Got an appointment in less than a day. The nurse practitioner probably gave me a more thorough look over (absent labs) than my primary care would have. Gave me an inhaler prescription probably as much to do something other than tell me to just continue the OTC medication I was already taking.
Sure, in an ideal world, we'd probably have a next-day MD appointment for everyone. But there's a ton of stuff when an ER or physician isn't really called for.
I'm not a hypochondriac and maybe in a pre-COVID world I'd just have assumed I was "fine" but having a second opinion seemed warranted given the option.
I've also been in an ER when the diagnosis from an infectious disease specialist (after some really bad lab work and high fever) was basically go home, rest, and drink plenty of fluids when his assessment (of a fairly serious tropical disease) took a month to be confirmed from a lab in Paris.
So we just basically self-diagnose and assume it will all just get better?
In one case, it would have been pretty ridiculous for me to have gone to the ER given that I didn't otherwise have COVID or other serious symptoms.
In the other case, in spite of a pretty high fever, I'm quite confident that had I gone into the local rural ER at the time they would have had zero idea about the tropical disease I had and, even after I got home with a fairly persistent mild fever, my very experienced primary care MD just knew that my blood work looked bad and it took an on-call infectious disease specialist to know what was going on.
You're not always going to have an expert specialist available.
Not that it mattered in either case because there wasn't really anything they could do other than let my body do its thing.
And France places an ER doctor in emergency response ambulances - apparently that has value (and they sometimes park themselves while the doctor works to stabilize the patient rather than try to bounce around to the ER.)
Same for France and urgent care. If the phone screen goes in the right direction, a doctor driving around from patient to patient will get to you quickly (~ 20 minutes last time for me.) Even if you don't have local insurance, and for a surprisingly low price.
None of this is impossible - as the US med professions want you to believe.
NP: "if it gets worse go to the ER" Thanks...I guess.
One thing you plausibly could do is attempt medical tourism, if nothing else, your perspective will improve.
Blood count tests used to be done by people actually counting cells. Now, it's all machines, likely even in a very poor countries.
Please don't add racial and gender resentments into an already bad problem.
Neither the US nor Europe has enough medical professionals to drag arbitrary racial and gender demands into the mix.
And without old doctors in general being willing to work even though they could enjoy their retirement, many places in Europe would have no healthcare left. Which doesn't bode well for 2040 or 2050.
But when you have to choose between a overworked and exhausted doctor, who gives you 10 seconds of slight attention, then I might choose the AI, mixed with my own judgement.
Anyway, why not more of both? Better AI tools and more doctors?
Much of the medical field is like this unfortunately, it's not just doctors. Take for example this article about Duke's Nursing School and racism: https://archive.is/DIJ98. From what I've heard through third-party, corruption at Duke is at an all-time high. This is just the stuff we hear about too, so I'm sure these problems affect all of the top-tier colleges that nobody reports so they don't get ejected from these programs.
So baseline if you're smart and hard working, you need to take the hardest college track from ages 18-22, medical school (22-26). Then work two jobs worth of hours as a trainee making well under 100k starting at age 27 and into your early 30s [3] so you can't save or pay down any of your debt from getting here.
So if you choose to be a doctor, you have to: (a) dedicate to working your ass off at 18, (b) keep at it until you're in your early 30s, (c) start with massive debt
I think it's actually pretty amazing that we have as many doctors as we do.
[1] https://medschoolinsiders.com/medical-student/how-long-is-re... [2] https://www.ama-assn.org/medical-students/preparing-residenc... [3] https://www.inspiraadvantage.com/blog/how-much-do-medical-re...
Why not just expand the amount of spots and train more doctors? Surely they don't take everyone that applies and then filter them out (even CS doesn't do that).
In my opinion though, I can't see why the number of doctors should be something that is principally controlled by congress at all, and ideally some other method should come about.
Until that happens though, it's up to Congress to fix this.
Looking around the world, it seems to me that most developed countries (if not all) suffer from the same problem of lack of doctors. Some mask it by pulling doctors from poorer countries (including poorer developed countries), but it seems like there's a lack of doctors everywhere. If that's the case then Congress can't really be the only limiting factor.
Why are there no developed countries that have far too many doctors? The only countries that I can think of that export doctors are Cuba and third world countries.
Unfortunately most people taking notice of how broken the system is end up get fixated on the large figures on those fraudulent bills, and think single payer can do something to fix at least part of the system. But systematically, at best single payer would be tying the garbage bag off for tidy disposal, when what we actually need is for the sheer majority of medical care to have a functioning market that allows for patient agency.
The artificial scarcity created by doctors gatekeeping is unnecessary.
For example, I successfully diagnosed my own anemia disorder (thalassemia) this way. It's a simple test. I paid for it. The results are unequivocal. We can now stop giving me iron, thank you very much.
1: https://www.npr.org/sections/health-shots/2022/06/13/1104141...
We can learn new domains, assess risk, and evaluate trade-offs.
This is our health. Self-research is love. It's advocating on your behalf.
That is completely meaningless in this context.
And much of that time will need to be during weekdays during work hours, over multiple week days probably, and with so many unknowns about how much time it’ll actually take. I dunno how people without semi-flexible white collar work situations do anything with the healthcare system at all. I guess they either don’t, or they just have no vacation time left for actual vacation, ever. Especially if they have kids they need to guide through the same time-wasting bullshit.
Interacting with doctors takes me like 45-60 minutes for every five minutes of doctor time, at best. It’s fucking miserable. That’s the actual main benefit of things like telehealth, at least I can get a referral spending only 2-3x as much of my own time’s as the doctor’s, and all I have to do is give up all the benefits of having an actual family doctor who knows my history and also a good chance of just being told to see a GP anyway.
Insurance company, starry-eyed: “You mean they can’t make many claims and we keep all the money?”
Employer, salivating: “and they won’t be able to take leave for more than a few hours at a time?!”
They want you to use the insurance, so they can raise premiums and that % profit they're allowed to have is a larger absolute dollar amount.
Yes, we’ll get you scheduled for that initial consult in a couple weeks, then a few weeks after that we can probably get you a test appointment, then a follow-up consultation a few weeks later. We might have to repeat that cycle a few times to get all the tests. The epitome of speedy treatment (/s)—but only if you’re an existing patient. If you’re a new patient, then bump that up a few months.