Kepler
Cornell Big Red
Nobody with a brain in their head considers us among even the top 10 countries in the world. There's an argument to be made we are not even top 20.
We sure used to be, though.
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The Medical Thread: We're experts on everything else; why not?
- Thread starter The Sicatoka
- Start date
Nobody with a brain in their head considers us among even the top 10 countries in the world. There's an argument to be made we are not even top 20.
We sure used to be, though.
Then what's so wrong with Making America Great Again?
Kepler
Cornell Big Red
leswp1
New member
Thing is, even if we were to do those things, we have a whole generation of medicals trained and told this system is acceptable. They are taught to think of what the accountants, insurance, money grubbers expect. They are not trained to think of what is best for the patient without factoring in non-medical influences. We would need to retrain and revamp the programs to undo the teaching that is all about surviving the demands of pushing people thru, keeping numbers up, what the particular insurance will allow, how best to manipulate the system to attempt to get appropriate care with the caveat that if you can't get it, then you have to accept it and move on.
Today's challenge- it looks as though things are stabilized (Yay, the man has 9 lives). Rehab is the next step. No one can say when or if they will be doing this. No one has talked about how that would work, what we need to do to prepare. He doesn't get to chose. They send him where there is a bed.
Scarier- if he doesn't make progress he can't stay in Rehab. Depending on the situation they may say he will go to Long term care. He lives in a house with 2 businesses in the building. He doesn't qualify for assistance to pay for that. Which means if this transpires, they may have to sell the building displacing the businesses and the person he lives with.
Probably jumping the gun a little but so far I have been a step ahead, every time, of what they are telling the family
For sure. Whenever anyone in our family has the slightest inkling of a medical issue, our first calls are not to our doctors, hospitals, or even insurance companies. No, we immediately reach out to our friends who are doctors or even friends of friends who are doctors so they can get us seen right away and we consult with those personal contacts regularly throughout whatever process transpires. Without those insider contacts, I seriously do not think it’s possible to obtain adequate health care in this country.
This was the situation we faced with my mother a few years ago. Too wealthy for assistance but nowhere near wealthy enough to afford it. We ended up with her on home hospice for a few months. Which is great, but that wasn't remotely enough to the care needed. We managed to take care of her, between me working remotely a few times a week and some family friends who would sit with her while my dad was at work, but without that family and friend network for support, what were we supposed to do? Being a caretaker like that is a full time job, period. It is virtually impossible to work.
SonofSouthie
Misanthrope
Slip and fell in work yesterday. Surgery this am for a fractured left hip. 
Kepler
Cornell Big Red
Slip and fell in work yesterday. Surgery this am for a fractured left hip.
F-ck. Good luck and feel better soon.
SonofSouthie
Misanthrope
Thx
dxmnkd316
Lucia Apologist
Slip and fell in work yesterday. Surgery this am for a fractured left hip.
oh fuck. Godspeed on your recovery
Slip and fell in work yesterday. Surgery this am for a fractured left hip.
Ouch! At least it happened at work. Get well.
dxmnkd316
Lucia Apologist
I can't remember where we were talking about releasing test results, but I think today was a reminder of why it's probably better to not release test results to goobers like me before your doctor sees it.
Got a result. Nearly had a heart attack reading through it. Turns out it's an exceptionally common and easily corrected issue. Despite the fact that the result said the result was abnormal and... extremely abnormal at that.
Got a result. Nearly had a heart attack reading through it. Turns out it's an exceptionally common and easily corrected issue. Despite the fact that the result said the result was abnormal and... extremely abnormal at that.
dxmnkd316
Lucia Apologist
Lack of brain does seem to be a common issue these days.
Kepler
Cornell Big Red
Abby Someone.
WisconsinWildcard
The plural of anecdote is not data
Its the law. It sucks in many cases but they have to be released. It is frustrating as I typically get results to patients (actually call the patient most of the time) within 12 hours of release...yet often my patient is already freaking out. Sometimes appropriately, most often not.
Yup. The 21st Century Cures Act prohibits any information blocking. Clinical data must be released without delay and cannot be systematically suppressed, with very few exceptions. I have spent a ton of time on it, as it's been phased in over three years. Right now, the final phase is to require healthcare providers to release this data in a computer-readable form (I'm not sure if it's HL7 or XML), which my company is currently working on.
It does, however, lead to a lot of ethical issues, and our ethics and legal departments have and continue to work out exceptions:
- Patient direct request.
- PHI that includes a different patient's PHI
- newborn documentation that includes pertinent information on the mother, for example
- Any reference to another person's health info that is actually relevant to this patient (so, "family history of xxx" doesn't really count, but "father had xxx condition" might)
- Concern for imminent self harm or harm to others if information is delivered via patient portal
- In MA, state laws greatly restrict sharing of info related to HIV/AIDS, so we have to suppress anything even remotely related to that
- Organ donor/recipient documentation, at least the clinical documentation on where a patient sits on a waiting list
Ultimately, I think transparency is good, but unfortunately it's shined a bright light on how awful health education is in our country.
One benefit from this is that we've had a lot of patients pointing out documentation mistakes, which we then need to correct. Someone abstracts the wrong problem list and then that just propagates through every progress and H&P note ever after.
dxmnkd316
Lucia Apologist
Huh. Interesting. That's a dumb law. Should be something like 48 business hours after test performed it should be released. Give the doctor a chance to properly frame the result.
My wife had an interesting take on this. Since she's a licensed therapist, results of her assessments and tests are usually not released immediately. It can be a huge risk to her patients if "diagnosis: bipolar, etc" is released without other info or discussion around it.
Edit: I see Swansong mentioned imminent risk.
My wife had an interesting take on this. Since she's a licensed therapist, results of her assessments and tests are usually not released immediately. It can be a huge risk to her patients if "diagnosis: bipolar, etc" is released without other info or discussion around it.
Edit: I see Swansong mentioned imminent risk.