The Role of Doctors in Weight Loss
Options
Replies
-
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.
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.
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
-
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
Categories
- All Categories
- 1.4M Health, Wellness and Goals
- 391.4K Introduce Yourself
- 43.5K Getting Started
- 259.7K Health and Weight Loss
- 175.6K Food and Nutrition
- 47.3K Recipes
- 232.3K Fitness and Exercise
- 388 Sleep, Mindfulness and Overall Wellness
- 6.4K Goal: Maintaining Weight
- 8.5K Goal: Gaining Weight and Body Building
- 152.7K Motivation and Support
- 7.8K Challenges
- 1.3K Debate Club
- 96.2K Chit-Chat
- 2.5K Fun and Games
- 3.2K MyFitnessPal Information
- 22 News and Announcements
- 918 Feature Suggestions and Ideas
- 2.3K MyFitnessPal Tech Support Questions