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

[MossRoad]

As a physician and a specialist (Head and Neck surgeon) I often see people who have symptoms of illnesses that fall outside my specialty such as diabetes. I will often suggest that the patient follow up with their family doctor for further work-up and diagnosis for several reasons:

1. I am not aware of all of their medical history like the family doctor is. The patient may have already been tested and found to be negative. (You would think that most patients would know this information, but many do not).

2. I may not be aware of the best test to rule-in or rule-out a specific disorder outside of my specialty.

3. Since it is not in my specialty and was not the reason that they were referred to me, insurance companies may not cover the test, leaving the patient alone responsible for the cost. I spend a fair amount of my time on the phone with insurance companies justifying tests that I order for problems that fall within my specialty (CT scans, MRI's, etc.).

4. In your case, the test may have required a specific prep, such as fasting, making it more than a simple blood draw for diagnosis.

So as you can see, there are valid reasons for a specialist to refer you back to your family doctor for further testing. I try to do the best for my patients every day and just like a family doctor should not be performing a neck dissection or parotidectomy because they do not have the training, I should not be diagnosing and treating diabetes.

Aaaaaand..... no one quotes the physician and says "Thanks for the great explanation!".

Thanks for the great explanation! :thumbsup: :laughing:

 

[Travelover]

These scenarios will continue until the "profit motive" is taken out of the picture. Doctors are trained on borrowed money. Lots of borrowed money.
Some Doctors do enter the profession for noble purposes. To cure and help people. Most do it for the potential for earning money and prestige. I have known both types.

The Doctor "shortage" is not a shortage at all. It's just mismanagement of resources. Many physicians are not treating as General Practitioners but enter the high paying limited access "specialty" fields. High profit "very few poor people are referred to specialists" and low patient contact "lots of money coming from insured patients".

The high cost of medical care is not a result of high physician's wages. The huge money suck takes place in hospitals, even nonprofit hospitals. When it comes to pricing, it is the wild wild west out there. There are numerous articles out there, but take a look at this one as an example: One hospital charges $8,000


Here is a snippet:

In the District, George Washington University average bill for a patient on a ventilator was $115,000, while Providence Hospital average charge for the same service was just under $53,000. For a lower joint replacement, George Washington University charged almost $69,000 compared with Sibley Memorial Hospital average of just under $30,000.

Virginia highest average rate for a lower limb replacement was at CJW Medical Center in Richmond, more than $117,000, compared with Winchester Medical Center charging $25,600 per procedure. CJW charged more than $38,000 for esophagitis and gastrointestinal conditions, while Carilion Tazewell Community Hospital averaged $8,100 in those cases.

 

[MotorSeven]

Aaaaaand..... no one quotes the physician and says "Thanks for the great explanation!".

Thanks for the great explanation! :thumbsup: :laughing:

Hey, I did....and agree with him...but your right, I didn't say thanks.....THANKS!

 

[ultrarunner]

The high cost of medical care is not a result of high physician's wages. The huge money suck takes place in hospitals, even nonprofit hospitals. When it comes to pricing, it is the wild wild west out there. There are numerous articles out there, but take a look at this one as an example: One hospital charges $8,000

Here is a snippet:

This is why we always quote a firm price when requested... surprise at how few patients even ask.

Most really don't want to know... they say they have insurance and leave it at that.

 

[Western]

Rick, I read one positive thing in your post "Off to another surgeon that specializes in elbows, who then tells me, I'm special and will need two surgeons":laughing: At least you know your "special"


I can relate to almost everything you said, form the elbows to the numb feet. Found out I was, Hypoglycemic and have bone degeneration to a degree, Stenosis in 3 vertebra and I'm only 51!!but mostly from abusing my self in the early years. It is a merry- go- round. I had 3 MRI's in a month last year for 3 different Doctors:confused3: Heart tested good last month:thumbsup: I actually found a great cardiologist as a person and a professional, he spent over an hour with me during the testing and never acted in a hurry, I was surprised.

Dentist IMO, are worse than the others from my experience, I have been through it with them and I suffer now for it.

As far as your injury from LEO work, I also have one in my left shoulder from a similar incident, but "brudda" we went home:thumbsup: and I got a "Meritorious " award:laughing:


As far as insurance, ours has almost become negotiable after the premium hike, deductible doubled to $7500 and lost our co-pays and discounted prescriptions. Not counting the 3% decrease in pay my wife took, her company (medial) said it was to help pay "their healthcare cost" increases.

 

[MotorSeven]

I paid cash($500) for my MRI at an independant MRI center. Initially I was sent to the local hospital who said they would bill my insurance company over $7,500...I said no thanks.

 

[MotorSeven]

Rick, I read one positive thing in your post "Off to another surgeon that specializes in elbows, who then tells me, I'm special and will need two surgeons":laughing: At least you know your "special"

Ha, that's exactly what the wife pointed out:laughing:

 

[powerpace]

The high cost of medical care is not a result of high physician's wages. The huge money suck takes place in hospitals, even nonprofit hospitals. When it comes to pricing, it is the wild wild west out there. There are numerous articles out there, but take a look at this one as an example: One hospital charges $8,000


Here is a snippet:

The new clinics and Urgent Care Facilities in this area are all Physician owned. Some of the Docs are people my wife works with at the ER of a For-Profit Hospital. That hospital charges less money than the local not-for-profit sixty miles away. Many people drive sixty miles to save onethird to onehalf of cost for ER visit and proceedures.

 

[MossRoad]

A couple years ago I had an ultrasound done at a hospital on my carotid arteries in my neck on a Friday afternoon. They said the blood flow in one of them was going backwards and I needed to get an MRI. "Unfortunately, the MRI department closed at 5:00, so go home, don't do anything and come back on Monday..... " Don't do anything? The blood in the artery to my brain is flowing backwards and you tell me go home for 3 days and do nothing??? AAARRRGH!!!!! Came back Monday. Got MRI. Oops. Ultrasound was a false positive. Sorry, no problem. Thanks, folks! :confused2:

 

[Travelover]

This is why we always quote a firm price when requested... surprise at how few patients even ask.

Most really don't want to know... they say they have insurance and leave it at that.

That you can and will provide a firm price is outstanding. The frustration from a patient's part is knowing their personal cost. For example is every one involved (anesthetist, labs, etc) "in network"? If not, how will that affect my out of pocket costs?

I paid cash($500) for my MRI at an independent MRI center. Initially I was sent to the local hospital who said they would bill my insurance company over $7,500...I said no thanks.

Why do you think one place charges $500 and another place charges $7500? Are the expensive MRIs 15 times as good?