Attention seniors: The Hospital is not a Holiday Inn.

[thegenius]

This is one thing I truly never understood about America.

It's astonishing too, how many immigrants who come here with nothing and somehow manage to take care of 85yo abuela with no support from the government while essentially being day laborers, meanwhile folks here will call 911, burn $1000 in public funds for an ambulance ride and demand admission because "I don't like my nursing home".

It's because they (the Americans) can. They dump them to the ER because we allow it. It's just a matter of time until non-American families catch on and do the same thing.

---

Members don't see this ad.

 

[thegenius]

People show the most entitlement when they aren’t paying a direct bill

This.

 

[Pudortu]

It's because they (the Americans) can. They dump them to the ER because we allow it. It's just a matter of time until non-American families catch on and do the same thing.

I have seen a hospitals case management call ICE on an undocumented young teenager who was dumped by distant relatives in the ER for being aggressive with other family. Their immediate family was out of the country. Ironically, ICE dumped it on the department of health and human services. That patient was in the ER for a couple months. So sad.

 

[Kryptocoin]

The ER is probably the only private institution in the country where the less money you have, the more you feel entitled to.

We can't have universal healthcare in this country until we fix our primary care and social services sectors.

Universal healthcare without fixing the above will just drive an already teetering ER system to a halt.

 

[Mount Asclepius]

This is the downside of increased life expectancy. Back in the day people died of dysentery in their 30s on the Oregon trail after a long, fulfilling (i.e. semi suffering) life of hard work. It’s the reason I picked EM and nocturnal work. So I could shorten my lifespan and die in my 50s. You’re welcome kids. You don’t have to take care of me or expect society to do it for you I kid (sort of).

 

[JacobMcCandles]

This is the downside of increased life expectancy. Back in the day people died of dysentery in their 30s on the Oregon trail after a long, fulfilling (i.e. semi suffering) life of hard work. It’s the reason I picked EM and nocturnal work. So I could shorten my lifespan and die in my 50s. You’re welcome kids. You don’t have to take care of me or expect society to do it for you I kid (sort of).

I know you joke but this plays a part. The people who would have died at a younger age are living their unhealthy lives longer and longer. Medicine focused on making people live longer through various medications and interventions that they lost track of the importance of healthy living that wouldn’t require these medications and interventions in the first place. There are people who lost the genetic lottery and there’s no amount of diet and exercise that will significantly help but that isn’t the majority of the people we see.

 

[John Rawls]

Apparently I'm in the minority here. I think life is still too damn short, people deserve to live however they want to live, seek pleasure in whatever is pleasurable to them within legal boundaries, and show up when they need my help. I treat everyone like my family. Hospital employees on the other hand, I will cuss out any day of the week, sometimes directly confrontational if necessary. Examples include:

- Rads going off to do elective procedures instead of responding to emergency studies
- Rad techs for the same reason, along with questioning orders
- Admin telling me to street someone that needs to stay
- Hospitalists for the same reason
- Docs in general who never seemed to learn collegiality and professional ethics (not to sidetrack, but in my career has been majority foreign grads)

 

[allantois]

We aren't even doing that well in life-expectancy as a country. Are other counties in the West experiencing the same issues? Germany has a lot more seniors (%) than us.

Emigrating From the U.S. May Be the Only Way To Afford Eldercare

A nursing home for my mother in Germany would cost less than half of what she pays in Sacramento.

inthesetimes.com

 

[allantois]

The ER is probably the only private institution in the country where the less money you have, the more you feel entitled to.

We can't have universal healthcare in this country until we fix our primary care and social services sectors.

Universal healthcare without fixing the above will just drive an already teetering ER system to a halt.

What does fixing primary care even mean? For one, universal healthcare will help with shuffling patients where they really need to be (PCP and specialist offices) as opposed to the ED.

 

[Rekt]

What does fixing primary care even mean? For one, universal healthcare will help with shuffling patients where they really need to be (PCP and specialist offices) as opposed to the ED.

You’d have to be delusional to think that people would go to their PCP/specialist. They’re already weeks to months booked out. ED volume would explode in “I need it now” medicine and it would be mass chaos.

 

[thegenius]

What does fixing primary care even mean? For one, universal healthcare will help with shuffling patients where they really need to be (PCP and specialist offices) as opposed to the ED.

No it won't. Universal (free) health care will just promote more medical care usage, clogging up PCP and specialist offices more so than even now. That combined with rationing will just send millions more people into the ED demanding to get their ears cleaned, joints replaced, and their chronic pain permanently alleviated.

Primary care almost never manages acute problems anymore. It's too much work for them to order blood tests and imaging, and then spend hours on the phone with insurance companies who deny them payment or authorization. And when authorized it takes 2-8 weeks to actually get the CT or MRI.

 

[Brigade4Radiant]

No it won't. Universal (free) health care will just promote more medical care usage, clogging up PCP and specialist offices more so than even now. That combined with rationing will just send millions more people into the ED demanding to get their ears cleaned, joints replaced, and their chronic pain permanently alleviated.

Primary care almost never manages acute problems anymore. It's too much work for them to order blood tests and imaging, and then spend hours on the phone with insurance companies who deny them payment or authorization. And when authorized it takes 2-8 weeks to actually get the CT or MRI.

Yeah u til you see what pcp deals with you know why they tell you to go to the ER. They won’t incise or drain an abscess some have to deal with constant mychart messages and calls about imaging and blood work.

 

[RustedFox]

Yeah u til you see what pcp deals with you know why they tell you to go to the ER. They won’t incise or drain an abscess some have to deal with constant mychart messages and calls about imaging and blood work.

Yeah, I don't begrudge the PCPs their job.
If only they could be freed up to do the medicine.

 

[doctalaughs]

Yeah u til you see what pcp deals with you know why they tell you to go to the ER. They won’t incise or drain an abscess some have to deal with constant mychart messages and calls about imaging and blood work.

The lawyers have it right. You want them to use their valuable time to review your email message for 15 minutes? No problem- 500 an hour so that’ll be $125.

I’m not sure why we think in healthcare that it’s a good idea to provide more and more “free” stuff like unlimited messages and calls that needs a free response…. More “free” services lead to more demand…. for free services….not rocket science. Same thing for Medicaid 2 dollar copays.

 

[Brigade4Radiant]

The lawyers have it right. You want them to use their valuable time to review your email message for 15 minutes? No problem- 500 an hour so that’ll be $125.

I’m not sure why we think in healthcare that it’s a good idea to provide more and more “free” stuff like unlimited messages and calls that needs a free response…. More “free” services lead to more demand…. for free services….not rocket science. Same thing for Medicaid 2 dollar copays.

Yeah Mayo has it right by charging for mycharts. I would only do mycharts if I did direct primary care

 

[thegenius]

The lawyers have it right. You want them to use their valuable time to review your email message for 15 minutes? No problem- 500 an hour so that’ll be $125.

I’m not sure why we think in healthcare that it’s a good idea to provide more and more “free” stuff like unlimited messages and calls that needs a free response…. More “free” services lead to more demand…. for free services….not rocket science. Same thing for Medicaid 2 dollar copays.

Medicaid 2 dollar copays in Utah didn't work as I'm sure you eluded to.
Healthcare shouldn't be free at all. Under a payment model there would be a few who would get screwed who were born with or have chronic debilitating problems. Life sucks, life is hard.

Ultimately what's really sad is we actually have the money to help people in the US. Everyone. We just spend it on those who deny health care to others. Such a sick system. So sick

 

[JacobMcCandles]

The lawyers have it right. You want them to use their valuable time to review your email message for 15 minutes? No problem- 500 an hour so that’ll be $125.

I’m not sure why we think in healthcare that it’s a good idea to provide more and more “free” stuff like unlimited messages and calls that needs a free response…. More “free” services lead to more demand…. for free services….not rocket science. Same thing for Medicaid 2 dollar copays.

The only people that think it’s a good idea are the people it doesn’t affect.

 

[Brigade4Radiant]

If we have healthcare that has no upfront cost like Canada we will have to change the populations behavior no second opinion and less testing

In some provinces in Canada it’s illegal to go to a private clinic or pay out of pocket. It will be like the VA so ERs will be excempt from EMTALA violations

 

[RustedFox]

When you make something "free", demand becomes infinite.

Basic economics question:

"If you could have as much gasoline as you wanted, without limit... how much would you want?"

There's only one correct answer.

All of it.

 

[doctalaughs]

Medicaid 2 dollar copays in Utah didn't work as I'm sure you eluded to.
Healthcare shouldn't be free at all. Under a payment model there would be a few who would get screwed who were born with or have chronic debilitating problems. Life sucks, life is hard.

Ultimately what's really sad is we actually have the money to help people in the US. Everyone. We just spend it on those who deny health care to others. Such a sick system. So sick

Agree. Utah isn’t the only place that tried 2 dollar copays.

We need to totally scrap the whole system and start from scratch. With someone with a brain and no lobbying influence creating the system.

Of course that will never happen.

 

[allantois]

If we have healthcare that has no upfront cost like Canada we will have to change the populations behavior no second opinion and less testing

In some provinces in Canada it’s illegal to go to a private clinic or pay out of pocket. It will be like the VA so ERs will be excempt from EMTALA violations

We should start with med mal reform as that's where these things stem from. People in other countries don't win a lottery through med mal

 

[thegenius]

If we have healthcare that has no upfront cost like Canada we will have to change the populations behavior no second opinion and less testing

In some provinces in Canada it’s illegal to go to a private clinic or pay out of pocket. It will be like the VA so ERs will be excempt from EMTALA violations

The chance of that happening in the US is about as high as a person winning the lotto.

 

[thegenius]

When you make something "free", demand becomes infinite.

Basic economics question:

"If you could have as much gasoline as you wanted, without limit... how much would you want?"

There's only one correct answer.

All of it.

It is true if you offered free gut punches to those who want it, you would probably end up with a broken hand. Imagine if the following were free:
- Bags of very small rocks
- Eggs
- Xbox / Nintendo / PS
- Spit
- Fingernail shavings
- buckets of stinging beetles

 

[xaelia]

Bros.

I work in a land of free healthcare. You can make it function. So-called "infinite demand" does not emerge.

It does means a culture of limits the U.S. may not be willing to accept.

Amusingly, many Americans already directly experience limits on the healthcare they receive whether Medicare criteria, pre-authorization, Medicaid, etc. – but remain staunchly opposed to universal care and its explicit limits.

 

[Boatswain2PA]

Healthcare must be, and forever will be, rationed.

We can ration it by who can pay for it. We can ration it by insurance company authorizations and declines. We can ration it by inconvenience (The Doctor will see you in 7 months). We can ration it by government regulations (death panels). We can ration it by AI. Or we can ration it by a mix of the above.

Once the polis understands that we can start having the discussion of how we want to do ration care.

But we do, and we will, ration care.

 

[Tipsy McStagger]

It does means a culture of limits the U.S. may not be willing to accept.

I believe this is the crux of our problem. American culture is so accustomed to the have it your way, customer is always right, instant oatmeal, drive through satisfaction that it has created a belief that we're basically entitled to what we want and when we want it. Advertising over the past 60 years has reinforced this.

Outside of Madison avenue however, the promise is not delivered upon, but everybody still believes in it. Like i said before, this is all a cultural problem. We in the USA are the problem. It will take a massive paradigm shift to alter the course we're on now. I honestly don't know that as a society we have it in us.

What we really need is for the power to go out in the world for like 5 good years. Get back to the basics, let people who are needlessly kept alive by machines pass away, lose social media, 24 hour news networks, talking heads... The people who survive are those who have a skillset. A culture built on mutual support, respect and perspective is born. If I were a supervillain, that'd be my plot.

 

[VA Hopeful Dr]

You’d have to be delusional to think that people would go to their PCP/specialist. They’re already weeks to months booked out. ED volume would explode in “I need it now” medicine and it would be mass chaos.

That's step 1 to fixing primary care.

 

[TooMuchResearch]

Agree. Utah isn’t the only place that tried 2 dollar copays.

We need to totally scrap the whole system and start from scratch. With someone with a brain and no lobbying influence creating the system.

Of course that will never happen.

Every empire gets a chance to start over.

 

[BoardingDoc]

If I were a supervillain, that'd be my plot.

#Thanosdidnothingwrong

 

[DocEspana]

Are you guys actually discharging the weak, old gomers that can’t walk and need SNF? If they physically cannot walk I’m normally just stuck admitting them regardless of any other reasons or context.

Oh I discharge them whenever I can get safe discharge care. Which is a 60-40 situation. This relies on me usually intimidating a family member to do so. Nursing homes down here are ruthless and will hung up the phone on you if you try to send them back and they dont want them. "We don't have sufficient resources" is their go-to statement, even if they are a full medicare accredited nursing home. The patient themself is usually easy to convince that we simply *cannot* keep them. Family members are hard, but you can twist there arm and threaten a DCF complaint. Nursing homes are basically honey badgers (they don't care, they fully DNGAF) and will laugh when you tell them you're filing a complaint against their facility. I had one tell me, on a recorded line "if you bring that patient here they will find the doors are locked, no one will open the door, and they will just sleep outside until the day shift gets here and sends them back to your hospital dehydrated and STILL needing to be admitted. Feel free to file your complaint, we will just change our name and reopen."

BTW I did file the complaint. Nursing home association (its something under CMS but i forget their acronym) called me to confirm an investigation and then like 4 weeks later that they were 'shutting the place down.'

'shutting it down' happened on a Friday. Social work incidentally told me they had a horrible weekend because they couldnt transfer to that nursing home all weekend "because of some credentialing issue". and it "reopened" as a new legal entity with a slightly different name but with 100% identical staff on monday. I'll be damned, that nurse was 100% correct about what would happen.

 

[DocEspana]

I believe this is the crux of our problem. American culture is so accustomed to the have it your way, customer is always right,....

fun fact: the full phrase is "the customer is always right in matters of taste." AKA, they can definitely be objectively wrong, but if they want to buy your product don't get in their way - just accept their money. Doesn't give them free reign to dictate anything to you except what they want to spend money on.

Which I still don't like because of my customers asking for non-indicated tests and throwing fits over it- but its better than the stupid wrong way most people use it.

 

[Vandalia]

Wait really? Educate me on this por favor.

It is really complicated.

There are some circumstances where it can be worth it. However, depending on your financial situation, you may be better off protecting your assets from Medicaid, or just investing the premiums.

I wrote a long answer, but not surprisingly "White Coat Investor" has a better analysis.

Long Term Care Insurance

 

[DrDrummer]

What we really need is for the power to go out in the world for like 5 good years. Get back to the basics, let people who are needlessly kept alive by machines pass away, lose social media, 24 hour news networks, talking heads... The people who survive are those who have a skillset. A culture built on mutual support, respect and perspective is born. If I were a supervillain, that'd be my plot.

I read a book like this recently after one of my co-workers recommended it. It wasn't *good* but it did make for an interesting thought experiment about what would actually happen. It was called One Second After by William R. Forstchen.

I would describe it as prepper porn with a healthy dose of "sheepdog" vibes in which the author inserts an idealized version of himself as the main character, so you can get a sense from that of what I thought of the book as a whole, but if you want to read a description of this scenario that actually has a fairly realistic medical subplot (e.g. everyone with a stent starts having MIs after they run out of their DAPT, the diabetics all go into DKA after insulin runs out, GOMERs don't make it very long and your friendly local ER doctor be a useful addition to town so would be allowed to come through your barricades), it's at least readable.

 

[thegenius]

I believe this is the crux of our problem. American culture is so accustomed to the have it your way, customer is always right, instant oatmeal, drive through satisfaction that it has created a belief that we're basically entitled to what we want and when we want it. Advertising over the past 60 years has reinforced this.

Outside of Madison avenue however, the promise is not delivered upon, but everybody still believes in it. Like i said before, this is all a cultural problem. We in the USA are the problem. It will take a massive paradigm shift to alter the course we're on now. I honestly don't know that as a society we have it in us.

What we really need is for the power to go out in the world for like 5 good years. Get back to the basics, let people who are needlessly kept alive by machines pass away, lose social media, 24 hour news networks, talking heads... The people who survive are those who have a skillset. A culture built on mutual support, respect and perspective is born. If I were a supervillain, that'd be my plot.

Interesting plot. About 100 frequent flyers in my ED would be gonzo in about 1 week.

 

[thegenius]

Oh I discharge them whenever I can get safe discharge care. Which is a 60-40 situation. This relies on me usually intimidating a family member to do so. Nursing homes down here are ruthless and will hung up the phone on you if you try to send them back and they dont want them. "We don't have sufficient resources" is their go-to statement, even if they are a full medicare accredited nursing home. The patient themself is usually easy to convince that we simply *cannot* keep them. Family members are hard, but you can twist there arm and threaten a DCF complaint. Nursing homes are basically honey badgers (they don't care, they fully DNGAF) and will laugh when you tell them you're filing a complaint against their facility. I had one tell me, on a recorded line "if you bring that patient here they will find the doors are locked, no one will open the door, and they will just sleep outside until the day shift gets here and sends them back to your hospital dehydrated and STILL needing to be admitted. Feel free to file your complaint, we will just change our name and reopen."

BTW I did file the complaint. Nursing home association (its something under CMS but i forget their acronym) called me to confirm an investigation and then like 4 weeks later that they were 'shutting the place down.'

'shutting it down' happened on a Friday. Social work incidentally told me they had a horrible weekend because they couldnt transfer to that nursing home all weekend "because of some credentialing issue". and it "reopened" as a new legal entity with a slightly different name but with 100% identical staff on monday. I'll be damned, that nurse was 100% correct about what would happen.

What state is this?
What exactly does DCF stand for? Department ....

 

[RustedFox]

Oh I discharge them whenever I can get safe discharge care. Which is a 60-40 situation. This relies on me usually intimidating a family member to do so. Nursing homes down here are ruthless and will hung up the phone on you if you try to send them back and they dont want them. "We don't have sufficient resources" is their go-to statement, even if they are a full medicare accredited nursing home. The patient themself is usually easy to convince that we simply *cannot* keep them. Family members are hard, but you can twist there arm and threaten a DCF complaint. Nursing homes are basically honey badgers (they don't care, they fully DNGAF) and will laugh when you tell them you're filing a complaint against their facility. I had one tell me, on a recorded line "if you bring that patient here they will find the doors are locked, no one will open the door, and they will just sleep outside until the day shift gets here and sends them back to your hospital dehydrated and STILL needing to be admitted. Feel free to file your complaint, we will just change our name and reopen."

BTW I did file the complaint. Nursing home association (its something under CMS but i forget their acronym) called me to confirm an investigation and then like 4 weeks later that they were 'shutting the place down.'

'shutting it down' happened on a Friday. Social work incidentally told me they had a horrible weekend because they couldnt transfer to that nursing home all weekend "because of some credentialing issue". and it "reopened" as a new legal entity with a slightly different name but with 100% identical staff on monday. I'll be damned, that nurse was 100% correct about what would happen.

Where was that post where you first said you were filing a complaint?

 

[DocEspana]

What state is this?
What exactly does DCF stand for? Department ....

Department of children and families. Basically they cover elder abuse for the state of Florida.

 

[DocEspana]

Where was that post where you first said you were filing a complaint?

Oh **** if I know. But you're right, I did post about it before.

 

[Ceke2002]

Bros.

I work in a land of free healthcare. You can make it function. So-called "infinite demand" does not emerge.

It does means a culture of limits the U.S. may not be willing to accept.

Amusingly, many Americans already directly experience limits on the healthcare they receive whether Medicare criteria, pre-authorization, Medicaid, etc. – but remain staunchly opposed to universal care and its explicit limits.

I live in a country with universal healthcare (actually a dual system with universal healthcare alongside a private system) and I've rarely been in a medical setting where I've seen people being genuinely entitled and demanding for no other reason than "I don't have to pay, so gimme". Of course if you're in the ED you'll always get those folks that start getting shirty if they've been waiting a long time, or the frequent flyers that are there for other reasons deciding to throw a fit, but the only time I've ever seen people basically waltz in and demand to be seated, oops I mean demand to be seen in 5 seconds flat were folks who pulled the "I pay good money for my private health insurance, so you will see me right now" song and dance routine.

The main way I, and most other people I know, utilise a universal healthcare system is with stuff like making sure we get regular health checks, and visiting a GP when we're unwell. Not having to pay out of pocket, or at least not having to put ourselves in financial strife to get healthcare does mean we're probably more likely to go to the Doctor when we need, but I don't think that's the same as demanding everything including the kitchen sink just because we don't have to pay for it upfront.

I think for me one of the perfect example between attitudes towards healthcare here (Australia) and the US came when I was diagnosed with marginal zone lymphoma last year (thanks to those regular health checks I mentioned prior). The cancer was staged at 4a, so not currently symptomatic, don't need treatment at this time & I'm under a 'watch and wait' protocol. The only section of my friend group who were aghast at the 'no treatment necessary at this time' deal, and who emailed and messaged to let me know that wasn't good enough, and I should start kicking up a giant fuss and demanding treatment, were some of my American friends. And yes some of them did suggest that the fact I wouldn't have to pay out pocket should mean there was nothing to stop me demanding everything be done right this very second, and it was like, "Okay, but why would I do that when it's not medically indicated?" They honestly just didn't seem to grasp (at least not without a lot of explaining and reassurances) that I would hear the word 'cancer', hear the words, 'treatment not needed at this stage', and then just be accepting of that.

 

[DocEspana]

I live in a country with universal healthcare (actually a dual system with universal healthcare alongside a private system) and I've rarely been in a medical setting where I've seen people being genuinely entitled and demanding for no other reason than "I don't have to pay, so gimme". Of course if you're in the ED you'll always get those folks that start getting shirty if they've been waiting a long time, or the frequent flyers that are there for other reasons deciding to throw a fit, but the only time I've ever seen people basically waltz in and demand to be seated, oops I mean demand to be seen in 5 seconds flat were folks who pulled the "I pay good money for my private health insurance, so you will see me right now" song and dance routine.

The main way I, and most other people I know, utilise a universal healthcare system is with stuff like making sure we get regular health checks, and visiting a GP when we're unwell. Not having to pay out of pocket, or at least not having to put ourselves in financial strife to get healthcare does mean we're probably more likely to go to the Doctor when we need, but I don't think that's the same as demanding everything including the kitchen sink just because we don't have to pay for it upfront.

I think for me one of the perfect example between attitudes towards healthcare here (Australia) and the US came when I was diagnosed with marginal zone lymphoma last year (thanks to those regular health checks I mentioned prior). The cancer was staged at 4a, so not currently symptomatic, don't need treatment at this time & I'm under a 'watch and wait' protocol. The only section of my friend group who were aghast at the 'no treatment necessary at this time' deal, and who emailed and messaged to let me know that wasn't good enough, and I should start kicking up a giant fuss and demanding treatment, were some of my American friends. And yes some of them did suggest that the fact I wouldn't have to pay out pocket should mean there was nothing to stop me demanding everything be done right this very second, and it was like, "Okay, but why would I do that when it's not medically indicated?" They honestly just didn't seem to grasp (at least not without a lot of explaining and reassurances) that I would hear the word 'cancer', hear the words, 'treatment not needed at this stage', and then just be accepting of that.

I think my patients are just entitled at baseline.

Well to do and have insurance? "I am paying damn good money to get whatever test I damn well please."
Well to do and uninsured? "What does it matter what it costs. I'm just going to contest the bill and knock 40-50% off the top, so its not a big deal."
Poor and insurance? "No. Its okay. I have insurance, they'll cover it." me: not necessarily "I mean, just do it anyway."
Poor and no insurance? "Doc. Listen. I ain got no credit card. I have no use for a car. I don't have a house to take, I live with my parents. What is your hospital going to do? send me a bill? I'll throw it in the garbage. Threaten my credit? I don't give a **** about my credit score. You see doc, you're going to run the test because - for me - you are free-ninety-nine. I aint visiting a primary doctor, because he wants cash up front. You are my primary doctor now, and everything you do is totally free for me."

That last one is an actual quote. Its seared in my memory.

 

[Ceke2002]

I think my patients are just entitled at baseline.

Well to do and have insurance? "I am paying damn good money to get whatever test I damn well please."
Well to do and uninsured? "What does it matter what it costs. I'm just going to contest the bill and knock 40-50% off the top, so its not a big deal."
Poor and insurance? "No. Its okay. I have insurance, they'll cover it." me: not necessarily "I mean, just do it anyway."
Poor and no insurance? "Doc. Listen. I ain got no credit card. I have no use for a car. I don't have a house to take, I live with my parents. What is your hospital going to do? send me a bill? I'll throw it in the garbage. Threaten my credit? I don't give a **** about my credit score. You see doc, you're going to run the test because - for me - you are free-ninety-nine. I aint visiting a primary doctor, because he wants cash up front. You are my primary doctor now, and everything you do is totally free for me."

That last one is an actual quote. Its seared in my memory.

That is appalling.

I don't know really know what the exact difference is here, maybe because we pay for our healthcare system collectively rather than individually, or maybe because most of us are grateful for the healthcare system we have. Regardless there's absolutely no excuse for anyone to speak to a Doctor, who's just trying to do their job well, like those patients have spoken to you.

 

[RustedFox]

Oh **** if I know. But you're right, I did post about it before.

Oh, yes. I wanted to read it again. It was a great post.

 

[DocEspana]

Oh, yes. I wanted to read it again. It was a great post.

So it took about 2 months for the state of Florida to get back to me to state that they were going to look into it. And of course about 2 weeks later they tell me they don't have any evidence that any of this occurred. But since we have a recorded call of it and I specifically knew that it was going to come up, I had the recorded call pulled and held by our department secretary. So I referred at this state agent too our secretary. Literally another month goes by and then I get a phone call that they are going to take action and close down the center.

And then as my post above stated, it seemed to have only prevented them from taking on new patients for one weekend before they changed legal identity and continued business as usual.

 

[Ceke2002]

We aren't even doing that well in life-expectancy as a country. Are other counties in the West experiencing the same issues? Germany has a lot more seniors (%) than us.

Emigrating From the U.S. May Be the Only Way To Afford Eldercare

A nursing home for my mother in Germany would cost less than half of what she pays in Sacramento.

inthesetimes.com

In terms of life expectancy alone The World Bank Group places Australia as 6th in the world with an average life expectancy of 83.20 (the US ranks at 55 with an average life expectancy of 77.28). Not sure how the pandemic will affect average life expectancy going forward, but we do seem to have a fairly good record in terms of people not just living longer, but living healthier. Before I toot my countries own horn too loudly though, we do have some major issues with our elderly care when its needed, and we had a Royal Commission into the issue (things have to be pretty bad to have a Royal Commission). I was lucky that I did manage to get my Mum into an excellent care facility, but not everyone has had that experience. Having said that things are starting to improve, slowly, and we are seeing a gradual increase in quality of care delivered overall.

 

[Ceke2002]

You’d have to be delusional to think that people would go to their PCP/specialist. They’re already weeks to months booked out. ED volume would explode in “I need it now” medicine and it would be mass chaos.

Wait, what?! Are you serious? Like that wasn't hyperbole? If so then I gotta ask what sort of half ar5ed, dodgy brothers system have you guys got over there?

Just wow, yeah, sorry I'm absolutely blown away by that. I mean weeks to months to get an appointment with a Primary Care Physician even, I cannot even begin to fathom that.

No wonder all the debris ends up washing into your Emergency Departments.

 

[RustedFox]

Wait, what?! Are you serious? Like that wasn't hyperbole? If so then I gotta ask what sort of half ar5ed, dodgy brothers system have you guys got over there?

Just wow, yeah, sorry I'm absolutely blown away by that. I mean weeks to months to get an appointment with a Primary Care Physician even, I cannot even begin to fathom that.

No wonder all the debris ends up washing into your Emergency Departments.

Bro. He's totally serious. It's months to see a PCP.

 

[deleted206819]

You mean the PCPs finally started seeing sick patients again instead of turfing them to the ED because they have cold- like symptoms and may have COVID?

We get multiple turfs to our small facility from the larger non-profithealth system’s physician group PCPs all the time. It’s getting to be comical.

 

[Rekt]

Wait, what?! Are you serious? Like that wasn't hyperbole? If so then I gotta ask what sort of half ar5ed, dodgy brothers system have you guys got over there?

Just wow, yeah, sorry I'm absolutely blown away by that. I mean weeks to months to get an appointment with a Primary Care Physician even, I cannot even begin to fathom that.

No wonder all the debris ends up washing into your Emergency Departments.

Going to be regional. Maybe in a rural rural area you can slide in next week.

In my area it’s about 3-4 months for neuro or GI. 3 months for any actual psychiatrist that’s not some fake nurse. We seem real saturated on cards. Can get an appointment in 2-3 weeks but they still do useless stress testing and stress is booked out 3-4 months. Some are using ccta but that’s even worse.

Once I moved here I tried to find a pcp. The top 5 recommended to me are 3-5 months for a new patient unless I wanted to see the mid level.

@VA Hopeful Dr can speak more accurately

 

[Arcan57]

Going to be regional. Maybe in a rural rural area you can slide in next week.

In my area it’s about 3-4 months for neuro or GI. 3 months for any actual psychiatrist that’s not some fake nurse. We seem real saturated on cards. Can get an appointment in 2-3 weeks but they still do useless stress testing and stress is booked out 3-4 months. Some are using ccta but that’s even worse.

Once I moved here I tried to find a pcp. The top 5 recommended to me are 3-5 months for a new patient unless I wanted to see the mid level.

@VA Hopeful Dr can speak more accurately

VA here is taking 3-6 months to get new patients who've enrolled with a PCP in to be seen. Many of the PCP teams are headed by NPPs. Ortho is 2-3 weeks out for acute fractures, 6-9 months for routine visits. Routine (non-STAT) imaging takes 3-6 months to be performed.

On the private side, with good insurance, it took me 2 months to see a PCP with most PCPs no longer accepting new patients. Specialty services are hit or miss, derm takes months to get an appointment, I can see ortho next day.

 

[BoardingDoc]

VA here is taking 3-6 months to get new patients who've enrolled with a PCP in to be seen. Many of the PCP teams are headed by NPPs. Ortho is 2-3 weeks out for acute fractures, 6-9 months for routine visits. Routine (non-STAT) imaging takes 3-6 months to be performed.

On the private side, with good insurance, it took me 2 months to see a PCP with most PCPs no longer accepting new patients. Specialty services are hit or miss, derm takes months to get an appointment, I can see ortho next day.

Yeah, weird regional differences.
PCP: Months
Ortho: Maybe 6 weeks.
Derm: 2 weeks.

My numbers are also as someone with good insurance.