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What Drives Your Doctor Nuts about You
interesting perspective from doctor's point of view:
(excerpted from http://www.medpagetoday.com/PracticeManagement/PracticeManagement/1...) "The most frustrating thing for me is patients whose lifestyle is making them miserable but they won't change it," Dr. Green said.
He said many problems, such as sleep apnea and chronic tiredness, can be attributed to eating too much and moving too little. In that case, the treatment isn't disease, but "lack of health."
(excerpted from http://www.medpagetoday.com/PracticeManagement/PracticeManagement/1...) "The most frustrating thing for me is patients whose lifestyle is making them miserable but they won't change it," Dr. Green said.
He said many problems, such as sleep apnea and chronic tiredness, can be attributed to eating too much and moving too little. In that case, the treatment isn't disease, but "lack of health."
Views: 120
Replies to This Discussion
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Permalink Reply by bonesigh on
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Well, that's why I stated that it's "asking too much". I know it can't really be done. I do know however how good it has felt in the past when my doctor actually HAS called me.
Judy said:The average general practitioner (family doctor) today has 2500 patients in his practice.
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Permalink Reply by B Robles MD on
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For the most part doctors do not consider themselves superior to the general public, though this is not to say that some may project that sentiment. Doctors have been trained to provide information or treatment options. It is possible that some may interpret the manner in which the information is provided as having a sense of superiority, but in most cases it a misinterpretation of the facts. As for a vocation that is treated differently, you are right about that. There are very few industries where the government is allowed to price fix, medicine being one and maybe the only. All of the government payers of healthcare are the worst possible payers and only reimburse a fraction of what is available to physicians from private insurers. In fact, if it were not for the private payers, doctors could not afford to care for government sponsored patients. Just imagine if everybody had to accept 30% of their usual payment when their work is associated with any government agency? Imagine if every supermarket had to accept food stamps worth 1/3 their face value? Or imagine a teacher who was paid 1/3 their salary every time they taught a child on welfare? This is the very reason county hospitals exist, because those employees can be subsidized which allows for patients with bad insurance to be seen. As a physician I cannot negotiate with the government for a better reimbursement. If they could force me to work for free for all Medicare patients they would. In fact when caring for a Medicare patient recently, two hours of my time was worth less than one third (1/3) the price of a cloth and foam sling. Medicare paid the supply company $750.00 for that cloth and foam sling. A friend of my had previously purchased the same sling, from the same company at his cash rate of $170.00. Wonder why healthcare is so expensive? Here is another difference that make doctors so high and mighty. The government says that I have to deliver care at whatever time of the day, and if I do not get paid, tough. I have yet to see a lawyer be told that he has to represent someone and well if they do not get paid, tough. I would love to earn the $350.00 an hour lawyers I have used in the past charge. Yup, you are right we are treated differently and maybe that is why so many are frustrated when the President won't tell trial lawyers to go get a real job. As for negligence being criminal, do we apply the same tact to patients who fail to follow treatment plans? You cannot have it both ways.
Dan Lyons said:Please explain to me what makes the doctors think they are superior to the rest of the public? Why is their vocation treated so differently than any other vocation? Should they not have to warrant their work? They complain about their malpractice insurance rates being so exorbitant. Easy solution. Make their negligence criminal and subject them to criminal penalties.
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B Robles MD said:... As for negligence being criminal, do we apply the same tact to patients who fail to follow treatment plans? You cannot have it both ways.
I will disagree w/you on this point, Dr Robles. The patient is the one to endure the benefits or consequences of any treatment plan you suggest. Therefore, the patient is the one w/the RIGHT to make the final decision as to whether to follow that treatment plan or not.
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Permalink Reply by sleepycarol on
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I know that my daughter-in-law worked for our primary care doctor for a time. We live in a rural community. Her charge, if self-pay, is $40.00. She takes the time to listen to patients and many times offers samples to those that don't have prescription plans. She is not rich by stretch of the imagination.
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Permalink Reply by RockRpsgt on
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It is a pt's right to choose or not choose to follow a Dr.s advice. if they choose not to then they should have no right to complain about that doc. Why even waist the money on a doc if you are not going to listen to them. That does not make any sense to me. How many times on this site have we seen " my doc told me to do this, but........yadayadayada" These same people wonder why they are not getting any better. Come on Judy!
Judy said:B Robles MD said:... As for negligence being criminal, do we apply the same tact to patients who fail to follow treatment plans? You cannot have it both ways.
I will disagree w/you on this point, Dr Robles. The patient is the one to endure the benefits or consequences of any treatment plan you suggest. Therefore, the patient is the one w/the RIGHT to make the final decision as to whether to follow that treatment plan or not.
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Because doctors do NOT walk on water, Rock Hinkle. They slip and fall on the ice the same as I do. There have been times I have NOT followed my doctor's advice. And been d*mn glad I didn't! It was suggested that I have surgery 10 years ago - I didn't and am still doing fine! The same doctor from 10 years ago has finally agreed that I continue to wait and watch until symptoms begin as I've been doing these last 10 years. I can cite a few (very few) other examples. As I tell all my doctors, it has to make sense to me or it doesn't get done. If you think it needs to be done bad enough then it is your job to make it make sense to me. I'm a FIRM believer in second opinions as well. Especially when I disagree w/a doctor I highly respect. (And yeah, for all my carping about the medical profession I have been blessed w/some good ones - but - I had to look long and hard to find them, they didn't just one day knock on my door and say "here I am".)
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I can't argue with you on elective surgery Judy. Tehy are a whole different ballgame and need to be looked at on an individual basis. I was in a car accident when I was 16 that left me nearly dead(flatlined 3 times). 8 sugeries and 12 weeks of inpatient care later, and a body wire together like the million dollar man they told me I had one more sugery left. This would have been to fine tune some things and fix a scar I have running from the top of my forehead to the bottom of my right eye. Long story short i still have the scar. I have been blessed with some great docs throughout my whole life. I do not know if it is the luck of the draw or just the great talent of the indy medical complex. My grandmother has seen incompetence one after another lately.
My point was not to put Docs on a pedastal. They do not walk on water. In both of these examples we made a choice based on medical advice. neither of us chose to outrite ignore our physicians. It sounds to me like you might even still be with yours. The Doc in question with me actually worked on my youngest brother and my daughter before retiring. My point was that there are alot of pts here on sleepguide and elsewhere that choose to completely ignore what any doc says to them. I have seen it here, cpaptalk, and in my lab. Self medication is not the answer. Some of these docs went to school for 12 years to get to their positions. For that alone I think we have to at least give them a chance to screw up. We cannot cut down the entire tree because an apple or 2 was rotten. Any way on the whole and despite it's flaws I believe that the American medical complex is one of the greatest in the world. As jnk would say; I too am just a pt and that's just my opinion.
Rock
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Rock Hinkle said:
Any way on the whole and despite it's flaws I believe that the American medical complex is one of the greatest in the world
Yeah, well, Rock, please do your best to convince our government of that before they REALLY screw up American health care!!!! Those guys in Washginton scare the h*ll outta me tinkering w/our health care system!!!!!
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Permalink Reply by Dan Lyons on
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Doc,
Do you not have the choice to treat Medicare patients? Does the government force you to accept these patients?
I am not disagreeing with your conclusion that the system is screwed up.
I also agree that lawyers are the major reason that the system is failing, for that matter that the country is failing. Lawyers write every law written in this country. They, for the purpose of self-preservation, write loopholes into them.
If you think of your practice alone, look at every aspect, from your forms, placards, actions, staff, etc., and think what a lawyer has influenced. Everything.
You need to stand back and look at your practice from the patient's view, not the lawyers.
Lawyers have been able to interject their positioning into your practices as a direct result of the medical/industrial complex and the physicians mindset of "holier than thou."
As a result, everyone suffers.
Now you have a situation to which the entire medical system will be destroyed by another group of lawyers and politicians with the current health care reform now being presented. It is bad now, but it is going to get worse, much worse.
B Robles MD said:For the most part doctors do not consider themselves superior to the general public, though this is not to say that some may project that sentiment. Doctors have been trained to provide information or treatment options. It is possible that some may interpret the manner in which the information is provided as having a sense of superiority, but in most cases it a misinterpretation of the facts. As for a vocation that is treated differently, you are right about that. There are very few industries where the government is allowed to price fix, medicine being one and maybe the only. All of the government payers of healthcare are the worst possible payers and only reimburse a fraction of what is available to physicians from private insurers. In fact, if it were not for the private payers, doctors could not afford to care for government sponsored patients. Just imagine if everybody had to accept 30% of their usual payment when their work is associated with any government agency? Imagine if every supermarket had to accept food stamps worth 1/3 their face value? Or imagine a teacher who was paid 1/3 their salary every time they taught a child on welfare? This is the very reason county hospitals exist, because those employees can be subsidized which allows for patients with bad insurance to be seen. As a physician I cannot negotiate with the government for a better reimbursement. If they could force me to work for free for all Medicare patients they would. In fact when caring for a Medicare patient recently, two hours of my time was worth less than one third (1/3) the price of a cloth and foam sling. Medicare paid the supply company $750.00 for that cloth and foam sling. A friend of my had previously purchased the same sling, from the same company at his cash rate of $170.00. Wonder why healthcare is so expensive? Here is another difference that make doctors so high and mighty. The government says that I have to deliver care at whatever time of the day, and if I do not get paid, tough. I have yet to see a lawyer be told that he has to represent someone and well if they do not get paid, tough. I would love to earn the $350.00 an hour lawyers I have used in the past charge. Yup, you are right we are treated differently and maybe that is why so many are frustrated when the President won't tell trial lawyers to go get a real job. As for negligence being criminal, do we apply the same tact to patients who fail to follow treatment plans? You cannot have it both ways.
Dan Lyons said:Please explain to me what makes the doctors think they are superior to the rest of the public? Why is their vocation treated so differently than any other vocation? Should they not have to warrant their work? They complain about their malpractice insurance rates being so exorbitant. Easy solution. Make their negligence criminal and subject them to criminal penalties.
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Dan How do I get a copy of this health care reform that you keep talking about? I would really like to read it. I apologize if you have posted it already. I truly believe the fault to be in the insurance companies. All of our laws seem to help them and them alone. The laws seem to be written to keep their pay out lower. Just my opinion though.
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Rock,
Here you go. Some interesting reading.
Pay attention to page 114.
http://help.senate.gov/BAI09A84_xml.pdf
Rock Hinkle said:Dan How do I get a copy of this health care reform that you keep talking about? I would really like to read it. I apologize if you have posted it already. I truly believe the fault to be in the insurance companies. All of our laws seem to help them and them alone. The laws seem to be written to keep their pay out lower. Just my opinion though.
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