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| Number of Posts: | 110 |
| Registered on: | 4/23/2019 |
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Recent Posts
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re: Is the healthcare system in America bloated?
Posted by Wiener on 2/11/26 at 10:45 am to GreenRockTiger
quote:
I’m not - I’m hung up on the fact that pills are thrown at patients before anything else is ever done.
Welcome to medicine as a service industry.
I get shite on by patients in the office who I don't immediately give testosterone to. When I recommend diet and exercise for low testosterone I can see them get ready mentally to write up that negative review...
This isn't just a physician problem, it's patients, too.
1
re: Is the healthcare system in America bloated?
Posted by Wiener on 2/11/26 at 10:32 am to GreenRockTiger
quote:
Students are taught to read charts on systems made by epic and have made diagnosis before they ever see the real person. They study things virtually and not in real time and can’t even deal with people. Some of that is corrected during residency but if it’s not coming from something electronic, they cannot deal with it.
Students aren't taught to "read charts". We learned diagnosis and organ systems before we ever got a hint of electronic medical records.
Why are you so hung up on the medium. Do you think it's inherently better to read all of this stuff from paper before getting into clinical applications?
re: Is the healthcare system in America bloated?
Posted by Wiener on 2/11/26 at 9:14 am to Epic Cajun
quote:
This is what people who want a single payer system don’t understand. Sure you can have “free” healthcare, your taxes are going to cover that though. There are some provinces in Canada that have provincial tax rates of 20%, on top of their federal taxes.
My main argument for something like a single payer system would be that the current system is also reportable to investors.
If I'm a CEO of an insurance company that is publicly traded, is my customer the patients or my investors? How do I keep my investors happy? It can only come at cost to patients.
re: Is the healthcare system in America bloated?
Posted by Wiener on 2/11/26 at 8:31 am to winkchance
quote:
Add to that no medical profession is being taught healing
Please expand. This should be good...
re: Is the healthcare system in America bloated?
Posted by Wiener on 2/11/26 at 8:07 am to WaydownSouth
quote:That reply was to you saying more tests should be covered. Now I'm doubting the costs savings you claim even more because nobody will do them?
Except the average American is not doing any of this.
The last data suggest less than 10% of Americans are getting routine recommended clinical services
re: Is the healthcare system in America bloated?
Posted by Wiener on 2/11/26 at 6:11 am to WaydownSouth
quote:
I guess logic should have told me catching and treating disease states earlier would drive up costs
Obviously catching disease states earlier is cheaper. What you're claiming to be absolute is entirely different.
You're claiming that healthcare costs will be lower by screening earlier at a population level without knowing incidence of disease in those age groups and costs of screening.
For instance, we could screen as early as age 10 for colon cancer because catching it early is better. However, if nobody at age 10 has colon cancer it's all cost without benefit. What test did you use to screen everybody and what is the total cost there? You don't know the age where the inflection point occurs, so making absolute claims (and calling it logic) like that is kind of silly.
re: Is the healthcare system in America bloated?
Posted by Wiener on 2/11/26 at 5:53 am to WaydownSouth
quote:I just figured you had some numbers lying around to back up your claim of it absolutely decreasing healthcare costs.
How do you want me to produce stats for something we don't do?
re: Is the healthcare system in America bloated?
Posted by Wiener on 2/11/26 at 5:45 am to WaydownSouth
quote:
No, but if we incorporated more screenings/scans than just here is your yearly BMP/CBC/Lipid panel blood draw, they absolutely would.
quote:
Link to stats?
This only goes to 2014, but is descriptive enough since it isn't getting any better. There are people on this board that will tout that the extra we pay leads to innovation, but it really just leads to more administrators making more money.
Being a part of it firsthand, the bloat is unreal. If you are interested, look up how many vice presidents your local non-profit health system has. That's generally a good sign of them making too much money to keep their non-profit status so the money gets pushed to expansion and more administrators.
Reminds me of residency and seeing terribly infected dongs after people tried this at home...
re: Any of you guys ever have a priapism?
Posted by Wiener on 1/25/26 at 1:08 pm to Big Block Stingray
quote:At least the spinal cord injury priapisms are high flow and don't require drainage.
I do see it fairly regularly with spinal cord injuries, couple a year.
quote:It's not typically painful if addressed in a timely fashion. Also, the chances of permanent damage decrease with earlier intervention. I've seen it happen less with medications like Viagra than I have other reasons like cocaine (most common during training) and a certain sleep medication.
I’ve never heard of anyone actually gettting one even though you hear about it as a warning for some ED meds.
It sounds like it would be unbelievably painful. I can’t image going through that.
I've treated some 48+ hour erections in the past. Those guys will never have normal erections again...
re: Any of you guys ever have a priapism?
Posted by Wiener on 1/25/26 at 11:52 am to RazorBroncs
quote:More testing is needed.
Side note: is there anything more universally funny to both men and women than calling a penis a weiner in a joking fashion? Basically any time it's referred to that in real life or TV I can look over at my wife and she's audibly giggling
quote:
Insurance companies are getting richer and so are the doctors and medical equipment suppliers, and big pharma, too.
The ACA holds probably the largest hit against physician income in history by limiting physician ownership in healthcare facilities.
Since then, the American Hospital Association has run wild and you've likely seen an explosion of one or more hospital systems in your area depending on how large a city you live in. These businessmen aren't looking to make sure physicians are well paid and aren't looking to save you any money either.
quote:
One interesting factoid about ACA/ObamaCare: Prior to implementation, only about 35% of physicians were employed. Now over 77% are. Regardless of political affiliation, these are the facts and show the power of this piece of legislation to fundamentally alter the US health system. The shift in reimbursement models, increased regulation, increased power of insurance companies in their ability to vertically integrate has killed the private practice model in the US.
This cannot be overstated. The AHA lobbied hard against physician ownership of medical facilities and won. They've used that leverage to kill private practice and bring physicians under their control. The funny part is they've used the employed model to recreate the scenario they created fear of - self referrals because you own the hospital.
If your physician seems more detached these days, they're probably reminded daily that they're just an easily replaceable cog in the machine the AHA lobbied to turn medicine into.
There's a reason hospital systems are metastasizing like wildfire now.
quote:
(very major plan, big group)
Large insurers reimburse less to physicians as the cost of access to their patients.
And only once you're in do they start to come up with even more reasons to not reimburse you.
re: Why do women complain to their men?
Posted by Wiener on 6/17/25 at 8:01 am to burger bearcat
Why are you doing it now?
quote:
3.) The Nile River in the Bible is actually the Mississippi River because the Mississippi River has 7 outlets (this is especially dumb because the number of rivers inlets changes over time and also nothing else in the Bible would make sense if this was true. )
He must be in de-Nile that he's just another fanatic of a Middle Eastern religion.
quote:
What are odds of him beating it?
We do not have a cure for metastatic prostate cancer, but we can manage it fairly well. A lot of the prognosis depends on the degree of spread and labs at time of diagnosis, which we don't know.
re: Former President Joe Biden was diagnosed with an "aggressive form" of prostate cancer
Posted by Wiener on 5/19/25 at 4:38 pm to Chucktown_Badger
quote:
Pretty sure I was correct:
quote:
(WACH-ful WAY-ting) Closely watching a patient's condition but not giving any treatment unless signs or symptoms appear or change. Watchful waiting may be used when the risks of treatment or repeated tests, such as biopsies, are greater than the possible benefits.
Cute, you posted a definition and still don't understand the difference.
Active surveillance is planned blood tests and biopsies to defer treatment/side effects until definitive treatment is warranted. This is what that guy described with PSA testing and repeat biopsy.
Watchful waiting is what you posted, doing nothing until symptoms occur, and more or less letting it run its course and treat for symptoms as needed. This is not what that guy described.
re: Former President Joe Biden was diagnosed with an "aggressive form" of prostate cancer
Posted by Wiener on 5/18/25 at 7:25 pm to Chucktown_Badger
quote:
That’s not treatment, that’s watchful waiting.
Correction, that's active surveillance.
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