The Role of Doctors in Weight Loss
Replies
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In the us free physical is federal law under obamacare. If you are being charged, they are breaking the law.This is also why the GP population is dwindling. No glory, no money, all grief. You don't need a GP for this other than to confirm you are healthy enough to start an exercise program.
There is simply too much information for one person to know - the purpose of a generalist is to point you in the right direction and assemble the data for a proper comprehensive diagnosis.
Ahree about need for a GP unless theres a serious reason and then you can put it to them. I think GPs salaries will vary enormously by country. In the UK there are often a lot of female GPs as its a job they cna do part time. Its suprisingly well paid.
Do you people in the US have to pay for every visit/ consultation?
Technically, yes. But it depends on the insurance provider. Some allow for a free physical exam every year, some do wellness visits for free. Otherwise, most insurance plans have a deductible amount where all medical costs incurred are paid by the patient, then a percentage of all medical costs is covered until an out-of-pocket limit is met, and then the insurance plan covers all costs.
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They've been phasing it in, though.0
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I just mentioned my experiences with doctors and weight on the "I've been thin and I've been fat" thread yesterday.
Basically, I gained 25 pounds in 6 weeks after giving in to violent sugar cravings when I was put on a new set of psych meds last summer. At my 6 week check-up with the psych NP, he took me off that medication. I figured my weight would trend back down after that, but I gained 5 more by December, putting me at almost 20 lbs above the top of my recommended weight range. I see my nephrologist every three months, and he didn't mention the ultra fast weight gain at all. He didn't even seem too concerned that my blood pressure was averaging higher.
I had lost about 35 lbs when I saw him last month. And I pointed it out. He actually said something along the lines of "Isn't it inappropriate to discuss a woman's weight?" Dude, you're a doctor. The top two causes of kidney failure are hypertension and diabetes. I understand not wanting anyone to *feel* bad, but that attitude is so dangerous. I told him that it's an important thing to discuss with his patients, especially if it's a dramatic weight gain! He's a great doctor, otherwise. Of course, I was his first patient when he started at this practice, and he kind of hit the jackpot getting a patient with a rare disease and 15 year old transplant who is proactive about her health.
On the other side of things, When I first got sick, I dropped about 10 lbs from the constant migraines and renal diet. I was 4 lbs under my lowest recommended weight, and they threatened hospitalization for anorexia. I was in heaven when they prescribed Ensure bars. I didn't mind being skinny, but my appetite was never the problem. By the time I had my transplant, I was the same weight, but the surgeon asked me if I had been working out when he examined my abs pre-surgery! I told him I had, because I knew I would be needing to heal from a transplant at any time within the next 5 years!
I had a minor procedure today, and percocet makes me needlessly verbose. I'm sorry if you read this all the way through and didn't get anything out of it.
Personally, I've rarely had bad or useless doctors. I've been through some bad healthcare groups in a general sense, and I had to switch some doctors around last year due to insurance problems. I even had to go without my transplant meds for an entire week because I was homeless and found housing in a different city. The ER doctor I saw wrote me a prescription for a specific brand that needed to be ordered through a lengthy mail-in process. Luckily, Walgreens (of all places) managed to solve the problem, and I was able to get in with a primary care the following week. I found my current PCP after my insurance dropped my other one. I just looked up physicians at my insurance company's website that were taking new patients, and narrowed it down from there. She's the greatest. I only see her once a year, but she takes care of my millions of referrals and I see the NP for minor stuff like shots and smears.
You know you're disabled when you talk about medical stuff like it's your profession.0 -
Vaccinations and yearly wellness exams only. After that, copays vary among insurance carriers. Here's a link on Obamacareandympanda wrote: »
In the us free physical is federal law under obamacare. If you are being charged, they are breaking the law.This is also why the GP population is dwindling. No glory, no money, all grief. You don't need a GP for this other than to confirm you are healthy enough to start an exercise program.
There is simply too much information for one person to know - the purpose of a generalist is to point you in the right direction and assemble the data for a proper comprehensive diagnosis.
Ahree about need for a GP unless theres a serious reason and then you can put it to them. I think GPs salaries will vary enormously by country. In the UK there are often a lot of female GPs as its a job they cna do part time. Its suprisingly well paid.
Do you people in the US have to pay for every visit/ consultation?
Technically, yes. But it depends on the insurance provider. Some allow for a free physical exam every year, some do wellness visits for free. Otherwise, most insurance plans have a deductible amount where all medical costs incurred are paid by the patient, then a percentage of all medical costs is covered until an out-of-pocket limit is met, and then the insurance plan covers all costs.
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I went to the doctor for a routine check-up. I got on the scales (as per routine) and he said "Well You've put on quite a lot of weight, haven't you?". I hadn't realised just how much and I was shocked. Visibly shocked. I burst in to tears. His response wasn't to sympathize and talk through some kind of plan with me, he just said "Don't eat carbs and go to the gym". Considering my medical records will show I have struggled with an eating disorder in the past, I was absolutely distraught to be told that I am pretty damm overweight and then given the most ridiculous advice ever. Totally ruined my day and I haven't been back to the doctor in over 4 months! I think these issues need to be dealt with a little more delicately..
A GOOD GP will support you and help you reach your goals - weight gain/loss is related to your HEALTH which is what they are supposed to be experts on, so if you have a good GP then take advantage of what they can offer. Unfortunately, I don't have a good GP and therefore had to start from scratch. I soon dismissed his ridiculous "Don't eat carbs" and "Just run". He was only interested in lowering my BMI. Nevermind my mental health.0 -
Vetticus_3 wrote: »http://www.sciencetimes.com/articles/7155/20150824/study-reveals-the-key-to-success-in-weight-loss.htm
Hi,
I'm just linking an article which mentions the importance of having a supportive doctor in weight loss.
This sort of hit home for me. This happened to me a couple of months ago.
I'm usually not sick. I don't visit the doctors that often (maybe once a year, if that). I do have a herniated back, which I manage with physio and pilates. Anyway, I recently moved, my back gave me some problems, and needed to get a new physio (a referral from a friend with a similar problem). To make a long story short, he was terrible, and made my back worse. From that, I decided to get a referral from the GP.
At the same as my back issues happened, my BMI crept up to 30 (the heaviest I've ever been - and this was on my really dodgy scales). The thing is, I wasn't really over eating. I don't indulge in chocolate or take out. I don't buy prepackaged food. I'm a vegetable and protein person. I thought it might be a health issue. (It turned out it's big-portion issue...
)
I had never been to this GP before - and it was a week long wait. I figured, I've never talked to a doctor about weight loss before, and thought she could help. I was expecting her to record my weight and measurements, and a blood test to check thyroid levels - maybe see the nurse or something.
What I got was a big bunch of nothing.
Not only did she not help with my back (no referral, just a suggestion that I should do pilates... which I've been doing for years)... but her advice on weight loss was that she has no problem keeping her weight down. And I was too thin to get any nutritional advice from the dietician.
I'm serious. This was all she said: She has no problem keeping her weight within a healthy BMI. How is that supposed to help me? And I was on the threshold of being obese.
No measurements.
No scales.
No advice.
I got so mad. And when I asked if this was usual (on another weight loss forum)... it happens all the time. How are people supposed to get medical help when the GPs don't do anything?
I've noticed that there is the flow chart that pops up when people don't lose weight - and after exhausting all the possibilities it suggests seeing a doctor to check for health issues. Has anyone gotten a good response when talking to their GP about these health checks?
Anyway, I got so mad I went back to CICO and then I joined this website a couple of weeks later. 6kgs down, and other 8kgs to go (on good reliable scales).
Just thought I'd share. Maybe someone has some information regarding supportive GPs when it comes to weight loss.
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tincanonastring wrote: »This is also why the GP population is dwindling. No glory, no money, all grief. You don't need a GP for this other than to confirm you are healthy enough to start an exercise program.
There is simply too much information for one person to know - the purpose of a generalist is to point you in the right direction and assemble the data for a proper comprehensive diagnosis.
Ahree about need for a GP unless theres a serious reason and then you can put it to them. I think GPs salaries will vary enormously by country. In the UK there are often a lot of female GPs as its a job they cna do part time. Its suprisingly well paid.
Do you people in the US have to pay for every visit/ consultation?
Technically, yes. But it depends on the insurance provider. Some allow for a free physical exam every year, some do wellness visits for free. Otherwise, most insurance plans have a deductible amount where all medical costs incurred are paid by the patient, then a percentage of all medical costs is covered until an out-of-pocket limit is met, and then the insurance plan covers all costs.
By law, all ACA-compliant major medical plans in the USA have to cover wellness checks (including things like immunizations) at 100%. From there, though, things can get crazy fast. I work for a company that does benefit enrollments for nationwide corporations, unions, and municipalities, so I see plans that run the gamut. Living in a society that has a for-profit health system is maddening.
Bottom line is you end up paying for every visit, whether your insurance covers it or not. In the US we are now doing "TeleDoc" to minimize cost of visit, so physicians can consult by phone or vidcon and diagnose and prescribe.0 -
I have never found help with my primary doctors either and I have been "obese" since I was young. I have asked several times and they shrug it off or say to excersise more. Finally, I went to a weightloss doc and met with a dietician. She was fabulous with tips and advise on both what type of diet I needed for my body type and what excersise was best for me. Then I met with the doc and he reviewed it all with me and helped me set goals and time frames. He also prescribed appetite suppressant to help me get going. This was two days ago and im so excited to see where it goes. I would recommend a specialist!
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tincanonastring wrote: »This is also why the GP population is dwindling. No glory, no money, all grief. You don't need a GP for this other than to confirm you are healthy enough to start an exercise program.
There is simply too much information for one person to know - the purpose of a generalist is to point you in the right direction and assemble the data for a proper comprehensive diagnosis.
Ahree about need for a GP unless theres a serious reason and then you can put it to them. I think GPs salaries will vary enormously by country. In the UK there are often a lot of female GPs as its a job they cna do part time. Its suprisingly well paid.
Do you people in the US have to pay for every visit/ consultation?
Technically, yes. But it depends on the insurance provider. Some allow for a free physical exam every year, some do wellness visits for free. Otherwise, most insurance plans have a deductible amount where all medical costs incurred are paid by the patient, then a percentage of all medical costs is covered until an out-of-pocket limit is met, and then the insurance plan covers all costs.
By law, all ACA-compliant major medical plans in the USA have to cover wellness checks (including things like immunizations) at 100%. From there, though, things can get crazy fast. I work for a company that does benefit enrollments for nationwide corporations, unions, and municipalities, so I see plans that run the gamut. Living in a society that has a for-profit health system is maddening.
Bottom line is you end up paying for every visit, whether your insurance covers it or not. In the US we are now doing "TeleDoc" to minimize cost of visit, so physicians can consult by phone or vidcon and diagnose and prescribe.
Yep. It's semantics. You're either paying for it through your premiums and out-of-pocket costs or you're paying for it directly to the doctor's office.
ETA: To be fair, though, even in a single-payer system, it's still a service you pay for. Instead of insurance premiums, you're paying higher taxes.0 -
tincanonastring wrote: »This is also why the GP population is dwindling. No glory, no money, all grief. You don't need a GP for this other than to confirm you are healthy enough to start an exercise program.
There is simply too much information for one person to know - the purpose of a generalist is to point you in the right direction and assemble the data for a proper comprehensive diagnosis.
Ahree about need for a GP unless theres a serious reason and then you can put it to them. I think GPs salaries will vary enormously by country. In the UK there are often a lot of female GPs as its a job they cna do part time. Its suprisingly well paid.
Do you people in the US have to pay for every visit/ consultation?
Technically, yes. But it depends on the insurance provider. Some allow for a free physical exam every year, some do wellness visits for free. Otherwise, most insurance plans have a deductible amount where all medical costs incurred are paid by the patient, then a percentage of all medical costs is covered until an out-of-pocket limit is met, and then the insurance plan covers all costs.
By law, all ACA-compliant major medical plans in the USA have to cover wellness checks (including things like immunizations) at 100%. From there, though, things can get crazy fast. I work for a company that does benefit enrollments for nationwide corporations, unions, and municipalities, so I see plans that run the gamut. Living in a society that has a for-profit health system is maddening.
Bottom line is you end up paying for every visit, whether your insurance covers it or not. In the US we are now doing "TeleDoc" to minimize cost of visit, so physicians can consult by phone or vidcon and diagnose and prescribe.
True, nothing in life is free. Either you pay up front, the costs are hidden, or you are taxed out the wazoo for it.
But what I really wanted to comment on is the "TeleDoc" concept. There's an additional push to develop remote analytics usable via an internet device, particularly smartphones, to not only aid in diagnosis but also in monitoring treatment (because compliance is a huge problem) and out-patient physical rehabilitation. You can imagine a systems that could not only monitor when you do your rehab (compliance again) or take your medication, but could also give you feedback on whether your movement is correct or on particular health markers. It has enormous potential to advance medical treatment and research if it can be done in such a way that it protects patient privacy.0 -
tincanonastring wrote: »This is also why the GP population is dwindling. No glory, no money, all grief. You don't need a GP for this other than to confirm you are healthy enough to start an exercise program.
There is simply too much information for one person to know - the purpose of a generalist is to point you in the right direction and assemble the data for a proper comprehensive diagnosis.
Ahree about need for a GP unless theres a serious reason and then you can put it to them. I think GPs salaries will vary enormously by country. In the UK there are often a lot of female GPs as its a job they cna do part time. Its suprisingly well paid.
Do you people in the US have to pay for every visit/ consultation?
Technically, yes. But it depends on the insurance provider. Some allow for a free physical exam every year, some do wellness visits for free. Otherwise, most insurance plans have a deductible amount where all medical costs incurred are paid by the patient, then a percentage of all medical costs is covered until an out-of-pocket limit is met, and then the insurance plan covers all costs.
By law, all ACA-compliant major medical plans in the USA have to cover wellness checks (including things like immunizations) at 100%. From there, though, things can get crazy fast. I work for a company that does benefit enrollments for nationwide corporations, unions, and municipalities, so I see plans that run the gamut. Living in a society that has a for-profit health system is maddening.
Bottom line is you end up paying for every visit, whether your insurance covers it or not. In the US we are now doing "TeleDoc" to minimize cost of visit, so physicians can consult by phone or vidcon and diagnose and prescribe.
True, nothing in life is free. Either you pay up front, the costs are hidden, or you are taxed out the wazoo for it.
But what I really wanted to comment on is the "TeleDoc" concept. There's an additional push to develop remote analytics usable via an internet device, particularly smartphones, to not only aid in diagnosis but also in monitoring treatment (because compliance is a huge problem) and out-patient physical rehabilitation. You can imagine a systems that could not only monitor when you do your rehab (compliance again) or take your medication, but could also give you feedback on whether your movement is correct or on particular health markers. It has enormous potential to advance medical treatment and research if it can be done in such a way that it protects patient privacy.
those ideas always sound good, but in the end, people get lazy, the good idea done correctly winds up costing too much, and things turn to *kitten* anyway.0 -
Cost savings can be found by buying in bulk. This is where collective health care may be considerably cheaper than the privatized model. There's the potential to use lay health workers.
http://www.who.int/rpc/meetings/LHW_review.pdf
Portable and inexpensive tests are being developed every day.0 -
tincanonastring wrote: »This is also why the GP population is dwindling. No glory, no money, all grief. You don't need a GP for this other than to confirm you are healthy enough to start an exercise program.
There is simply too much information for one person to know - the purpose of a generalist is to point you in the right direction and assemble the data for a proper comprehensive diagnosis.
Ahree about need for a GP unless theres a serious reason and then you can put it to them. I think GPs salaries will vary enormously by country. In the UK there are often a lot of female GPs as its a job they cna do part time. Its suprisingly well paid.
Do you people in the US have to pay for every visit/ consultation?
Technically, yes. But it depends on the insurance provider. Some allow for a free physical exam every year, some do wellness visits for free. Otherwise, most insurance plans have a deductible amount where all medical costs incurred are paid by the patient, then a percentage of all medical costs is covered until an out-of-pocket limit is met, and then the insurance plan covers all costs.
By law, all ACA-compliant major medical plans in the USA have to cover wellness checks (including things like immunizations) at 100%. From there, though, things can get crazy fast. I work for a company that does benefit enrollments for nationwide corporations, unions, and municipalities, so I see plans that run the gamut. Living in a society that has a for-profit health system is maddening.
Bottom line is you end up paying for every visit, whether your insurance covers it or not. In the US we are now doing "TeleDoc" to minimize cost of visit, so physicians can consult by phone or vidcon and diagnose and prescribe.
True, nothing in life is free. Either you pay up front, the costs are hidden, or you are taxed out the wazoo for it.
But what I really wanted to comment on is the "TeleDoc" concept. There's an additional push to develop remote analytics usable via an internet device, particularly smartphones, to not only aid in diagnosis but also in monitoring treatment (because compliance is a huge problem) and out-patient physical rehabilitation. You can imagine a systems that could not only monitor when you do your rehab (compliance again) or take your medication, but could also give you feedback on whether your movement is correct or on particular health markers. It has enormous potential to advance medical treatment and research if it can be done in such a way that it protects patient privacy.
I love futurism and have been absolutely tickled that it looks like bio-tech is starting to really advance.0 -
Cost savings can be found by buying in bulk. This is where collective health care may be considerably cheaper than the privatized model. There's the potential to use lay health workers.
http://www.who.int/rpc/meetings/LHW_review.pdf
Portable and inexpensive tests are being developed every day.
Agreed. The concept of insurance is to spread risk across a large pool. What larger pool can you get than everybody?0 -
tincanonastring wrote: »tincanonastring wrote: »This is also why the GP population is dwindling. No glory, no money, all grief. You don't need a GP for this other than to confirm you are healthy enough to start an exercise program.
There is simply too much information for one person to know - the purpose of a generalist is to point you in the right direction and assemble the data for a proper comprehensive diagnosis.
Ahree about need for a GP unless theres a serious reason and then you can put it to them. I think GPs salaries will vary enormously by country. In the UK there are often a lot of female GPs as its a job they cna do part time. Its suprisingly well paid.
Do you people in the US have to pay for every visit/ consultation?
Technically, yes. But it depends on the insurance provider. Some allow for a free physical exam every year, some do wellness visits for free. Otherwise, most insurance plans have a deductible amount where all medical costs incurred are paid by the patient, then a percentage of all medical costs is covered until an out-of-pocket limit is met, and then the insurance plan covers all costs.
By law, all ACA-compliant major medical plans in the USA have to cover wellness checks (including things like immunizations) at 100%. From there, though, things can get crazy fast. I work for a company that does benefit enrollments for nationwide corporations, unions, and municipalities, so I see plans that run the gamut. Living in a society that has a for-profit health system is maddening.
Bottom line is you end up paying for every visit, whether your insurance covers it or not. In the US we are now doing "TeleDoc" to minimize cost of visit, so physicians can consult by phone or vidcon and diagnose and prescribe.
Yep. It's semantics. You're either paying for it through your premiums and out-of-pocket costs or you're paying for it directly to the doctor's office.
ETA: To be fair, though, even in a single-payer system, it's still a service you pay for. Instead of insurance premiums, you're paying higher taxes.
Speaking as someone in the medical system I'm amazed at how few people get this, and by inserting insurance companies you dramatically increase the cost. Medicine is at pace with the rest of consumer goods, but once you introduce insurance it skyrockets because you are intentionally bringing in "middle-men". As in all things - follow the money.
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tincanonastring wrote: »tincanonastring wrote: »This is also why the GP population is dwindling. No glory, no money, all grief. You don't need a GP for this other than to confirm you are healthy enough to start an exercise program.
There is simply too much information for one person to know - the purpose of a generalist is to point you in the right direction and assemble the data for a proper comprehensive diagnosis.
Ahree about need for a GP unless theres a serious reason and then you can put it to them. I think GPs salaries will vary enormously by country. In the UK there are often a lot of female GPs as its a job they cna do part time. Its suprisingly well paid.
Do you people in the US have to pay for every visit/ consultation?
Technically, yes. But it depends on the insurance provider. Some allow for a free physical exam every year, some do wellness visits for free. Otherwise, most insurance plans have a deductible amount where all medical costs incurred are paid by the patient, then a percentage of all medical costs is covered until an out-of-pocket limit is met, and then the insurance plan covers all costs.
By law, all ACA-compliant major medical plans in the USA have to cover wellness checks (including things like immunizations) at 100%. From there, though, things can get crazy fast. I work for a company that does benefit enrollments for nationwide corporations, unions, and municipalities, so I see plans that run the gamut. Living in a society that has a for-profit health system is maddening.
Bottom line is you end up paying for every visit, whether your insurance covers it or not. In the US we are now doing "TeleDoc" to minimize cost of visit, so physicians can consult by phone or vidcon and diagnose and prescribe.
Yep. It's semantics. You're either paying for it through your premiums and out-of-pocket costs or you're paying for it directly to the doctor's office.
ETA: To be fair, though, even in a single-payer system, it's still a service you pay for. Instead of insurance premiums, you're paying higher taxes.
Speaking as someone in the medical system I'm amazed at how few people get this, and by inserting insurance companies you dramatically increase the cost. Medicine is at pace with the rest of consumer goods, but once you introduce insurance it skyrockets because you are intentionally bringing in "middle-men". As in all things - follow the money.
I work in employee benefits and I'm a licensed health insurance agent. I would basically be out of a job if the USA switched to a single-payer system, but I'd gladly spend some time in the unemployment line for that!0 -
aha, pulled this out from somewhere in my brain: "regression to the mean". The status quo re human behaviour in terms of giving a crap about projects/processes that don't produce apparent (not actual) value under capitalism is to drop them0
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tincanonastring wrote: »This is also why the GP population is dwindling. No glory, no money, all grief. You don't need a GP for this other than to confirm you are healthy enough to start an exercise program.
There is simply too much information for one person to know - the purpose of a generalist is to point you in the right direction and assemble the data for a proper comprehensive diagnosis.
Ahree about need for a GP unless theres a serious reason and then you can put it to them. I think GPs salaries will vary enormously by country. In the UK there are often a lot of female GPs as its a job they cna do part time. Its suprisingly well paid.
Do you people in the US have to pay for every visit/ consultation?
Technically, yes. But it depends on the insurance provider. Some allow for a free physical exam every year, some do wellness visits for free. Otherwise, most insurance plans have a deductible amount where all medical costs incurred are paid by the patient, then a percentage of all medical costs is covered until an out-of-pocket limit is met, and then the insurance plan covers all costs.
By law, all ACA-compliant major medical plans in the USA have to cover wellness checks (including things like immunizations) at 100%. From there, though, things can get crazy fast. I work for a company that does benefit enrollments for nationwide corporations, unions, and municipalities, so I see plans that run the gamut. Living in a society that has a for-profit health system is maddening.
Bottom line is you end up paying for every visit, whether your insurance covers it or not. In the US we are now doing "TeleDoc" to minimize cost of visit, so physicians can consult by phone or vidcon and diagnose and prescribe.
True, nothing in life is free. Either you pay up front, the costs are hidden, or you are taxed out the wazoo for it.
But what I really wanted to comment on is the "TeleDoc" concept. There's an additional push to develop remote analytics usable via an internet device, particularly smartphones, to not only aid in diagnosis but also in monitoring treatment (because compliance is a huge problem) and out-patient physical rehabilitation. You can imagine a systems that could not only monitor when you do your rehab (compliance again) or take your medication, but could also give you feedback on whether your movement is correct or on particular health markers. It has enormous potential to advance medical treatment and research if it can be done in such a way that it protects patient privacy.
those ideas always sound good, but in the end, people get lazy, the good idea done correctly winds up costing too much, and things turn to *kitten* anyway.
Ah, but that's one of the motivations for setting up the system.
If people don't comply with prescribed therapeutics then actions can be taken, whether that's changing medication to something they're more likely to take even if it's less effective, or refusing to refill prescriptions without a visit (in cases of suspected abuse or selling of prescriptions), or scheduling a visit with a PT for people are doing their exercises, but not correctly.
If nothing else, we then know which treatments are working when the protocol is adhered to, and when a failure is in spite of complete adherence. That in and of itself is extremely valuable information. Right now we rely on self-reporting. Amazing how many otherwise fine and upstanding citizens will lie like a rug about their compliance.0 -
Cost savings can be found by buying in bulk. This is where collective health care may be considerably cheaper than the privatized model. There's the potential to use lay health workers.
http://www.who.int/rpc/meetings/LHW_review.pdf
Portable and inexpensive tests are being developed every day.
Ok that is cool
I think I'm just grumpy today, lol, sorry!
(although personally i am not usually a fan of rushing studies, but who knows, maybe the benefits there very much outweigh the calculable risks. i am really glad i don't have to make those decisions
) 0 -
tincanonastring wrote: »This is also why the GP population is dwindling. No glory, no money, all grief. You don't need a GP for this other than to confirm you are healthy enough to start an exercise program.
There is simply too much information for one person to know - the purpose of a generalist is to point you in the right direction and assemble the data for a proper comprehensive diagnosis.
Ahree about need for a GP unless theres a serious reason and then you can put it to them. I think GPs salaries will vary enormously by country. In the UK there are often a lot of female GPs as its a job they cna do part time. Its suprisingly well paid.
Do you people in the US have to pay for every visit/ consultation?
Technically, yes. But it depends on the insurance provider. Some allow for a free physical exam every year, some do wellness visits for free. Otherwise, most insurance plans have a deductible amount where all medical costs incurred are paid by the patient, then a percentage of all medical costs is covered until an out-of-pocket limit is met, and then the insurance plan covers all costs.
By law, all ACA-compliant major medical plans in the USA have to cover wellness checks (including things like immunizations) at 100%. From there, though, things can get crazy fast. I work for a company that does benefit enrollments for nationwide corporations, unions, and municipalities, so I see plans that run the gamut. Living in a society that has a for-profit health system is maddening.
Bottom line is you end up paying for every visit, whether your insurance covers it or not. In the US we are now doing "TeleDoc" to minimize cost of visit, so physicians can consult by phone or vidcon and diagnose and prescribe.
True, nothing in life is free. Either you pay up front, the costs are hidden, or you are taxed out the wazoo for it.
But what I really wanted to comment on is the "TeleDoc" concept. There's an additional push to develop remote analytics usable via an internet device, particularly smartphones, to not only aid in diagnosis but also in monitoring treatment (because compliance is a huge problem) and out-patient physical rehabilitation. You can imagine a systems that could not only monitor when you do your rehab (compliance again) or take your medication, but could also give you feedback on whether your movement is correct or on particular health markers. It has enormous potential to advance medical treatment and research if it can be done in such a way that it protects patient privacy.
those ideas always sound good, but in the end, people get lazy, the good idea done correctly winds up costing too much, and things turn to *kitten* anyway.
Ah, but that's one of the motivations for setting up the system.
If people don't comply with prescribed therapeutics then actions can be taken, whether that's changing medication to something they're more likely to take even if it's less effective, or refusing to refill prescriptions without a visit (in cases of suspected abuse or selling of prescriptions), or scheduling a visit with a PT for people are doing their exercises, but not correctly.
If nothing else, we then know which treatments are working when the protocol is adhered to, and when a failure is in spite of complete adherence. That in and of itself is extremely valuable information. Right now we rely on self-reporting. Amazing how many otherwise fine and upstanding citizens will lie like a rug about their compliance.
oh yeah! i am all about making systems & treatments as usable as possible, i think that's critical. (given realistic assumptions about human behaviour. but there's research on that, too )
the sort of thing i mean is a cfo or manager or project lead deciding that safety procedure X is maybe not SO essential, bc process Y is cheaper and probably just as good, etc etc
OR safety procedure X just falling off bc Y is somehow more "efficient" or more easily fits into users' workflows given time constraints etc0 -
tincanonastring wrote: »This is also why the GP population is dwindling. No glory, no money, all grief. You don't need a GP for this other than to confirm you are healthy enough to start an exercise program.
There is simply too much information for one person to know - the purpose of a generalist is to point you in the right direction and assemble the data for a proper comprehensive diagnosis.
Ahree about need for a GP unless theres a serious reason and then you can put it to them. I think GPs salaries will vary enormously by country. In the UK there are often a lot of female GPs as its a job they cna do part time. Its suprisingly well paid.
Do you people in the US have to pay for every visit/ consultation?
Technically, yes. But it depends on the insurance provider. Some allow for a free physical exam every year, some do wellness visits for free. Otherwise, most insurance plans have a deductible amount where all medical costs incurred are paid by the patient, then a percentage of all medical costs is covered until an out-of-pocket limit is met, and then the insurance plan covers all costs.
By law, all ACA-compliant major medical plans in the USA have to cover wellness checks (including things like immunizations) at 100%. From there, though, things can get crazy fast. I work for a company that does benefit enrollments for nationwide corporations, unions, and municipalities, so I see plans that run the gamut. Living in a society that has a for-profit health system is maddening.
Bottom line is you end up paying for every visit, whether your insurance covers it or not. In the US we are now doing "TeleDoc" to minimize cost of visit, so physicians can consult by phone or vidcon and diagnose and prescribe.
True, nothing in life is free. Either you pay up front, the costs are hidden, or you are taxed out the wazoo for it.
But what I really wanted to comment on is the "TeleDoc" concept. There's an additional push to develop remote analytics usable via an internet device, particularly smartphones, to not only aid in diagnosis but also in monitoring treatment (because compliance is a huge problem) and out-patient physical rehabilitation. You can imagine a systems that could not only monitor when you do your rehab (compliance again) or take your medication, but could also give you feedback on whether your movement is correct or on particular health markers. It has enormous potential to advance medical treatment and research if it can be done in such a way that it protects patient privacy.
those ideas always sound good, but in the end, people get lazy, the good idea done correctly winds up costing too much, and things turn to *kitten* anyway.
Ah, but that's one of the motivations for setting up the system.
If people don't comply with prescribed therapeutics then actions can be taken, whether that's changing medication to something they're more likely to take even if it's less effective, or refusing to refill prescriptions without a visit (in cases of suspected abuse or selling of prescriptions), or scheduling a visit with a PT for people are doing their exercises, but not correctly.
If nothing else, we then know which treatments are working when the protocol is adhered to, and when a failure is in spite of complete adherence. That in and of itself is extremely valuable information. Right now we rely on self-reporting. Amazing how many otherwise fine and upstanding citizens will lie like a rug about their compliance.
oh yeah! i am all about making systems & treatments as usable as possible, i think that's critical. (given realistic assumptions about human behaviour. but there's research on that, too )
the sort of thing i mean is a cfo or manager or project lead deciding that safety procedure X is maybe not SO essential, bc process Y is cheaper and probably just as good, etc etc
Terrifying, right?0 -
tincanonastring wrote: »tincanonastring wrote: »This is also why the GP population is dwindling. No glory, no money, all grief. You don't need a GP for this other than to confirm you are healthy enough to start an exercise program.
There is simply too much information for one person to know - the purpose of a generalist is to point you in the right direction and assemble the data for a proper comprehensive diagnosis.
Ahree about need for a GP unless theres a serious reason and then you can put it to them. I think GPs salaries will vary enormously by country. In the UK there are often a lot of female GPs as its a job they cna do part time. Its suprisingly well paid.
Do you people in the US have to pay for every visit/ consultation?
Technically, yes. But it depends on the insurance provider. Some allow for a free physical exam every year, some do wellness visits for free. Otherwise, most insurance plans have a deductible amount where all medical costs incurred are paid by the patient, then a percentage of all medical costs is covered until an out-of-pocket limit is met, and then the insurance plan covers all costs.
By law, all ACA-compliant major medical plans in the USA have to cover wellness checks (including things like immunizations) at 100%. From there, though, things can get crazy fast. I work for a company that does benefit enrollments for nationwide corporations, unions, and municipalities, so I see plans that run the gamut. Living in a society that has a for-profit health system is maddening.
Bottom line is you end up paying for every visit, whether your insurance covers it or not. In the US we are now doing "TeleDoc" to minimize cost of visit, so physicians can consult by phone or vidcon and diagnose and prescribe.
True, nothing in life is free. Either you pay up front, the costs are hidden, or you are taxed out the wazoo for it.
But what I really wanted to comment on is the "TeleDoc" concept. There's an additional push to develop remote analytics usable via an internet device, particularly smartphones, to not only aid in diagnosis but also in monitoring treatment (because compliance is a huge problem) and out-patient physical rehabilitation. You can imagine a systems that could not only monitor when you do your rehab (compliance again) or take your medication, but could also give you feedback on whether your movement is correct or on particular health markers. It has enormous potential to advance medical treatment and research if it can be done in such a way that it protects patient privacy.
those ideas always sound good, but in the end, people get lazy, the good idea done correctly winds up costing too much, and things turn to *kitten* anyway.
Ah, but that's one of the motivations for setting up the system.
If people don't comply with prescribed therapeutics then actions can be taken, whether that's changing medication to something they're more likely to take even if it's less effective, or refusing to refill prescriptions without a visit (in cases of suspected abuse or selling of prescriptions), or scheduling a visit with a PT for people are doing their exercises, but not correctly.
If nothing else, we then know which treatments are working when the protocol is adhered to, and when a failure is in spite of complete adherence. That in and of itself is extremely valuable information. Right now we rely on self-reporting. Amazing how many otherwise fine and upstanding citizens will lie like a rug about their compliance.
oh yeah! i am all about making systems & treatments as usable as possible, i think that's critical. (given realistic assumptions about human behaviour. but there's research on that, too )
the sort of thing i mean is a cfo or manager or project lead deciding that safety procedure X is maybe not SO essential, bc process Y is cheaper and probably just as good, etc etc
Terrifying, right?
Terrifying and totally normal, habitual. I am mostly amazed that things even roughly work0 -
There are a shortage of doctors in my province and when my old doctor closed her practice, it was very hard finding a replacement. I insist on having the same practitioner over time so we build some history and trust, and I want a doctor who will explain things to me. So Medi-Centre doctors don't cut it for me. Other doctors in town have waiting lists months long.
So I followed the suggested plan offered by our provincial health care insurance provider, to pick a doctor looking for patients off their website. I found out why those doctors were still taking patients. They sucked. One even refused to do an internal exam.
After three years of not finding a suitable replacement, I wrote a pleading letter to my husband's family doctor to take my file. She did, thank goodness.
Many moved south for better pay many years ago I remember.
0 -
the sort of thing i mean is a cfo or manager or project lead deciding that safety procedure X is maybe not SO essential, bc process Y is cheaper and probably just as good, etc etc
OR safety procedure X just falling off bc Y is somehow more "efficient" or more easily fits into users' workflows given time constraints etc
Seen some of that in our collectivized health care here in Alberta. Does the US track certain prescriptions (like opiates) on a centralized database? Since we started doing that, doctors who over-prescribe opiates were caught. Patients who were double dipping were caught too. Because of systems like this, my pharmacy won't fill my prescriptions until they are due. If I lost a bottle, I'm hooped. I suspect insurance providers are tightening up on this as a cost savings measure. My insurance provider also will only cover the cost of generic (cheaper) versions of prescriptions.
Our health care system recently stopped covering the cost of blood tests for vitamin D deficiency, except for certain conditions. It was noted that nearly all Albertans are deficient in vitamin D. Don't need a test for that. Duh.0 -
tincanonastring wrote: »tincanonastring wrote: »This is also why the GP population is dwindling. No glory, no money, all grief. You don't need a GP for this other than to confirm you are healthy enough to start an exercise program.
There is simply too much information for one person to know - the purpose of a generalist is to point you in the right direction and assemble the data for a proper comprehensive diagnosis.
Ahree about need for a GP unless theres a serious reason and then you can put it to them. I think GPs salaries will vary enormously by country. In the UK there are often a lot of female GPs as its a job they cna do part time. Its suprisingly well paid.
Do you people in the US have to pay for every visit/ consultation?
Technically, yes. But it depends on the insurance provider. Some allow for a free physical exam every year, some do wellness visits for free. Otherwise, most insurance plans have a deductible amount where all medical costs incurred are paid by the patient, then a percentage of all medical costs is covered until an out-of-pocket limit is met, and then the insurance plan covers all costs.
By law, all ACA-compliant major medical plans in the USA have to cover wellness checks (including things like immunizations) at 100%. From there, though, things can get crazy fast. I work for a company that does benefit enrollments for nationwide corporations, unions, and municipalities, so I see plans that run the gamut. Living in a society that has a for-profit health system is maddening.
Bottom line is you end up paying for every visit, whether your insurance covers it or not. In the US we are now doing "TeleDoc" to minimize cost of visit, so physicians can consult by phone or vidcon and diagnose and prescribe.
True, nothing in life is free. Either you pay up front, the costs are hidden, or you are taxed out the wazoo for it.
But what I really wanted to comment on is the "TeleDoc" concept. There's an additional push to develop remote analytics usable via an internet device, particularly smartphones, to not only aid in diagnosis but also in monitoring treatment (because compliance is a huge problem) and out-patient physical rehabilitation. You can imagine a systems that could not only monitor when you do your rehab (compliance again) or take your medication, but could also give you feedback on whether your movement is correct or on particular health markers. It has enormous potential to advance medical treatment and research if it can be done in such a way that it protects patient privacy.
those ideas always sound good, but in the end, people get lazy, the good idea done correctly winds up costing too much, and things turn to *kitten* anyway.
Ah, but that's one of the motivations for setting up the system.
If people don't comply with prescribed therapeutics then actions can be taken, whether that's changing medication to something they're more likely to take even if it's less effective, or refusing to refill prescriptions without a visit (in cases of suspected abuse or selling of prescriptions), or scheduling a visit with a PT for people are doing their exercises, but not correctly.
If nothing else, we then know which treatments are working when the protocol is adhered to, and when a failure is in spite of complete adherence. That in and of itself is extremely valuable information. Right now we rely on self-reporting. Amazing how many otherwise fine and upstanding citizens will lie like a rug about their compliance.
oh yeah! i am all about making systems & treatments as usable as possible, i think that's critical. (given realistic assumptions about human behaviour. but there's research on that, too )
the sort of thing i mean is a cfo or manager or project lead deciding that safety procedure X is maybe not SO essential, bc process Y is cheaper and probably just as good, etc etc
Terrifying, right?
Terrifying and totally normal, habitual. I am mostly amazed that things even roughly work
It does seem to be a bit of blind luck, doesn't it?0 -
tincanonastring wrote: »tincanonastring wrote: »This is also why the GP population is dwindling. No glory, no money, all grief. You don't need a GP for this other than to confirm you are healthy enough to start an exercise program.
There is simply too much information for one person to know - the purpose of a generalist is to point you in the right direction and assemble the data for a proper comprehensive diagnosis.
Ahree about need for a GP unless theres a serious reason and then you can put it to them. I think GPs salaries will vary enormously by country. In the UK there are often a lot of female GPs as its a job they cna do part time. Its suprisingly well paid.
Do you people in the US have to pay for every visit/ consultation?
Technically, yes. But it depends on the insurance provider. Some allow for a free physical exam every year, some do wellness visits for free. Otherwise, most insurance plans have a deductible amount where all medical costs incurred are paid by the patient, then a percentage of all medical costs is covered until an out-of-pocket limit is met, and then the insurance plan covers all costs.
By law, all ACA-compliant major medical plans in the USA have to cover wellness checks (including things like immunizations) at 100%. From there, though, things can get crazy fast. I work for a company that does benefit enrollments for nationwide corporations, unions, and municipalities, so I see plans that run the gamut. Living in a society that has a for-profit health system is maddening.
Bottom line is you end up paying for every visit, whether your insurance covers it or not. In the US we are now doing "TeleDoc" to minimize cost of visit, so physicians can consult by phone or vidcon and diagnose and prescribe.
True, nothing in life is free. Either you pay up front, the costs are hidden, or you are taxed out the wazoo for it.
But what I really wanted to comment on is the "TeleDoc" concept. There's an additional push to develop remote analytics usable via an internet device, particularly smartphones, to not only aid in diagnosis but also in monitoring treatment (because compliance is a huge problem) and out-patient physical rehabilitation. You can imagine a systems that could not only monitor when you do your rehab (compliance again) or take your medication, but could also give you feedback on whether your movement is correct or on particular health markers. It has enormous potential to advance medical treatment and research if it can be done in such a way that it protects patient privacy.
those ideas always sound good, but in the end, people get lazy, the good idea done correctly winds up costing too much, and things turn to *kitten* anyway.
Ah, but that's one of the motivations for setting up the system.
If people don't comply with prescribed therapeutics then actions can be taken, whether that's changing medication to something they're more likely to take even if it's less effective, or refusing to refill prescriptions without a visit (in cases of suspected abuse or selling of prescriptions), or scheduling a visit with a PT for people are doing their exercises, but not correctly.
If nothing else, we then know which treatments are working when the protocol is adhered to, and when a failure is in spite of complete adherence. That in and of itself is extremely valuable information. Right now we rely on self-reporting. Amazing how many otherwise fine and upstanding citizens will lie like a rug about their compliance.
oh yeah! i am all about making systems & treatments as usable as possible, i think that's critical. (given realistic assumptions about human behaviour. but there's research on that, too )
the sort of thing i mean is a cfo or manager or project lead deciding that safety procedure X is maybe not SO essential, bc process Y is cheaper and probably just as good, etc etc
Terrifying, right?
Terrifying and totally normal, habitual. I am mostly amazed that things even roughly work
Heh, I have this thought all the time, about lots of things.0 -
tincanonastring wrote: »tincanonastring wrote: »tincanonastring wrote: »This is also why the GP population is dwindling. No glory, no money, all grief. You don't need a GP for this other than to confirm you are healthy enough to start an exercise program.
There is simply too much information for one person to know - the purpose of a generalist is to point you in the right direction and assemble the data for a proper comprehensive diagnosis.
Ahree about need for a GP unless theres a serious reason and then you can put it to them. I think GPs salaries will vary enormously by country. In the UK there are often a lot of female GPs as its a job they cna do part time. Its suprisingly well paid.
Do you people in the US have to pay for every visit/ consultation?
Technically, yes. But it depends on the insurance provider. Some allow for a free physical exam every year, some do wellness visits for free. Otherwise, most insurance plans have a deductible amount where all medical costs incurred are paid by the patient, then a percentage of all medical costs is covered until an out-of-pocket limit is met, and then the insurance plan covers all costs.
By law, all ACA-compliant major medical plans in the USA have to cover wellness checks (including things like immunizations) at 100%. From there, though, things can get crazy fast. I work for a company that does benefit enrollments for nationwide corporations, unions, and municipalities, so I see plans that run the gamut. Living in a society that has a for-profit health system is maddening.
Bottom line is you end up paying for every visit, whether your insurance covers it or not. In the US we are now doing "TeleDoc" to minimize cost of visit, so physicians can consult by phone or vidcon and diagnose and prescribe.
True, nothing in life is free. Either you pay up front, the costs are hidden, or you are taxed out the wazoo for it.
But what I really wanted to comment on is the "TeleDoc" concept. There's an additional push to develop remote analytics usable via an internet device, particularly smartphones, to not only aid in diagnosis but also in monitoring treatment (because compliance is a huge problem) and out-patient physical rehabilitation. You can imagine a systems that could not only monitor when you do your rehab (compliance again) or take your medication, but could also give you feedback on whether your movement is correct or on particular health markers. It has enormous potential to advance medical treatment and research if it can be done in such a way that it protects patient privacy.
those ideas always sound good, but in the end, people get lazy, the good idea done correctly winds up costing too much, and things turn to *kitten* anyway.
Ah, but that's one of the motivations for setting up the system.
If people don't comply with prescribed therapeutics then actions can be taken, whether that's changing medication to something they're more likely to take even if it's less effective, or refusing to refill prescriptions without a visit (in cases of suspected abuse or selling of prescriptions), or scheduling a visit with a PT for people are doing their exercises, but not correctly.
If nothing else, we then know which treatments are working when the protocol is adhered to, and when a failure is in spite of complete adherence. That in and of itself is extremely valuable information. Right now we rely on self-reporting. Amazing how many otherwise fine and upstanding citizens will lie like a rug about their compliance.
oh yeah! i am all about making systems & treatments as usable as possible, i think that's critical. (given realistic assumptions about human behaviour. but there's research on that, too )
the sort of thing i mean is a cfo or manager or project lead deciding that safety procedure X is maybe not SO essential, bc process Y is cheaper and probably just as good, etc etc
Terrifying, right?
Terrifying and totally normal, habitual. I am mostly amazed that things even roughly work
It does seem to be a bit of blind luck, doesn't it?
Definitely seems to be some of that.
And, at least some people aren't *so* lazy/efficient, thankfully. And, regulation, thank dog for regulation (where it is enforced)0 -
the sort of thing i mean is a cfo or manager or project lead deciding that safety procedure X is maybe not SO essential, bc process Y is cheaper and probably just as good, etc etc
OR safety procedure X just falling off bc Y is somehow more "efficient" or more easily fits into users' workflows given time constraints etc
Seen some of that in our collectivized health care here in Alberta. Does the US track certain prescriptions (like opiates) on a centralized database? Since we started doing that, doctors who over-prescribe opiates were caught. Patients who were double dipping were caught too. Because of systems like this, my pharmacy won't fill my prescriptions until they are due. If I lost a bottle, I'm hooped. I suspect insurance providers are tightening up on this as a cost savings measure. My insurance provider also will only cover the cost of generic (cheaper) versions of prescriptions.
Our health care system recently stopped covering the cost of blood tests for vitamin D deficiency, except for certain conditions. It was noted that nearly all Albertans are deficient in vitamin D. Don't need a test for that. Duh.
re the database - yeah that is an issue for people who need prescribed controlled substances, definitely - i think it also has the effect of disinclining doctors to prescribe them in the first place. bad for people needing pain management & those suffering from eg adhd : /
vit d - here it's the same, unless there's a medical reason for checking it. i think we should test for it, though, bc OVERUSE of vit d can be bad for the liver (re calcium), & it's an OTC supp ppl are taking more often0 -
the sort of thing i mean is a cfo or manager or project lead deciding that safety procedure X is maybe not SO essential, bc process Y is cheaper and probably just as good, etc etc
OR safety procedure X just falling off bc Y is somehow more "efficient" or more easily fits into users' workflows given time constraints etc
Seen some of that in our collectivized health care here in Alberta. Does the US track certain prescriptions (like opiates) on a centralized database? Since we started doing that, doctors who over-prescribe opiates were caught. Patients who were double dipping were caught too. Because of systems like this, my pharmacy won't fill my prescriptions until they are due. If I lost a bottle, I'm hooped. I suspect insurance providers are tightening up on this as a cost savings measure. My insurance provider also will only cover the cost of generic (cheaper) versions of prescriptions.
Our health care system recently stopped covering the cost of blood tests for vitamin D deficiency, except for certain conditions. It was noted that nearly all Albertans are deficient in vitamin D. Don't need a test for that. Duh.
My insurance will not cover medications if there is an over the counter equivalent, not even generics. For example, I have to take a daily double dose of the OTC omeprazole (Prilosec). There's a presecription time release, but because of the OTC version, I can't get it covered. I end up paying nearly 4x as much because a) I'm taking twice as much as the normal OTC dose, and b) I lose out on the insurance negotiated generic pricing.0
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