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Message
re: What is Healthcare's future?
Posted on 8/5/16 at 12:39 pm to ksayetiger
Posted on 8/5/16 at 12:39 pm to ksayetiger
quote:
grandpa worked till three weeks before death. He fell, went to icu, and flat lined. He had a dnr, but because the hospital was to busy to look at his chart they revived him. Spent a couple weeks on life support at an insa
Even this is at a pie in the sky number. The cost should have been like a hotel. Grandpa pays what a Ritz Carlton costs mind you. But he got charged what it cost to stay at a resort in Fiji with celebrities. He got the quality of a Holiday Inn Express. Good quality but at an EXORBITANT rate.
It happens from intensive/end of life care, all the way down to an office visit for an earache.
0
Posted on 8/5/16 at 12:44 pm to Junky
quote:
Once your almighty and "benevolent" govt overseers get out, and insurance takes on the practice of car or home insurance (instead of paying for every damn little thing), will the problem ever be fix.
As it exists now, the government is the only thing big enough to fix it, or "bully" others to fix it.
There is very little money to be made in fixing it. Only money to be saved. That is far less motivating.
Posted on 8/5/16 at 12:44 pm to ksayetiger
quote:
My grandpa worked till three weeks before death. He fell, went to icu, and flat lined. He had a dnr, but because the hospital was to busy to look at his chart they revived him. Spent a couple weeks on life support at an insane cost.
Not sure of your specific example, but if he flat lined in the trauma room, they will revive him regardless. They aren't going to stop to look at the patient's chart.
ETA: Never mind, I see that he was in ICU after the fall. That's just lazy work on the part of his treatment team.
This post was edited on 8/5/16 at 12:49 pm
Posted on 8/5/16 at 12:44 pm to LSU alum wannabe
A tangled web we have weaved , no clue what the answer is , but to look at it from another prospective , dr Andrews (world renowned orthopedic surgeon with decades of experience ) does not get one penny more from Cigna to perform an ACL reconstruction than does a forgien trained newly licensed ortho performing their first case
I think we will see more and more of the MD VIP stuff, and why not ,
I think we will see more and more of the MD VIP stuff, and why not ,
Posted on 8/5/16 at 12:48 pm to LSU alum wannabe
Posted on 8/5/16 at 12:49 pm to LSU alum wannabe
"Health"care ???
The current system is to provide/manage "sick" care. There is rarely emphasis on health /optimization. The population based norms do not gaurentee health. They mainly give feedback if disease state levels are present. Normal in our population = substandard (look around and use the eyeball test...)
In the future, sick care will be tiered (in my opinion)
"Health" is all on the individual:
-nutrition
-sleep
-activity
-stress management
Manage these correctly and you will need less of sick care (catashopic care for unforeseen occurrences like trauma)
Disregard the things listed above, you will continue to board the Axiom with the rest is of the populace and need "sick" care management.
Practical recs:
Read as much as you can on how to maintain health (see link below for a good book to start with)
Find a provider who has an interest in functional medicine
If you are already chronically ill at this point, an MDVIP option may be reasonable if the provider is on board with personalizing care for you.
LINK
The current system is to provide/manage "sick" care. There is rarely emphasis on health /optimization. The population based norms do not gaurentee health. They mainly give feedback if disease state levels are present. Normal in our population = substandard (look around and use the eyeball test...)
In the future, sick care will be tiered (in my opinion)
"Health" is all on the individual:
-nutrition
-sleep
-activity
-stress management
Manage these correctly and you will need less of sick care (catashopic care for unforeseen occurrences like trauma)
Disregard the things listed above, you will continue to board the Axiom with the rest is of the populace and need "sick" care management.
Practical recs:
Read as much as you can on how to maintain health (see link below for a good book to start with)
Find a provider who has an interest in functional medicine
If you are already chronically ill at this point, an MDVIP option may be reasonable if the provider is on board with personalizing care for you.
LINK
Posted on 8/5/16 at 12:52 pm to Epic Cajun
quote:
sure of your specific example, but if he flat lined in the trauma room, they will revive him regardless. They aren't going to stop to look at the patient's chart.
Happens all the time. Has a LOT more to do with than merely not taking the time. You damned near have to have the DNR in your pocket when you die and a family member standing there screaming "he's a DNR" to everyone in scrubs or EMS pants.
I've coded many DNRs. I've even done EXACTLY what this poster had happen to his grandpa. I CALLED the code. The poor guy was there for weeks. His chart was massive. The word DNR got left out in report. Finally a cardiologist in the ICU thumbed through the chart and found the form buried in 20-30 pages of consult notes (was a few years back). But the damage was done. Patient revived and on a vent and stabilizing.
Always gonna err on the side of caution. Lot less shite to eat coding somebody who is a DNR than not coding someone who PROBABLY is a DNR.
Posted on 8/5/16 at 12:52 pm to LSU alum wannabe
This will be an unpopular opinion here but we need to find away to increase the MDs pay/reimbursements or we are all in trouble. Every year it seems the contracts decrease their pay. Would you take a pay cut yearly? Their school costs increase, their pay decreases and they deal with more beuracracy every year. We are going to reach a point where GPs only exist as hospitalists....
Posted on 8/5/16 at 12:53 pm to LSU alum wannabe
Whatever the new president killary wants it to be
Posted on 8/5/16 at 12:54 pm to ThinePreparedAni
quote:
The current system is to provide/manage "sick care"
You a vegan?
Posted on 8/5/16 at 12:55 pm to LSU alum wannabe
quote:
Finally a cardiologist in the ICU thumbed through the chart and found the form buried in 20-30 pages of consult notes (was a few years back). But the damage was done. Patient revived and on a vent and stabilizing.
This is where an EMR comes in handy. Much easier to find information electronically.
quote:
Always gonna err on the side of caution. Lot less shite to eat coding somebody who is a DNR than not coding someone who PROBABLY is a DNR.
Exactly, if you have a trauma coming in you're going to try to save the person. Do you really want someone going through your chart to see if you have a DNR when they could be saving your life (if you don't have one)?
Posted on 8/5/16 at 12:58 pm to jennBN
quote:
We are going to reach a point where GPs only exist as hospitalists....
Almost there now. I live in a large suburb. Plenty of insured patients out here. Google search for GP and you find slim pickings.
Posted on 8/5/16 at 1:00 pm to jennBN
quote:
we need to find away to increase the MDs pay/reimbursements or we are all in trouble. Every year it seems the contracts decrease their pay. Would you take a pay cut yearly? Their school costs increase, their pay decreases and they deal with more beuracracy every year. We are going to reach a point where GPs only exist as hospitalists....
You're actually making the argument for phasing out human GP's. If we can have their job performed better and cheaper by a computer then it should be a top priority to get them out of there. There's no reason to waste resources training human doctors to be general practitioners.
This post was edited on 8/5/16 at 1:02 pm
Posted on 8/5/16 at 1:00 pm to Epic Cajun
My question in this scenario is why the family lets the pt languish for 3 more weeks? He was DNR just terminally extubate on a morphine gtt and let him go. He was revived in error so now keep him on a ventilator and in ICU for 21 days?
Posted on 8/5/16 at 1:01 pm to jennBN
Yea, that doesn't make sense to me either. Unless they didn't know he had a DNR.
Posted on 8/5/16 at 1:02 pm to LSU alum wannabe
quote:
You a vegan?
Abso fricking lutely not
I do eat a shite ton of greens (coupled with lots of meat/fat)
Well timed/sourced carbs
Metabolic flexibility
I efficiently lift heavy shite 2 to 3 times per week
I sleep at least 7.5 hours/night
I meditate, do yoga, mobility work (all good stress outlets that complement my lifting/work)
Posted on 8/5/16 at 1:04 pm to LucasP
How do I page the computer when the pt starts looking bad and heading south? What if I don't know what's wrong but I just want someone else to assess the pt because my gut tells me something is wrong?
Posted on 8/5/16 at 1:05 pm to jennBN
quote:
My question in this scenario is why the family lets the pt languish for 3 more weeks? He was DNR just terminally extubate on a morphine gtt and let him go. He was revived in error so now keep him on a ventilator and in ICU for 21 days?
Middle of the night and family came in the next morning. Bitch of it was the patient made it! He lived and was discharged. The family was pissed at first but the hospital ate the cost of his ICU course due to the error.
What you propose is a lot of tough questions in the middle of the night for a pissed off family member. These are worst case scenarios. Families need it to be peaceful and quick. Push comes to shove I have seen many family members say "do everything".
Posted on 8/5/16 at 1:07 pm to ThinePreparedAni
quote:
Abso fricking lutely not
Sorry. I clicked your link. Had I done that before, I'd have not posted that.
Does sound like you saw Fat, Sick, and, Nearly Dead though.
Posted on 8/5/16 at 1:07 pm to jennBN
How does the computer know when the patient is not telling the truth?
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