Great read on one of the biggest contributor to rising healthcare costs that no one ever talks about. The blame always falls on insurance companies, big pharma, overpaid doctors, lawsuits, blah blah blah. Not to discount any of those issues, because they are real, but the demands of idiot patients are a significant factor as well.

http://www.epmonthly.com/columns/in-my-opinion/treating-a-nation-of-anxious-wimps/

Quote :

"Emergency departments are distilleries boiling complex blends of trauma, stress and emotion down to the essence of immediacy: what needs to be done, right now, to fix the problem. Working the past twenty years in such environments has shown me with great clarity what is wrong (and right) with our nation’s medical system. It’s obvious to me that despite all the furor and rancor, what is being debated in Washington currently is not healthcare reform. It’s only healthcare insurance reform. It addresses the undeniably important issues of who is going to pay and how, but completely misses the point of why. Healthcare costs too much in our country because we deliver too much healthcare. We deliver too much because we demand too much. And we demand it for all the wrong reasons. We’re turning into a nation of anxious wimps. I still love my job; very few things are as emotionally rewarding as relieving true pain and suffering, sharing compassionate care and actually saving lives. Illness and injury will always require the best efforts our medical system can provide. But emergency departments nationwide are being overwhelmed by the non-emergent, and doctors in general are asked to treat what doesn’t need treatment. In a single night I had patients come in for the following complaints (all brought by ambulance): “Smoked marijuana and got dizzy”, “stung by a bee and it hurts”, “got drunk and have a hangover”, “sat out in the sun and got sunburn”, “ate Mexican food and threw up”, “picked my nose and it bled, but now it stopped”, “just had sex and want to know if I’m pregnant.” Since all my colleagues and I have worked our shifts while suffering from worse symptoms than these (well, hopefully not the marijuana), we have understandably lost some of our natural empathy for such patients. When working with a cold, flu or headache, I often feel I am like one of those cute little animal signs in amusement parks that say “you must be taller than me to ride this ride” only my sign would read “you must be sicker than me to come to our emergency department.” You’d be surprised how many patients wouldn’t qualify. At a time when we have an unprecedented obsession with health – Dr. Oz, The Doctors, Oprah and a host of daytime talk shows make the smallest issues seem like apocalyptic pandemics – we have substandard national wellness. This is largely because the media focuses on the exotic and the sensational and ignores the mundane. Our society has warped our perception of true risk. We are taught to fear vaccinations, mold, shark attacks, airplanes and breast implants when we really should worry about smoking, drug abuse, obesity, cars and basic hygiene. If you go by pharmaceutical advertisement budgets, our most critical health needs are to have sex and fall asleep. Somehow we have developed an expectation that our health should always be perfect, and if it isn’t, there should be a pill to fix it. With every ache and sniffle we run to the doctor, or purchase useless quackery such as Airborne or homeopathic cures (to the tune of tens of billions of dollars). We demand unnecessary diagnostic testing, antibiotics for our viruses, narcotics for bruises and sprains. And due to time constraints on physicians, fear of lawsuits and the pressure to keep patients satisfied, we usually get them. Yet the great secret of medicine is that almost everything we see will get better (or worse) no matter how we treat it. Usually better. The human body is exquisitely talented at healing. If bodies didn’t heal by themselves, we’d be up the creek. Even in an Intensive Care Unit, with our most advanced techniques applied, all we’re really doing is optimizing the conditions under which natural healing can occur. We give oxygen and fluids in the right proportions, raise or lower the blood pressure as needed and allow the natural healing mechanisms time to do their work. It’s as if you could put your car in the service garage, make sure you gave it plenty of gas, oil and brake fluid, and then expect the transmission to fix itself. The bottom line is that most conditions are self-limited. This doesn’t mesh well with our immediate-gratification, instant-action society. But usually that bronchitis or back ache or poison ivy or stomach flu just needs time to get better. Take two aspirin and call me in the morning wasn’t your doctor being lazy in the middle of the night; it was sound medical practice. As a wise pediatrician colleague of mine once told me, “Our best medicines are Tincture of Time and Elixir of Neglect.” Taking drugs for things that go away on their own is rarely helpful and often harmful. We’ve become a nation of hypochondriacs. Every sneeze is swine flu, every headache a tumor. And at great expense, we deliver fantastically prompt, thorough and largely unnecessary care. There is tremendous financial pressure on physicians to keep patients happy. But unlike business, in medicine the customer isn’t always right. Sometimes a doctor needs to show tough love and deny patients the quick fix. A good physician needs to have the guts to stand up to people and tell them that their baby gets ear infections because they smoke cigarettes. That it’s time to admit they are alcoholics. That they need to suck it up and deal with discomfort because narcotics will just make everything worse. That what’s really wrong with them is that they are just too damned fat. Unfortunately, this type of advice rarely leads to high patient satisfaction scores. Modern medicine is a blessing which improves all our lives. But until we start educating the general populace about what really affects their health and what a doctor is capable (and more importantly, incapable) of fixing, we will continue to waste a large portion of our healthcare dollar on treatments which just don’t make any difference."

12/21/2011 10:39:54 AM

let insurance/medicare deny emergency room claims that arent valid emergencies. problem goes away

12/21/2011 10:48:03 AM

Everyone has heard the story where the guy goes to ER for a headache and gets sent home with advil, only to die the next day of a stroke/aneurysm/whatever. so sorta understandable.

12/21/2011 10:55:51 AM

And that's the problem. Everyone's heard the story of the 1 in a million outlier. Therefore everyone who comes into the ER with a headache gets a CATscan to avoid a lawsuit and... well patients feel entitled to it.

12/21/2011 10:58:26 AM

In general, if we could solve the problem of people being idiots, a lot of problems would go away.

a large portion of the population will be as stupid as is generally allowed.

12/21/2011 11:03:55 AM

Give me a break. No numbers, no stats, just anecdotal horse shit bordering on "Back in my day, men were men and we didn't go to the doctor for a toothache and when we did it was uphill both ways..."

Some people will say anything to justify the status quo, and usually they do so by blaming problems on the people most harmed by it.

It's worth noting that in many other modern countries with universal healthcare, people take many more doctors visits, and have fewer emergency room visits as a result, and every single one of these countries spends less as a % of GDP on health and most enjoy a longer average lifespan and higher reported wellbeing.

People going to doctors to get CATscans for headaches wouldn't be a problem if everybody did it once a year, instead of waiting until you get cancer, then start going to the emergency room once a week to deal with symptoms...too bad you can't get chemo at the emergency room.

In other words: people without insurance going to emergency rooms for this and that to get treated isn't the problem, the problem is that they don't have insurance, so they don't have regular checkups. So, instead of paying a doctor a hundred bucks to zap a black spot on their arm, they have to go to the emergency room once a week just to stay alive after that black spot turned into a bloodstream-traveling cancer, incurring tens of thousands of dollars in treatment that gets offloaded to paying customers and the healthcare system as a whole.

[Edited on December 21, 2011 at 11:31 AM. Reason : .]

12/21/2011 11:23:29 AM

government to the rescue!

12/21/2011 11:31:48 AM

Quote :

"Some people will say anything to justify the status quo,"

please point out the parts of the linked piece that talk about maintaining the status quo. It appears that you are ranting about something that has nothing to do with the piece in question. Go find a thread related to the things you want to rage about.

12/21/2011 11:40:41 AM

Quote :

"please point out the parts of the linked piece that talk about maintaining the status quo. It appears that you are ranting about something that has nothing to do with the piece in question. Go find a thread related to the things you want to rage about."

The entire fucking piece's premise is that the problem is people, not the system, dumbass.

12/21/2011 11:53:06 AM

Quote :

"government to the rescue!"

You know you have to pay for those uninsured people too. Every time some guy goes to the emergency room to get major treatment for a problem that could have been nipped in the bud years ago if he had insurance, you pay for that. The hospital has to make back its money and it does so by charging you and your insurance carrier more.

This isn't "Wah wah people are unhealthy government help us". It's "Our current system is costly and inefficient for everyone because of a lack of large-scale coordination and universal coverage, two things government is uniquely capable of doing."


[Edited on December 21, 2011 at 11:57 AM. Reason : .]

12/21/2011 11:55:34 AM

you shouldnt need insurance to go to the doctor. the whole concept of insurance pays for every little fucking thing is retarded

12/21/2011 11:58:28 AM

Quote :

"You know you have to pay for those uninsured people too. Every time some guy goes to the emergency room to get major treatment for a problem that could have been nipped in the bud years ago if he had insurance, you pay for that. The hospital has to make back its money and it does so by charging you and your insurance carrier more."

I'm very aware of that...Just as im sure you're aware that there are a large group of people that have insurance who do not engage in preventative care and end up costing the system just as much.

It's funny to me that you think every problem that exists can be legislated out of existence and individuals have no responsibility in the matter

12/21/2011 12:18:28 PM

I don't think that, you think I think that. Individual responsibility is to go to the doctor and get checked out, I think that anybody who wants to be responsible like that should be able to, and not have to worry about not even being able to get a fucking checkup because they don't have insurance.

What I'm talking about is enabling responsible behavior.

12/21/2011 12:26:43 PM

Quote :

"The entire fucking piece's premise is that the a problem is people, not the system, dumbass."

there is no "the problem." you, or anyone who believes that is a dumbass, McDanger. BTW, how about just picking one username and sticking with it?

12/21/2011 12:30:08 PM

Quote :

"you shouldnt need insurance to go to the doctor. the whole concept of insurance pays for every little fucking thing is retarded"

We have a winner folks. It costs me $50 for an annual checkup with my vet, no insurance. It costs me $35 for an annual visit with my doctor with insurance. It's over $100 if I have no insurance. If insurance never paid for office visits, you would see annual doctor's visits cost somewhere around $50 too, maybe even less. Recently, my vet has recently started pushing one of those "pet insurance" plans, and ever so coincidentally, the costs of almost all the procedures covered by the insurance plans have gone up at the same time, after having been constant for almost 5 years.

12/21/2011 12:48:49 PM

Quote :

"but the demands of idiot patients are a significant factor as well. "

this is exactly my argument about a lot of topics. not just healthcare.

12/21/2011 1:15:54 PM

Quote :

"If insurance never paid for office visits, you would see annual doctor's visits cost somewhere around $50 too, maybe even less."

See: HSA

Also...

Quote :

"Dr. Thomas A. Doyle is an emergency physician who practices in Sewickley, PA. He is the author of the forthcoming book “Suck It Up, America: The Tough Choices Needed for Real Health-Care Reform”"

I might have to get that book.

[Edited on December 21, 2011 at 1:44 PM. Reason : ]

12/21/2011 1:41:51 PM

Quote :

"We have a winner folks. It costs me $50 for an annual checkup with my vet, no insurance. It costs me $35 for an annual visit with my doctor with insurance. It's over $100 if I have no insurance."

I agree, what makes it even worse is price discrimination. Your insurance including the the individual's co-pay may be 70-85% of what one would pay without insurance.

12/21/2011 1:43:43 PM

Quote :

"It's worth noting that in many other modern countries with universal healthcare, people take many more doctors visits, and have fewer emergency room visits as a result, and every single one of these countries spends less as a % of GDP on health and most enjoy a longer average lifespan and higher reported wellbeing. "

how many more times are you going to post this misleading statistic that has been debunked a thousand times over? jesus, dude, you are incorrigible

12/21/2011 4:56:55 PM

How about post at least one link where it's been "debunked".

12/21/2011 6:11:34 PM

Why is a CT scan expensive in the first place?

12/21/2011 9:29:58 PM

12/21/2011 10:02:15 PM

I agree fully with this piece, and I like that it doesn't attempt to portray itself as the one big problem to the exclusion of other problems.

12/21/2011 10:08:52 PM

Quote :

" It's "Our current system is costly and inefficient for everyone because of a lack of large-scale coordination and universal coverage, two things government is uniquely capable of doing." "

yet despite the fact that our govt has taken over a larger share of our nations healthcare and pushing prices even HIGHER you call for MORE GOVT. haha. I hope one day that actually sinks in and you rethink your "logic".

Oh and who forces hospitals to see everyone or any complaint?

Its a great piece bobby. Thanks for sharing.

12/21/2011 10:47:53 PM

Quote :

"It's "Our current system is costly and inefficient for everyone because of a lack of large-scale coordination and universal coverage, two things government is uniquely capable of doing.""

We are talking about the same government right? The one that blamed the 9/11 attacks on a complete and utter lack of "large-scale coordination" between its various intelligence agencies?

12/22/2011 6:06:08 PM

Quote :

"How about post at least one link where it's been "debunked"."

don't have to. only a moron would expect a nation of fat people who won't get off the couch and put down the bon-bons to have good "health outcomes." it literally has NOTHING to do with how we structure our healthcare payment system and everything to do with what the populace will and won't do to be healthy in the first place. we want a pill for everything. fuck some exercise

[Edited on December 22, 2011 at 9:44 PM. Reason : ]

12/22/2011 9:42:58 PM

You're a damn hack and I think you know it.

12/22/2011 9:57:16 PM

ok. please explain how our obesity epidemic is NOT affecting our health

12/22/2011 10:08:45 PM

The fuck? Were you born retarded or is it a role you grew into? I'll step through it slowly because you've lost what minuscule ability you have to think critically somewhere between Sports talk and Chit Chat.

This was posted:

Quote :

"people take many more doctors visits, and have fewer emergency room visits as a result, and every single one of these countries spends less as a % of GDP on health and most enjoy a longer average lifespan and higher reported wellbeing."

To which you reply:

Quote :

"how many more times are you going to post this misleading statistic that has been debunked a thousand times over?"

Now, no actual statistic was posted so it's pretty hard to know technically wtf you were talking about. However, we can see from the thread that Str8toolish is advocating preventative care is a benefit of socialized medicine in that it leads to less money spent on health care and longer life spans.

I ask you for a link that debunks this idea and you start talking about fucking bon bons.

Can you not see how a reader of this thread can only assume that you are in fact a water baby lacking any ability to piece together a cogent thought?

12/22/2011 11:01:25 PM