One example of what's wrong with America

[JS80]

Dude, take off your shades, Downey is fucking GHETTO. It's not Watts ghetto, but it's pretty damn ghetto. Move to the midwest or the south man. It's not worth it.

 

[rpanic]

Downey in its self isn?t ghetto, but it borders Paramount and Bell Gardens, and Downey Hospital is walking distance to both of these cities which are certified ghetto, gang infested, Mexico satellite cities. That whole area of Los Angeles is crap, and I am sure it will just get worse expect more Hospitals to close in these areas.

Time to move on Doc you don?t have much choice if you want to make the living you deserve.

 

[FleshLight]

Wouldn't it be better to join a medical group (westwood, facey) or to transfer to a better situated hospital (cedars or sgv)?

 

[moshquerade]

it sounds like you're in a situation that you choose to be in. no one can help you until you help yourself out of it.

 

[zinfamous]

Originally posted by: mugs

Originally posted by: mjuszczak

Originally posted by: slsmnaz

Originally posted by: eits
try chiropractic... you'd have a badass practice being an md/dc.

you can treat people and fix the problem causing the symptoms rather than covering the symptoms only with drugs or surgery... and you can prescribe antibiotics and other necessary medicines if you need to without referring out.

so the real MD is the quack and the chiro is the healer? Wow...

Chiropractic has its uses eits. As a fellow visitor to chiropractic (when in MA I get adjusted about twice a month), I can say it definitely helped me, but I wouldn't say it "fixed all of my problems".

My Aeron > my chiropractor.

in the grand scale of quackery, Chiro rates just below Phrenology.

 

[TheVrolok]

Originally posted by: moshquerade
it sounds like you're in a situation that you choose to be in. no one can help you until you help yourself out of it.

As rough as your situation is, I must agree with Mosh. I'm sorry if you didn't realize getting into internal medicine would be like this .. but it's been a popular trend for years now and has no signs of slowing down. If you can find a way to fix the US Healthcare issues, you won't need to worry about your $50/day losses.

You are absolutely right tho, the system is abused. People skipping medical insurance because they know they can get minimum care for free are a drain - it's a shame there isn't a good way to eliminate this problem.

 

[RossGr]

The reason someone does not have insurance is becauee they have either no job or a crappy one. It follows that since you have no job you have no money for "extras" Like a visit to the Emergency room. When someone who has no money left at the end of the month gets a bill for $500 to $1000 after sitting for 2 hr in the waiting room, then seeing a nurse for a couple of minutes followed (another hour wait) for a few precious minutes with a Dr. who does little or nothing of course you do not send a thank you note or money you do not have.

Sorry those are simple facts of life, as you discovered it pretty much works that way, why are you surprised?

Oh yeah, if a Dr acutally DOES something the bill with double or triple.

poor people have few options, it really seems that Medical and Dental professions do not appreciate or understand the plight of the underpaid masses who struggle to make ends meet every week of their life. I really do not know (nor do you) the circumstances of the lady you were trying to care for. I do know that when I was in that position we went no where and did nothing.

 

[Slew Foot]

Originally posted by: RossGr
acutally DOES something the bill with double or triple.

poor people have few options, it really seems that Medical and Dental professions do not appreciate or understand the plight of the underpaid masses who struggle to make ends meet every week of their life. I really do not know (nor do you) the circumstances of the lady you were trying to care for. I do know that when I was in that position we went no where and did nothing.

The underpaid masses taking cruises and vacations to Vegas?

Take a look at the parking lot of my hospital, the patients lot has more BMWs and Escalades then the physicians lot.

 

[NikolaeVarius]

Originally posted by: Slew Foot

Originally posted by: RossGr
acutally DOES something the bill with double or triple.

poor people have few options, it really seems that Medical and Dental professions do not appreciate or understand the plight of the underpaid masses who struggle to make ends meet every week of their life. I really do not know (nor do you) the circumstances of the lady you were trying to care for. I do know that when I was in that position we went no where and did nothing.

The underpaid masses taking cruises and vacations to Vegas?

Take a look at the parking lot of my hospital, the patients lot has more BMWs and Escalades then the physicians lot.

Probably because there are 10 times more patients than physicians?

 

[Slew Foot]

Originally posted by: tenshodo13

Originally posted by: Slew Foot

Originally posted by: RossGr
acutally DOES something the bill with double or triple.

poor people have few options, it really seems that Medical and Dental professions do not appreciate or understand the plight of the underpaid masses who struggle to make ends meet every week of their life. I really do not know (nor do you) the circumstances of the lady you were trying to care for. I do know that when I was in that position we went no where and did nothing.

The underpaid masses taking cruises and vacations to Vegas?

Take a look at the parking lot of my hospital, the patients lot has more BMWs and Escalades then the physicians lot.

Probably because there are 10 times more patients than physicians?

90% of the patients here are uninsured or on government insurance. The majority of the insured patients, are people who work at the hospital.

 

[frostedflakes]

Originally posted by: RossGr
The reason someone does not have insurance is becauee they have either no job or a crappy one. It follows that since you have no job you have no money for "extras" Like a visit to the Emergency room. When someone who has no money left at the end of the month gets a bill for $500 to $1000 after sitting for 2 hr in the waiting room, then seeing a nurse for a couple of minutes followed (another hour wait) for a few precious minutes with a Dr. who does little or nothing of course you do not send a thank you note or money you do not have.

Sorry those are simple facts of life, as you discovered it pretty much works that way, why are you surprised?

Oh yeah, if a Dr acutally DOES something the bill with double or triple.

poor people have few options, it really seems that Medical and Dental professions do not appreciate or understand the plight of the underpaid masses who struggle to make ends meet every week of their life. I really do not know (nor do you) the circumstances of the lady you were trying to care for. I do know that when I was in that position we went no where and did nothing.

I'm not trying to claim it's the norm, but I think there are a lot of people out there who could afford health insurance, but choose not to pay for it. A couple friends go to school full time, work part time, and can still afford coverage. The plans are pretty basic, of course, but it's better than nothing. It's all about priorities, unfortunately some people would rather spend money on gadgets and other luxuries than basic health insurance.

 

[Bignate603]

Push to send it to collections. There's no reason that they should be able to get away with literally robbing the hospital, and you.

 

[SlickSnake]

Originally posted by: colossus
So I haven't posted in AT OT in almost 5 years (I used to post essays here on all kinds of stuff), but this really got under my skin.

This is the best part of this post! :thumbsup::thumbsup:

So you only returned to the unholy fold after 5 years to grace us with your pain at the nations spiraling healthcare fiasco?

I am on a volunteer fire department making EMS calls for FREE. Just this year alone, we already have as many EMS calls as ALL of last year. I get calls at all hours of the day and night looking for a free ambulance ride for stuff as deadly as tummy cramps and headaches. And it's often the same patients. Normally nobody says thank you or anything. Talk about under appreciated. You have no clue what that means, compared to me, Doc.

I think the rising price of gas is partly to blame. And if they get a free ride to the hospital, which is about 45 minutes away, they also get pushed to the front of any line of waiting patients that might be wanting free care at the hospital. So it's a win-win situation for the "critical" frequent flier 911 patient. I honestly think that everyone conveniently forgot what an actual medical emergency is around here. I am on the fire department primarily to fight fires not pander to hypochondriacs, but EMS is what I spend 99.9% of my emergency calls doing.

But they do train me in EMS and fire for FREE. I would hardly call that fair compensation for being toned out and woke up at 3 am for a stubbed toe or a broken fingernail. This is also the primary reason volunteer fire departments struggle to keep anyone in the departments, too. Of course, we do get an ACTUAL emergency EMS call occasionally, about 1 out of every 20 or so calls.

This is just a little medical reality check for you from someone much lower on the medical totem pole than you. I hope this post helps you in some convoluted way.

BTW, since it keeps coming up, I too am uninsured. Unless I get injured on the job doing an emergency call of some sort, I am shit out of luck. But I would also probably die rather than call an ambulance for myself, or I would try to drive myself to the hospital in critical condition rather than have my squad pick me up, no thanks, hehe.

And if someone tries to accuse me of negligence or malpractice, they have to first sue the city, because unless they can prove and win some sort of negligence suit against the city first, they can't even touch me. So I don't have to worry about any malpractice suits. But this also varies a lot from state to state, I think. And believe me, if I feel I can't perform some medical procedure, I won't. Especially without a doctors instructions to cover my ass.

 

[halik]

Oh please,
the whole system is priced so that the one guy that pays $20K for appendectomy (my health insurance last year) pays for all the assholes that don't carry insurance.

I only carry catastrophic coverage at the moment ($1500 deductible) and I'm not going to see a doctor for $150 a visit. I get allergic conjunctivitis every year for the 24 years I've been alive and I will not pay 100+ dollars for you to tell me I need the same antibiotics I've been using year after year.

 

[ric1287]

Originally posted by: SlickSnake

Originally posted by: colossus
So I haven't posted in AT OT in almost 5 years (I used to post essays here on all kinds of stuff), but this really got under my skin.

This is the best part of this post! :thumbsup::thumbsup:

So you only returned to the unholy fold after 5 years to grace us with your pain at the nations spiraling healthcare fiasco?

I am on a volunteer fire department making EMS calls for FREE....other shit that has nothing to do with being a doctor

the key word in this post. He does not volunteer, you did not fork over 100's of thousdand$ in school. He deserves money and isn't getting jack, simple as that.

 

[Baked]

Life is not fair. The US health care enterprise is fucked up. You should've done your residency in Europe and stayed there. QQing on an internet forum is not gonna change anything.

 

[lightstar]

i think it would be tough making money as a hospitalist. . . .maybe you could supplement your income by doing either urgent care or ER shifts where you're paid by the hour, plus there's no call. . . .

 

[ICRS]

Insurance companies aren't all great. I know someone who wanted to get ETS (Endoscopic Thoracic Sympathectomy) and not only did he have a hard time finding a doctor who would be willing to do it, but his insurance refused to pay for it. He had to pay for it all out of pocket. It was for sweaty palms.

 

[CptObvious]

In this economic climate I think it's generally a bad idea for recently graduated professionals to hang their own shingle. My experience is in law, but I've come across attorneys with 20+ years experience close shop on their private practice because of lack of clients or paying accounts.

The way I see it, you can't really blame the patients because you knew what they were when you decided to treat them.

Best advice I can think of is to either a) go back to school and specialize or b) find a job working for a solvent company. Easier said than done though, I know.

 

[SlickSnake]

Originally posted by: ric1287

Originally posted by: SlickSnake

Originally posted by: colossus
So I haven't posted in AT OT in almost 5 years (I used to post essays here on all kinds of stuff), but this really got under my skin.

This is the best part of this post! :thumbsup::thumbsup:

So you only returned to the unholy fold after 5 years to grace us with your pain at the nations spiraling healthcare fiasco?

I am on a volunteer fire department making EMS calls for FREE....other shit that has nothing to do with being a doctor

the key word in this post. He does not volunteer, you did not fork over 100's of thousdand$ in school. He deserves money and isn't getting jack, simple as that.

Yea, I understand he paid 240k to get training, obviously.

But the fact remains he is complaining about ungrateful patients and not getting paid extra fees for services. He is however getting paid something just for being there, however small that might be. The fact he is not getting paid fully is his choice for VOLUNTEERING to be there, is it not?

And the fact he is there, when he could be elsewhere making more money is OBVIOUSLY volunteerism to me. Otherwise, why would he be self flagellating himself there under those conditions? And he also admits he is there because he did his internship there. So you are WRONG about him not volunteering to be there.

And yea, he deserves to get paid extra for his services. But if he don't get any extra cash, whose fault is it for him being there again? Oh yea, HIS FAULT. If the patient can't pay, that's it then, isn't it? He can either try to collect it, or suck it up and write it off.

Moaning about some patient going on a trip is also kind of lame. How does he even know she paid for it herself? It could have been a gift or she could have won it or the trip was nonrefundable. Does he honestly expect her to grovel before him and hand him her trip as payment? Would he do that in her shoes? Hell NO.

 

[preslove]

Originally posted by: fisheerman
This is the exact way to fix the uninsured issue. Give people/companies huge tax deductions for sponsoring events such as this as well as incentives for doctors/nurses to volunteer and you would probably be able to provide, at least the basics to the majority of uninsured americans.


government run health care isn't the answer.

-fish

Yes, because we should follow the third world & not the rest of the fucking civilized world :roll:

 

[eakers]

I think that Canadian doctors who want to privatize healthcare should read this.

 

[preslove]

Originally posted by: Pastore

Originally posted by: Stiganator

Originally posted by: fisheerman
This is the exact way to fix the uninsured issue. Give people/companies huge tax deductions for sponsoring events such as this as well as incentives for doctors/nurses to volunteer and you would probably be able to provide, at least the basics to the majority of uninsured americans.


government run health care isn't the answer.

-fish

Setting up mobile triage is not the answer IMO. I think availability of free BASIC healthcare is a good idea. If you want some optional surgery then go to a private clinic.

Additionally, the medical system could allow more doctors into the market. I know plenty of capable and deserving students who have been denied medical school admission while dbags with rich dads who are doctors have gotten in. Let the market decide how many doctors we need. More doctors -->cheaper medical school --> cheaper healthcare.

--> Lower doctor wages --> Lower quality of service

In countries with universal healthcare, they are booked quite frequently. You could also look at it as a stepping stone. New MDs can work in the universal healthcare centers to get experience and then start their own practices if they are skilled or specialized enough.

Family practice doctors don't make shit in America because of issues described by the OP. If we had national health (like the rest of the fucking civilized world), family practice physicians would get paid and make more money, and there would be more of them.

The US health care system is broken because no doctors wants to go into basic practice & instead specialize in order to pay back their loans and make a shit ton of money. This means people rarely see a basic physician, but instead just wait till they get catastrophically sick & see the super expensive specialists.

This leads to the incredibly fucked up situation of America paying MORE than the rest of the civilized world, and yet get some of the worst health care of the industrialized west.

 

[Slew Foot]

http://www.nytimes.com/2008/07...mc=rss&no_interstitial

See, you should have done something besides medicine.

 

[colossus]

OK, there were 2 foci in my post although I only meant to talk about the stupidity of the patient. My complaint was about her lack of personal responsibility.

One other patient of the 8 that I admited had a tummy tuck in TJ and now came back here for a pneumonia (PNA) and possible PE. She has a hx of PE (pulmonary embolism which is life threatening) but stupid woman can't even tell me what kind of heart disease she has - she just knows something is wrong with her heart. Hmmm, that narrows it down to putting her in the ICU vs putting her on a normal floor. Now I have to do an echo on her to cover my legal ass cuz she's too lazy to have a typed list of her medical problems. She's only 43 - she can't use dementia as an excuse. Retarded maybe...

Call it stupidity, volunteerism, whatever you will. Yes I choose to work in Downey. Yes it is an altruistic thing. It strokes my ego as a hero. Hey, I'm not brave enough to wear a fire suit and run into a firey building on run patrols in Baghdad. I'm willing to donate my body (and if you don't think medicine takes a toll on the body just look at your doctor haha) to help others. I'm willing to sacrifice sleep. Nobody else wants this job. I have no idea why people even apply to med school anymore. Probably all the asian parents making them.

SlickSnake - I don't want to get into an arguement - but do you know what you're talking about? "Extra fees?". What extra fees. My only income comes from what insurance pays me. If the person has no insurance it is implied they will pay you. Is there any other service in this United States you can walk in and get done for free without even thinking about it. Maybe getting a sip of water the local library is free. My one insured patient left against-medical-advice (AMA). Oddly it's always the ones who have to go to work and have a life who always want to leave. So I made no $ today. I shelled out about $50 pre-tax to work. I can "write it off" as you say. If the damn goverment let me at least write off those non-payers as losses then it wouldn't be so bad. Hell, all my friends in HS had parents who owned mom/pop stores. They wrote off all their food as loss/theft.

Slicksnake - I doubt you have ever spent 5 hours on your birthday trying to convince a senile 94 year old woman to make her husband a hospice candidate all while your friends are all wondering where the hell you are (MIA for your surprise party). That is underappreciated. I do respect your decision to volunteer, but you're allowed to bail at any moment (I assume). Some people like marines and firefighters can just give up when they feel like it. They are underappreciated. I never heard of an All Star Game for Teachers or seen Rescue Teams make $200K a night like Kobe even though they put their life on the line. I've spent over 2 years of my life in what is considered the third world. I think people there are much more grounded in reality.

If there is a point to my bitching, it's that if a well intentioned (I believe I am) person like me is not willing to work with medicine the way it is (ghetto and all), then what do you think are the chances for good healthcare in this country? When I'm old I want somebody like me to take care of me and look out for. Now some schmuck who'se going to put me in a Long Term Acute Hospital to rip Medicare a new one and barely see me once a week while billing every day. If the goverment doesn't change it's reimbursement for FP then the country is going to fester like the abcess it is.

If Downey is ghetto, then 1/2 of LA is ghetto. By that standard all of Arkansas and Mississippi are ghetto. All of the suburbs in NY are ghetto.

The problems lies with the city of Los Angeles who closed MLK down and dumped the problem into the private sector. All of sudden our mayor has $300 million dollars to fix roads and fight crime while every hospital and physician in the area is getting bent over. Nurses and hospital staff too if you factor in that they can't raise wages since they're lossing money on uninsured people.

The Federal Goverment just sat on its ass. Good job Maxine Waters!