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Re:Her Various Symptoms Seemed Unrelated, Then One Doctor Pu... by ianai on Sunday February 18, 2018 @07:47AM (#16405814)
Is there a way to actually request a specific doctor have some time dedicated to figuring your case out at your expense? i.e. "Please do more troubleshooting for me above what insurance pays."

I like your idea - but I fear the industry might have already ruled it out.

-edit- Granted, I've done this in my own life by going to specialists at their own offices/outside of a hospital or medical group.

Re:Her Various Symptoms Seemed Unrelated, Then One Doctor Pu... by arkades on Sunday February 18, 2018 @07:54AM (#16405849)
Unfortunately, no. Your doctor is contractually bound to the insurer’s fee structure; they can’t take an extra penny off of you. You’d have to go to someone that doesn’t take your insurance at all (or just don’t tell them you have that insurance).

The side effect of all this, honestly, is that doctors stop learning how to turn off 7-minute-mode. When it comes to very serious problems, it pays to go to a practice that doesn’t accept insurance at all, because they never got into the bad habit to begin with.

Re:Her Various Symptoms Seemed Unrelated, Then One Doctor Pu... by Alex3917 on Sunday February 18, 2018 @11:12AM (#16406679)
> You’d have to go to someone that doesn’t take your insurance at all

There are some doctors at teaching hospitals who specialize in diagnosing rare diseases and don't take insurance for this reason.

Re:Her Various Symptoms Seemed Unrelated, Then One Doctor Pu... by jessaustin on Sunday February 18, 2018 @10:54AM (#16406593)
You're right that it's difficult for physicians to "turn it off". The contractual requirements you reference, however, are basically unenforced. The only way a physician will get "caught" charging more than agreed is if the patient calls the insurer to complain. Presumably you wouldn't do that to her after she saved your life.
Re:Her Various Symptoms Seemed Unrelated, Then One Doctor Pu... by netheril96 on Sunday February 18, 2018 @11:32AM (#16406769)
> Presumably you wouldn't do that to her after she saved your life.

Oh, you grossly underestimate what people are capable of. At least in China there are many reported cases of such horrible patients. Maybe US being a developed country have fewer these people, but definitely not zero.

Re:Her Various Symptoms Seemed Unrelated, Then One Doctor Pu... by jessaustin on Sunday February 18, 2018 @01:20PM (#16407325)
You're right of course, and this isn't limited to the Chinese. It's best to have physicians in the family; marry one if there isn't one already! This isn't practical for everyone, so perhaps it's best to choose a capable young physician early in life, so that by the time such trust is required it has already formed.

Probably there are other professions in which one gets better service if one has an inside connection, but this situation really speaks ill of how medicine is practiced.

Re:Her Various Symptoms Seemed Unrelated, Then One Doctor Pu... by arkades on Sunday February 18, 2018 @01:47PM (#16407460)
> Probably there are other professions in which one gets better service if one has an inside connection, but this situation really speaks ill of how medicine is practiced.

Having a doc in the family is a mixed blessing at best. You can get priority treatment, and the benefit of your family members full attention. On the flip side, all the docs I know that aren’t fools or morons don’t treat their own family for anything more serious than a scrape. You’re biased, you don’t want the guilt of an error, and you don’t want to be the bearer of bad news. I frequently ask my wife not to ask me about her mother’s health developments; I’d rather tell comforting lies than be a source of sour truth.

Being a VIP in a medical center due to your relatives gets you more ass kissing, not better care. People don’t want to step on toes, or give the impression that useful care is being withheld. And if your relative is a worse doc than the one you’re seeing? No one is going to overrule your family member to your face.

Re:Her Various Symptoms Seemed Unrelated, Then One Doctor Pu... by nitrogen on Sunday February 18, 2018 @02:24PM (#16407717)
The value I would see in having a physician as a close relative is in learning how to communicate effectively with other physicians. Then one could in theory need fewer visits to their own doc to get to the bottom of a problem.
Re:Her Various Symptoms Seemed Unrelated, Then One Doctor Pu... by arkades on Sunday February 18, 2018 @02:54PM (#16407970)
That’s actually a problem. When I myself see a doc, I make a point of being as colloquial about it as possible. Part of our training is about taking what people say and converting it into technical symptoms; when people start to “communicate effectively” it heavily biases us towards certain diagnoses. The more intelligent/educated the patient the more likely we are to take one of their word choices at face value.

Personally, all I ever want from a patient is a clear timeline of events, their best attempt to articulate what they felt, a list of scripts, and old medical records (especially imaging.) The patient that can give me that has made the task of helping them 1000x easier.

Re:Her Various Symptoms Seemed Unrelated, Then One Doctor Pu... by ianai on Sunday February 18, 2018 @03:43PM (#16408438)
That’s really helpful to know.
Re:Her Various Symptoms Seemed Unrelated, Then One Doctor Pu... by arkades on Sunday February 18, 2018 @11:42AM (#16406817)
> Presumably you wouldn't do that to her after she saved your life.

I wish that were so, but disease is not confined to the reasonable, the rational, the kind, the respectful, or the grateful. On the contrary, the stress of disease and it’s associated burdens (social, financial, psychological, etc) tends to diminish those qualities in even the best of us.

Harvard did a huge study on malpractice suits a while back. They found that most medical errors that caused the death of a loved one did not result in suits, and most suits did not originate from medical errors. That is to say, the good or ill you do a patient isn’t the reason they sue.

Re:Her Various Symptoms Seemed Unrelated, Then One Doctor Pu... by seanmcdirmid on Sunday February 18, 2018 @09:08AM (#16406129)
Almost makes the red envelope culture in Chinese hospitals seems appealing.
Re:Her Various Symptoms Seemed Unrelated, Then One Doctor Pu... by imron on Sunday February 18, 2018 @10:42AM (#16406521)
Not at all.

Having to slip the doc and the anaethetist a red envelope and hoping it's the enough that they'll take proper care of you is not a good system to live under.

Re:Her Various Symptoms Seemed Unrelated, Then One Doctor Pu... by erric on Sunday February 18, 2018 @10:21AM (#16406421)
https://en.wikipedia.org/wiki/Red_envelope

I’d never heard of this before.

Re:Her Various Symptoms Seemed Unrelated, Then One Doctor Pu... by jotm on Sunday February 18, 2018 @10:51AM (#16406575)
Lol, that's exactly life in Eastern Europe/ex-USSR. There's socialized medicine, but if you want better service, you have to bring a gift (whisky, chocolate, money, the latter is always desirable). Not just hand cash over, that's disrespectful nowadays.
Re:Her Various Symptoms Seemed Unrelated, Then One Doctor Pu... by linkmotif on Sunday February 18, 2018 @11:48AM (#16406852)
My grandmother was a pediatrician in Kiev in Soviet times. Her salary was about on par with anyone else, but she got tons of gifts.
Re:Her Various Symptoms Seemed Unrelated, Then One Doctor Pu... by twic on Sunday February 18, 2018 @10:43AM (#16406530)
On the situation in hospitals specifically:

https://www.seattletimes.com/opinion/the-red-envelope-capita...

Re:Her Various Symptoms Seemed Unrelated, Then One Doctor Pu... by goblins on Sunday February 18, 2018 @12:29PM (#16407081)
Glad I live in a country with a free health service.
[dead]
Re:Her Various Symptoms Seemed Unrelated, Then One Doctor Pu... by jacquesm on Sunday February 18, 2018 @01:14PM (#16407285)
Did you really link 'free healthcare' with 'a country that does not pay doctors'?

Clearly healthcare can be free to the recipients while doctors still get a good salary.

Re:Her Various Symptoms Seemed Unrelated, Then One Doctor Pu... by arkades on Sunday February 18, 2018 @01:50PM (#16407480)
Most countries with free healthcare do have woefully underpaid doctors. The NHS has been cutting back aggressively on doc salaries for years, letting them fall well behind inflation.

The only thing I can say in their defense is that at least docs in those countries don’t generally take on massive, private, un-dischargeable debt in order to do the job. In the US we treat the medical workforce as a public good, though they have to take on all the risk of entering that workforce through private financing.

Re:Her Various Symptoms Seemed Unrelated, Then One Doctor Pu... by jessaustin on Sunday February 18, 2018 @01:48PM (#16407467)
I get to drive on most roads without paying, but I wouldn't say that the roads are "free"?
Re:Her Various Symptoms Seemed Unrelated, Then One Doctor Pu... by jacquesm on Sunday February 18, 2018 @02:01PM (#16407548)
Compared to toll roads they are free...
Re:Her Various Symptoms Seemed Unrelated, Then One Doctor Pu... by jessaustin on Sunday February 18, 2018 @03:07PM (#16408113)
We've uncovered a potential ambiguity in the original phrasing of "free health service". Could the now-dead response to that comment have been highlighting this very ambiguity?
Re:Her Various Symptoms Seemed Unrelated, Then One Doctor Pu... by sowbug on Monday February 19, 2018 @12:12AM (#16410906)
Yes, I've done this. I paid an out-of-network specialist for a second opinion on a cancer treatment. My HMO ended up following that specialist's recommendation. While I likely would have survived either treatment, this one was shorter and had fewer long-term side effects. I paid for the consultation out of pocket. It was less than $1,000.

Not that outcome matters much to your question, but I have fewer scars, more original body parts, and better overall body function than I would have had with my HMO's original plan.

Re:Her Various Symptoms Seemed Unrelated, Then One Doctor Pu... by nitrogen on Sunday February 18, 2018 @02:28PM (#16407748)
Some possible search terms that might help (but I don't actually know the answer): concierge medicine, direct primary care, fee-for-service, out-of-network
Re:Her Various Symptoms Seemed Unrelated, Then One Doctor Pu... by stevenh on Sunday February 18, 2018 @11:04AM (#16406650)
Isn't this what concierge doctors offer?
Re:Her Various Symptoms Seemed Unrelated, Then One Doctor Pu... by arkades on Sunday February 18, 2018 @11:45AM (#16406835)
Some. Some push the same old practice model but with reasonably cheap prices, so they can keep their old patient base and make their income off the slightly higher billings and the reduced overhead of eliminating your billing (read: calling the insurer and arguing) staff.