The US one I presume? Says who? Based on what metric? We can, and other countries have, do much better.
That this parent "is “exhausted” by years spent campaigning to get doctors to take the illnesses seriously" doesn't say much.
It's not like she had to go the public health system and didn't have the option to go on "individual doctors for primary care" if she could afford it (in fact it would have been way more affordable than in the US).
She campaigned to spread awareness for the cause, not for them to treat her own special case.
Second, the average person would be much more exhausted when chacing their own (or kid's) treatment trying to afford hellishly expensive treatment in the US, sacrificing their kids college fund or their own pension (or even ending in bankruptcy (CNBC: "Two-thirds of people who file for bankruptcy say medical bills or other issues related to illness contributed to their financial downfall").
I had my pick of three ortholaryngologists today (all of them less than ideal according to reviews, but they were there).
I presume that's only when you want your expenses covered. If you pay with your own money/private insurance you can see whoever you want, no?
The article is about UK doctors not recognizing PANDAS as a real illness.
They even quote one doctor who refused to treat "an American illness".
The US NIH has a page on PANDAS and our (US) diagnostic and treatment recommendations here: https://www.nimh.nih.gov/health/publications/pandas
If you wanted an example of "US healthcare bad" then this is not it. The article is about UK doctors not recognizing a condition and the activities in Parliament to address the situation.
I know, I read it before commenting.
I'm not saying the article is about the US system. I'm saying the comment I responded to appeared to say that the US system is better, and how those countries with other systems like the UK have it bad.
"Doctors not recognizing X as a real illness" can happen, and has, anywhere. It's not a result of how the medical system is structured with regard to public/private, universal healthcare or not, and so on.
There is no shortage of stories from the US about doctors refusing to take some illness or condition as real that was later proven otherwise (or vise versa), dismissing patient concerns that were later proven, and so on.
Your last sentence (minus the specific country) is exactly what I was talking about. There is no shortage of stories where doctors don't get it right for a million reasons. There is room for improvement.
The idea of PANDAS from occult (aka hidden, not producing positive test results) strep infections is less proven and considered rare, although it is mentioned in official treatment recommendations such as those above.
The problem providers face is that some parents will read about PANDAS on the internet and assume it is the explanation for their child's problems, despite having negative throat culture. They jump from doctor to doctor demanding antibiotic treatment despite the negative test results, guided largely by their internet research. It's not hard to find PANDAS parent groups on Facebook or Reddit where someone can post vague symptoms and a chorus of group members will response "sounds like PANDAS".
The difficult part is that for some of these patients, PANDAS might be the right diagnosis. However, once a diagnosis becomes a cult favorite on the internet doctors get inundated with parents demanding antibiotics because their Facebook groups told them that's what their child needs.
Yes, antibiotic resistance is a concern if you start handing out antibiotics like candy, but if PANDAS is truly as rare as everyone would have you believe, then prescribing antibiotics to every kid that comes in with a PANDAS profile is not going to move the needle much with regard to global antibiotic resistance.
Alternatives:
Prescribe them anti-psychotics or some other medication to sedate them?
Likely much higher side-effects and risk profiles than antibiotics.
Send them to a therapist in hopes that the therapist can behaviorally condition that aggression away?
Bad news: talk-therapy for aggressive behavior in children has terrible outcomes. Most likely scenario in the mental health system is that they end up in an intensive group treatment setting somewhere with other aggressive children, learn more sophisticated aggressive behaviors, and gradually get worse.
On the other hand, antibiotics have a fairly low risk profile. Some pediatricians do literally hand them out like candy when kids come in with an ear infection or sore throat. Maybe stop prescribing antibiotics for those kids, tell them to try some tea tree oil or some other natural remedy, and save the antibiotics for the kids who fit a PANDAS profile instead?
That’s the big one in my experience. Functional medicine doctors are some miracle workers, but only if you can afford hundreds of dollars per visit / thousands of dollars in lab tests that insurance will never pay for.
Overall, I think this is a great, affordable first step for redefining primary care - one that makes sense for doctors and patients, but is not a replacement for specialties like Functional Medicine.
Rephrase it and it becomes the start of a solution. What should happen in a patient doctor interaction where the doctor is not able to reassure a patient that the prescribed treatment plan is the best plan.
I largely think that doctors, especially primary care doctors, are being limited/held hostage by the insurance companies and the health care corporations that they work for.
They are not reaping the profits from the care they give, and can't focus because of patient loads being way too high. As it was explained to me by my doctor, this is because of how insurance companies pay out (per visit, no matter the duration) and the places that employ doctors usually expect that they see a certain volume of patients. Most doctors have a large amount of student loan debt, and usually feel helpless to fight against it - starting a new practice is very costly.
Once you really look into how oppressive/restrictive the system is to our doctors, the issue with our health care becomes pretty clear. People can't get timely, accurate care -- they have to wait for most prescriptions (because as long as doctors take insurance, they cannot fill medications), and they are always guessing (fearing might be more apt) how much a particular medication, test, or scan will eventually cost, causing hesitancy to seek out care. And no longer do patients have to worry if their insurance company will cover XYZ medication or treatment under this model of care.
My doctors negotiated with a local lab company, and that company offers my doctor's patients pretty much any test at-cost - this is another business dealing that is restricted by insurance companies.
DPC takes all the mystery out (I pay $45 a month for this service): all common lab/scan/medication costs are up on the website (and are very reasonable/wholesale/at-cost), and I don't have to fight to get that information. I don't have to fight to get an appointment, I can text/email/etc. my doctor whenever and get a prompt response. Because he limits the amount of patients he sees this is possible.
I think if primary care was overall something like this model, but perhaps a bit more accessible (more doctors practicing this way); not only would a lot of illness be treated before it is chronic, people would be less afraid to seek care out, and hospitals and specialists would be less overloaded.
It's like that saying, "Capitalism: The worst economic system, except for all the others". Our medical system where we rely on individual doctors for primary care is really flawed but it's better than any alternatives that we have (or that we can afford anyway)