The problem is MBA administrators looking at their little accounting tables and deciding that not letting patients actually see a doctor is their purpose in life, just so they can pay everyone at a hospital as little as possible. This of course leads to global cost blowups and worse care.

Of course, by now there is no turning back, and the government has decided that actually training doctors must be prevented at all costs.

VERY short term vision, constantly sacrificing the future for a quick buck, leads over the span of decades, to spiraling costs and worse outcomes. Who knew ? Well, everybody knew.

I'm talking about teachers with master's degrees and MD doctors, which means many years of education. We've made it standard to have access to these people (unless you have a scratch???) but it's not a panacea. Just got word that my father is seeing the same doctor that has fucked up his care multiple times, not out of creativity or being too smart but because of not guessing the simplest and most common explanation of common symptoms. I'm very angry, but can't convince my father to move out of the home & town I grew up in so he doesn't have to deal with this incompetence.

If you live in a town where smart and educated people like to live, you get the cream of the crop of doctors. It's very different from living in a backwater where ambitious young people aspire not to live. And most of the world lives in backwaters, with unexceptional doctors who make simple but deadly mistakes when they go off script.

To add to this anecdote, I lived in the suburbs of a major city for quite some time. My primary care doctor's practice was in the city at a prestigious hospital.

The care I received at that hospital was a night and day difference compared to what I received in the suburbs.

My favorite experience was the time I was very sick, went to a doctor in the suburbs and was told I was absolutely fine, despite the coughing, difficulty breathing, looking like I was dying, chest pain and X-ray results. I was sent on my way without even a script for antibiotics.

The next day, I went to see my PCP who demanded the names of the doctors responsible for letting a patient with severe pneumonia leave their care without proper treatment. Said if I waited another day, I'd have to be hospitalized.

Your father's town's hospital only has 1 doctor? HN is pretty American-centric but I'm curious if that's in what is considered a developed nation?

I don't know for sure, but probably he means the primary care physician, not a hospital team.

Maybe at some hospitals but not mine. I have tried scheduling for example sleep apnea tests at my hospital and I have go through a doctor. I had a second one with in a year and they required me to still see a doctor for some reason. No exceptions. You would think a test like this wouldn't require an initial visit, an actual overnight stay and a follow up reading of the results with the doctor but it does.