31 replies to this topic

[maineman]

No disrespect Mark, but Freedom is not allowed in Medicine. Somehow people believe it is a government ordained "right". Where you have supplemental payment (i.e. "insurance") then people expect the providers (as we are now called) and the Drug Companies to provide "medical care" for free or at reduced prices, while Hospitals and Drug Companies and some doctors who are gaming the system charge MORE because they can get it from the insurers. Walk into Wal Mart for a TV and you may get a better price, so you'll buy it there. You don't walk into Wal Mart and say, "I don't care what the cost of the TV is, just send the bill to my "Insurance". That's what people do with subsidized, quasi-socialized medicine in this country. Want to fix the profit abuse and overuse of medicine in this country? Take away insurance for a few months, which will force people to ask what it all costs and then see if they still want to "order every test" or "send me to the "best" specialist for second, third opinion" or "give me that new pill".... Freedom in medicine? You've got to be kidding. It is supplemented and the closest thing we have to socialism/communism and you know how those experiments turned out. It is intrusive and abusive at multiple levels. In spite of that, most of us work our asses off to care for people, remain ethical and try to do the right thing. While getting harrassed from Insurers, patients, regulators, and critics. mm

[OEXCHAOS]

Basically, I agree. But what I'm saying is we need more freedom (including you), not less. And you're dead right, folks need to stop and ask what something costs. They don't. Even smart, responsible folks. Docs may well have some blame in that, but I'd say that gathering authority makes doing their job easier and if it's a problem for others, it's really THEIR responsibility to fix, not Docs. If you think I don't respect your field, you're quite wrong. I'm just going to get in your (or others') face when you or others say that it's somehow wrong to profit from helping others. You SHOULD profit from helping others. That's how you know we need help! Mark

[Rogerdodger]

But there is something up with this doctor-racism business I don't understand. Maybe you can enlighten me.

I have several doctors as clients and I love 'em.
They are people. Wonderful people.

Doc, being serious here, you often seem a bit touchy or over-reactive.
You're reactions are often like someone has slapped you personally.
Maybe it's just the problem with this type of bulletin board communication.
I think it causes many misunderstandings between people.

I think you take your profession very seriously, as you should.
No one can do it like you do. I believe that.
You jealously guard your profession. That is a good thing.

So I can understand how it must feel like an insult that some medical treatment is being done at Walmart.
But maybe what they are doing is filling a very real need.

You fear that they will make mistakes and people will suffer.
That will happen.
And I point out that doctors make mistakes, and people suffer.
That will happen.
But it does not put doctors on the same level as as a Walmart clinic.

Do you think it's OK for diabetics to take their own glucose readings and give themselves insulin shots?
Shouldn't doctors be the only ones to perform such medical procedures?
Sometimes the best medical treatment comes down to practicality in the real world.

[maineman]

Diabetics should take their Blood Sugar readings. Particularly Insulin Dependent diabetics. And record them and adjust their insulin according to guidelines. They are encouraged to do so and a lot of time is spent educating them. Yes, I am touchy and protective, if for no other reason than to fight for some integrity. I dislike the drug companies false tactics. Read today's New York Times regarding LYRICA and FIBROMYALGIA. If that doesn't turn your stomach I don't know what will. Or read the article about the failure of Zetia to control heart disease in spite of lowering cholesterol. In medicine, we will take that research and completely change our prescribing habits and what we tell our patients. HOWEVER when that type of research comes out about, say Vitamin A, like a few years ago, did the Heatlh FOod stores take it off their shelves? Did the vitamin companies ADMIT that it had no value in preventing breast cancer (I'm talking about the big breast cancer and Vitamin A/E study)? No, they just kept shilling it. Lying bastages that they are. So yes, I'm touchy. More on Wal Mart clinics later. Gotta go see a patient. MM

[Rogerdodger]

I will never go to a regular doctor for a minor, routine illness again. Sick and wanting an appointment immediately, I went to one of those medical clinics in Wal-Mart. I got in almost immediately, everyone on the staff was extremely friendly, and it only cost $59. Wow. I was pleasantly surprised and impressed.

For those who don't like the idea of Walmart offering "walk in" clinics, consider this real life situation:

Last week my daughter got sick, by Thursday she felt so bad that she called her doctor.
He would try to squeeze her in THE FOLLOWING TUESDAY!
5 DAYS!

So Tuesday she drug herself to the doctors office only to be told that the doctor didn't come in that day but that another doctor could work her in in a few hours.
She eventually was seen and diagnosed with brochititis and given a perscription for an antibiotic.
I betcha Walmart could have done that the previous Thursday.

And don't even think of going to an emergency room for such an illness.
The overworked & overcrowded ER rooms put critical patients first, of course,
Brochititis goes to the back of the line.

Harvard Study News LINK

Wait times are increasing in hospital emergency rooms across the country, up 36 percent from 1994 to 2004, according to a national study released last week by Harvard Medical School researchers.

In Tulsa, according to hospital officials, St. John Medical Center has an average wait time of 4 hours. Southcrest Hospital has an average visit time of 3 hours, while St. Francis Hospital has an average visit time of 4.5 hours. Hillcrest Medical Center has an average door-to-seen-by-physician time of 45 minutes, and Oklahoma State University Medical Center has a door-to-seen-by-physician time of 15 minutes.
"The critically ill and injured are our priority,"

Just a thought.

Edited by Rogerdodger, 26 January 2008 - 02:16 PM.

[OEXCHAOS]

This is exactly what the clinic is good for. Sure, she should check in with her doc when he could be bothered to see her, but in the mean time, she would have gotten treatment and been back in the game by now. I don't know about your daughter, but I really can't afford to be out of the game for 5 days more than I need to be. Mark

[Rogerdodger]

This did not happen at a Walmat clinic:

This week, my friend's 87 year old mother had stroke symptoms and was told by her doctor to go to the hospital immediately.
But the hospital told her to go back home since they had no beds available.
They promised to call if something came open!!!

So she went home and waited.
Her children eventually called the doctor back and he was able to get her into the hospital, where she is now.

What can I say?

It reminds me of when my uncle was in a head on wreck which shattered his legs.
The hospital examined him and said he looked ok and just needed to go home and get some rest.
He went home as directed but was in so much pain that he returned and spent the next 3 weeks in ICU and nearly died!

[maineman]

A patient goes to the hospital and has a good outcome, therefore hospitals are good? A patient goes to the hospital and has a bad outcome. Therefore hospitals are bad? A patient takes Vitamin C and doesn't catch a cold. Therefore vitamin c prevents colds? A patient takes Vitamin C and catches a cold. Therefore.... um... not enough? Bad karma? Wrong type? Etc. etc. None of these anectodal snips are of any logical or useful value and have no meaning. There are ways to participate in solutions. Become an activist in your community for improving health care. Educate yourself. Serve on the board of the hospital. Add to the solutions. mm

[Rogerdodger]

"these anectodal snips are of any logical or useful value and have no meaning."

Dismissive and pejorative.

Go watch the movie Patch Adams and guess who you sound like.

Edited by Rogerdodger, 04 February 2008 - 06:08 PM.

[maineman]

"these anectodal snips are of any logical or useful value and have no meaning."

Dismissive and pejorative.

Go watch the movie Patch Adams and guess who you sound like.

Frankly, this is why I get/got tired of posting here. Its a landscape of complaining with no positive suggestions.

I know Mark says no politics, but its this "politics as usual"...i.e. negative, put downs, complaints, and self-serving interest that is awash here. And Medicine is the whipping boy. When I put up a comprehensive post about my knowledge of medicine, obtained from years of study and two decades of INDEPENDENT SOLO practice of medicine, practiced with integrity, caring and hard work, my 2 cents are ripped to shreds by snippets of manure, frankly. If you recall I posted my thoughts on trading here for years without once mentioning that I was a doctor, but got so sick of the out and out lies that were increasingly posted by some "alternative" lunatics of fake medicine that I finally, albeit unwillingly, jumped in to counter utter LIES that were beginning to appear with the patina of legitmacy.

Whatever.

So, I'm back out on the door to door campaign trail, where I've been for the past months, talking to my colleagues, and key state reps (many of whom are my patients), attending caucus planning meetings, manning phone banks, etc. because I am sick and tired of 47 million uninsured people, I am sick and tired of disproportionate health care, manipulation by drug companies and medical monopolies and, yes, "Wal Mart" phony clinics as well as phony "Health Food" stores and Vitamin lobbies and if we, who know and care, don't do something, it will continue to be business as usual. Suffice it to say, out of respect to Mark's "no politics" guide, I"m not saying who i"m backing but I will say that, "Yes, we can" do a better job for ourselves, our country and our future.

Good luck at Wal Mart. I did see Patch Adams. In fact, when I'm telling a patient they have cancer I usually sing them the news with a banjo and a fake arrow through my head and, if necessary, throw in a few fart jokes. Because that's what "we" doctors are really like....

mm