I know enough people, and I remember enough medicine to make good choices and decisions, but for the lay person, it's a crap shoot.
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It's also creating healthcare deserts, where you're lucky to have a nurse practitioner.
The docs have left, unable to make ends meet and being sucked up into the corporate hospital world.
I would outlaw for-profit hospitals tomorrow, if I couldn't get it done today.
Always remember, Operation Valkyrie was an act of sedition.
Warning: I post things that interest me. Read and comment at your own discretion. -
@jolly said in "Medicine is quickly becoming overwhelmingly corporate":
The docs have left, unable to make ends meet and being sucked up into the corporate hospital world.
The internist I had for 20 years (we were interns together) just retired. He told me that his salary and bonuses were dependent upon referring patients "in house."
So, if he thought a neurosurgeon outside of his group practice would be a better fit for a patient, a referral to that guy would affect his income.
He would be penalized for spending too much time with a patient. Quotas gotta be met, dont'cha know.
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Until we make it stop, it's only going to get worse.
Massive, and I mean massive regulation of insurance companies which can start by outlawing "networks" (or just do away with insurance all together) and health care facilities is long overdue in this country.
I agree with Jolly, outlawing for profit health care would be a good start.
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When you shake someone's deep sense of self-worth, leaving a scar in their ego, they will persistently try to diminish you through petty arguments & obsessive captious criticism of your actions, just to soothe the wound.
- Nassim Nicholas Taleb
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When you shake someone's deep sense of self-worth, leaving a scar in their ego, they will persistently try to diminish you through petty arguments & obsessive captious criticism of your actions, just to soothe the wound.
- Nassim Nicholas Taleb
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@jon-nyc said in "Medicine is quickly becoming overwhelmingly corporate":
George I have never had that experience either at Duke or Columbia, both of which I use regularly. I make the appointment with the person I want.
I understand, but, I think you're missing my point. By accident, I came across an internist at Northwestern. She's young, smart, and knows what she doesn't know.
I had mentioned that I had my colonoscopy, and who had done it (the guy who takes care of Mrs. George's GI issues). She said, "Oh, is he good? I'm glad to know that because when I refer someone for a colonoscopy, I just send them to 'GI'. It's good to know that there's someone good."
The obvious conclusion is that she doesn't know who she's sending her patients to. Of course, if she has a name, she'll refer there, but if she doesn't, you're rolling the dice.
As I said in my original posts, there's lots of good docs and lots of so-so docs. Word-of-mouth is important if you trust your own doc. Otherwise, it's just a corporate referral.
For my eyes, I'm going to see the doc that did Mrs. George's cataracts. The only way to get that appointment is to call and specifically ask for her. Otherwise, you go through the site, and request "ophthalmology." And I'll betcha my internist doesn't know Mrs. George's ophthalmologist.
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“I am fond of pigs. Dogs look up to us. Cats look down on us. Pigs treat us as equals.” ~Winston S. Churchill
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@mik said in "Medicine is quickly becoming overwhelmingly corporate":
This is one of the reasons I pay more for traditional Medicare and supplement than taking an Advantage plan for less, maybe nothing. No network. I can go to any doctor or facility I want (that takes Medicare). Better coverage out of country.
Advantage is very good for people with few or very modest means. It sucks for people who can pay for a Medigap policy.
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@jon-nyc said in "Medicine is quickly becoming overwhelmingly corporate":
@mark said in "Medicine is quickly becoming overwhelmingly corporate":
I agree with Jolly, outlawing for profit health care would be a good start.
Most of these hospitals doing this are non-profits.
I am talking about the entire "health care" system not just hospitals. Specifically, the insurance racket.
Making profits on human illness and injury is just wrong on every level. Making me pay an obscene amount of money per month plus another obscene deductible, and then making me go to a specific group of facilities or I have to pay even more should be illegal. Down with network based health insurance. Health insurance should be just like any other kind of insurance. I should be able to pick and choose who I see and where I go to see them.
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@mark said in "Medicine is quickly becoming overwhelmingly corporate":
@jon-nyc said in "Medicine is quickly becoming overwhelmingly corporate":
@mark said in "Medicine is quickly becoming overwhelmingly corporate":
I agree with Jolly, outlawing for profit health care would be a good start.
Most of these hospitals doing this are non-profits.
I am talking about the entire "health care" system not just hospitals. Specifically, the insurance racket.
Making profits on human illness and injury is just wrong on every level. Making me pay an obscene amount of money per month plus another obscene deductible, and then making me go to a specific group of facilities or I have to pay even more should be illegal. Down with network based health insurance. Health insurance should be just like any other kind of insurance. I should be able to pick and choose who I see and where I go to see them.
The problem stems from zero controls on cost. Doctors don’t know what specific procedures cost and that’s seen as a virtue. Treatment A may cost 10k and have an efficacy of X, Treatment B may cost 1k and have an efficacy of X-5%. Docs don’t think along those lines.
No one in the system does. It’s gold plated steaks all around if you’re fully insured.
