Doctor rant...can I please please????

[Loren49]

Food for thought:

Do you want your heart surgery awarded to the lowest bidder?

Loren

 

[IslandTractor]

Food for thought:

Do you want your heart surgery awarded to the lowest bidder?

Loren

You can make fun but there are excellent cardiac surgery clinics in India that get comparable results to what our very good centers get for about a tenth the cost. Volume and specialization along with a focus on quality can give great results.

I'd rather depend on a Toyota Corolla than an Alfa Romeo.

 

[dave1949]

Food for thought:

Do you want your heart surgery awarded to the lowest bidder?

Loren

You can make fun but there are excellent cardiac surgery clinics in India that get comparable results to what our very good centers get for about a tenth the cost. Volume and specialization along with a focus on quality can give great results.

I'd rather depend on a Toyota Corolla than an Alfa Romeo.

Are there statistics that correlate costs to outcomes? I'd want to know something about the success rate of a procedure at a given facility first, then consider the cost.

 

[IslandTractor]

Are there statistics that correlate costs to outcomes? I'd want to know something about the success rate of a procedure at a given facility first, then consider the cost.

General comparisons are possible but true apples v apples comparisons are difficult. It depends a lot on what the patient population is. Often the high volume fancy cardiac surgical centers don't do very many procedures on very high risk patients (those already in the hospital who deteriorate etc) and therefore as they operate more on "elective" patients, their success rates appear artificially higher than those of some city hospital academic centers (which were the places where the high priced guys trained). Inter country comparisons are also difficult for similar reasons. You never really know whether for example any hospital is reporting an accurate post op infection rate. That said, most hospitals that do hundreds of procedures per year are going to have better outcomes. Practice makes perfect. That said, the only easily accessible public data is put out by US News and World Report. It is far from perfect and it really doesn't distinguish between #1-10 in a meaningful way but you can be pretty sure that a program listed in the top 10-20 is better than one listed in the 40-50 range.

 

[Travelover]

...............I'd rather depend on a Toyota Corolla than an Alfa Romeo.

Great analogy. :thumbsup: You really don't always get what you pay for, but it is a great way to scare someone into accepting whatever rate you want to charge them.

 

[tcreeley]

After 2 months of waiting, I got an appt to get my blood pressure checked out at with my new primary care doctor. I was 7 min. late and the office staff had to confer with the office manager if I should be allowed to see the doctor, even though the parking lot and waiting room were empty.

Doc is ok, orders some blood work and a tetanus shot. I get the tetanus shot and as the tech is moving to leave I ask about drawing the blood. She goes back and checks the paperwork, says she must have overlooked it, draws blood.
I get a prescription and make a double appointment for more lab work at a local hospital of my choice.
A few days later I get a call to pre-register. I wait a week and then call. The number turns out to be the hospital that I had wanted to avoid and they have no record of a double appointment, just an appointment 4 hours after the first of my earlier scheduled double appointments.
I was fed up. I cancelled it- it was for some procedure that did not sound like the one originally described to me by the doctor. And it was at the wrong location, at the wrong time.

My next appt with this primary care doctor is in mid April. While he is ok- the system around him borders on ineptitude. 5 secretaries work in the office, for a doctor and a physician's assistant. Somehow they could not schedule the appointment correctly, or notify me of any changes.

When initial lab work came back- they sent me a copy and a new prescription (signed by the pa) to replace the original prescription. Using the internet I figured out why.

I wouldn't call this being under a doctor's care, but a "system's care".

I'm looking for other ways to regulate high blood pressure without the use of a doctor.

 

[IslandTractor]

I'm looking for other ways to regulate high blood pressure without the use of a doctor.

Diet and exercise so long as your BP is not really out of whack.

 

[Loren49]

You can make fun but there are excellent cardiac surgery clinics in India that get comparable results to what our very good centers get for about a tenth the cost. Volume and specialization along with a focus on quality can give great results.

I'd rather depend on a Toyota Corolla than an Alfa Romeo.

I did not intend to look down on much more affordable options in other counties. There is evidence of great price and results with the "medical tourism" option. Article with some examples:
As More Americans Have Surgeries Overseas, US Companies Consider 'Medical Tourism' a Health Care Option - ABC News

The point I intended to make was that in the moment of a pressing medical issue it is less likely that a patient can do much useful/rational shopping for a better price. And also that going completely on price may have its problems.

With time and enough flexibility of coverage by your insurance provider you could do some shopping but how much exploring will any of us do for a wide variety of specialists when we are not yet aware of a problem? How far from home will one travel to receive this better priced care considering possible numerous visits.

The discrepancy in the cost of various procedures, even within relatively close facilities is outrageous.
Some examples:
One hospital charges $8,000
Cost Of Medical Procedures Varies Widely Across U.S. : NPR
New law requires insurers, providers to give consumers cost estimates for their medical care - Health & wellness - The Boston Globe
Hospital costs can vary more than $200,000 for same procedure, government report reveals - CBS News

Hospital Prices No Longer Secret As New Data Reveals Bewildering System, Staggering Cost Differences

When a patient arrives at Bayonne Hospital Center in New Jersey requiring treatment for the respiratory ailment known as COPD, or chronic obstructive pulmonary disease, she faces an official price tag of $99,690.

Less than 30 miles away in the Bronx, N.Y., the Lincoln Medical and Mental Health Center charges only $7,044 for the same treatment, according to a massive federal database of national health care costs made public on Wednesday.

My question did free market allow this behavior and did it self regulate.

Exposed by federal database.

Loren

 

[Bird]

After 2 months of waiting, I got an appt to get my blood pressure checked out at with my new primary care doctor. I was 7 min. late and the office staff had to confer with the office manager if I should be allowed to see the doctor, even though the parking lot and waiting room were empty.

Doc is ok, orders some blood work and a tetanus shot. I get the tetanus shot and as the tech is moving to leave I ask about drawing the blood. She goes back and checks the paperwork, says she must have overlooked it, draws blood.
I get a prescription and make a double appointment for more lab work at a local hospital of my choice.
A few days later I get a call to pre-register. I wait a week and then call. The number turns out to be the hospital that I had wanted to avoid and they have no record of a double appointment, just an appointment 4 hours after the first of my earlier scheduled double appointments.
I was fed up. I cancelled it- it was for some procedure that did not sound like the one originally described to me by the doctor. And it was at the wrong location, at the wrong time.

My next appt with this primary care doctor is in mid April. While he is ok- the system around him borders on ineptitude. 5 secretaries work in the office, for a doctor and a physician's assistant. Somehow they could not schedule the appointment correctly, or notify me of any changes.

When initial lab work came back- they sent me a copy and a new prescription (signed by the pa) to replace the original prescription. Using the internet I figured out why.

I wouldn't call this being under a doctor's care, but a "system's care".

I'm looking for other ways to regulate high blood pressure without the use of a doctor.

I must be missing something. You were late for your appointment, then you get a call to pre-register and you waited a week to call????

 

[Travelover]

After 2 months of waiting, I got an appt to get my blood pressure checked out at with my new primary care doctor. I was 7 min. late and the office staff had to confer with the office manager if I should be allowed to see the doctor, even though the parking lot and waiting room were empty............

This is too funny. How many of us have arrived on time and waited a half hour or even an hour to be put in a little room and then wait another 15 minutes or more?

I'd shave a few points off your last blood pressure reading - mine would have spiked. :laughing: