People are bad at evaluating doctors and even afterwards whether they are satisfied or sue for malpractice has more to do with whether they like the doctor personally - the doctor listened to them or pretended to listen to them - than the outcomes.
I used to listen to the radio show by Dr. Dean Edell and he recommended, at least for surgeons, that you figure out how to ask the nurses on the sly. They know who the good doctors are.
sue for malpractice has more to do with whether they like the doctor personally - the doctor listened to them or pretended to listen to them - than the outcomes.
This is a popular idea, and hospital administrators like it because itās a simple idea (which is the only sort of idea they can handle, tbh) - but a recent LARGE study showed that, at least in my specialty, the only thing that determined how likely you were to get sued was the number of patients you saw. Period. End of story. No relationship to where you trained, how experienced you are, how āniceā" you are (as measured by patient satisfaction scores). Nothing else.
In other specialties itās likely a little different - when I was COS I reviewed a case where a family wanted to sue everyone who touched the chart EXCEPT the doc who fucked up, because he was ātheirā doctor. He had basically driven the patient into the ground like a tent stake, but it was everyone elseās fault. So YMMV, I suppose.
āat least for surgeons, that you figure out how to ask the nurses on the sly. They know who the good doctors are.ā Yep - or ER docs. There is a (Pleasent) surgeon in town that I wouldnāt let cut my lawn, cause I take care of his frequent complications.
MM MD
Maybe it was posted by someone here but I recall reading a study that found tone of voice is associated with malpractice claims for surgeons.
For common surgeries, the ProPublica data for complication rates is available which also gives an idea of volume. Iām not sure those two numbers tell the whole story but itās more than nothing, and trying to create unbiased estimates for complication rates is, well, complicated.
There is a (Pleasent) surgeon in town that I wouldnāt let cut my lawn
A very young doctor is he?
Nope. Bout 10 years younger than me, and Iām old.
Heās just unlucky or something. I guess.
MM MD
It was a āyou kids get off my lawnā joke.
Iām slow. Or old. Or something.
MM MD
The insane expenses donāt stop once the baby arrives
https://twitter.com/TheStalwart/status/1176922520777383937
How will we pay for Medicare For All, though?!?!
This isnāt even particularly serious, but another example of how dumb our system is.
My 12-year old daughter has had a sore knee for weeks, probably stemming from gymnastics. Sheās off of school this week, so what better time to see an orthopedist? Made an appointment - great!
My wife, whose insurance we use, lost her job in the spring, so we have been on a different insurance plan for a few months. When I gave the info to the doctorās office, they said we need a referral from my daughterās pcp. Ok, called the pcp. They said that they need to see my kid for this issue first before they can refer her. OH, ANDā¦the insurance company put a random doctorās name on her card, so that needs to be changed.
In the meantime, my wifeās new insurance kicks in next week (sheās had a new job since August - yay), so now itās better to just wait and not have to jump through hoops. Of course, then Iāll probably have to pull my daughter out of school for an appointment.
Iāve also been putting off an eye doctor appointment because we donāt have vision insurance until 10/1. I have a chronic eye issue, but no matter. Fuck my vision (Iām fine, no worries).
First world country, for sure.
Jump through hoops time.
Need an insurance co waiver for 2 150mg capsules instead of 1 150mg capsule of a psych med Iāve been taking for 10 years. Of course dr, pharmacy, and insurance company canāt get it together to get it done in less than 11 days. And the waiver is only good for a year. So see you next year. Somehow, itās only the expensive medication that needs this process.
But beware nationalized medicine and rationing of healthcare right?
āVision Insuranceā as people commonly use the term is almost never worth it. Itās not hard to just pay for the ābenefitsā (eye exam, glasses, contacts) directly and spend less than you would in premiums, if you shop around. I suppose itās possible your could have some really amazing deal on vision insurance through employer, where this may not be true. But thatās relatively uncommon.
On the other had if you have actual eye disease that requires you to see an ophthalmologist, that should be covered by regular health insurance. Once again, this is how it usually works, but Iām sure some exceptions exist.
https://twitter.com/katefeetie/status/1178509653652758528
I saw this on the news this morning and had a one way conversation with my one year old explaining how USA #1
I watched the Super Bowl last year through an experimental Oculus app that works sort of like the movie The Cell (with Jennifer Lopez). For seats, I chose best available and got paired with a fan identifying simply as Borodog. It was pretty unremarkable although the national anthem was baked.
I had a similar issue trying to get a waiver and after the fourth go around I had to give up as the doctor would say contact the pharmacy who would say contact the insurance company who would say contact the doctor.
I had to give up taking a medicine I should have because I could not get anyone to take responsibility. My insurance provider changed though so I will try again.
Always seems ridiculous to make something you lose if you make too much money dependent on having a job. This judges seem to agree it goes against the purpose of Medicaid.
Iām convinced that if we did serious investigations into insurance companies, weād find that there is a lot of automatic denying of referrals and claims on the first go around going on as a company policyā¦ or at the very least, theyāre incentivizing the people who make those initial decisions to skew towards rejecting claims/referrals by being harsh on the ones who make mistakes in the other direction. Once you argue on the phone with them, it gets fixed most of the time, but only if youāre willing to spend a couple hours across a few days making phone calls, which a lot of people probably canāt/wonāt do. Itās evil but itās what the free market is doing to us in a lot of different industries.
If it could be proven right now, I would bet about 90% of my net worth that GrubHub is/was doing it. I say was, because they lost my business over it. At least three times, my account there was hacked, I was told that the fraudulent order would be refunded, then it wasnāt until I followed up a second or third time. The first time I didnāt follow up and forgot by the time I was paying my credit card bill, and it was like six months later when I remembered and I lost the dispute. The worst part is that I caught the fraudulent order before the food was even delivered and notified them. Iām convinced that they are purposely deprioritizing security, as a policy not refunding fraudulent orders unless people follow up, then forcing you to deal with their customer service a few times to get the refund.
Cable companies - if you want the best price after the introductory offer, youāve got to call them and spend time on the phone threatening to leave and trying to negotiate with their customer service department. And obviously thereās some collusion going on here, as in locations with two different cable companies they are always similarly priced, the introductory offers are always for the same length of time, and they always jack you back up to the full price. Their ānormalā price is so high that theyāve calculated that colluding and basically accepting 50% of the market share instead of competing to get it higher is more profitable.
And why does this stuff happen?
Customer service is now cheaper since so much of it is outsourced.
The average American is more busy, more stressed, and thus less capable of spending time on the phone.
The average household now has a higher percentage of people working, and a lower percentage of stay-at-home parents. Itās not like you can have the stay-at-home parent spend a couple hours on the phone throughout the week, itās typically going to be someone at work doing it.
In healthcare, in particular, the people most susceptible to this (sick, injured, old) are the ones who will have the toughest time fighting back.
There are probably a lot of smaller fees that we barely even notice that a) popped up in the last decade (or got bigger) and b) can be waived if you spend some time arguing on the phone.
I guess the right free market way to fight back is for consumers to essentially team up and hire outsourced customer service representatives, then empower them to fight back on our behalf.
So our outsourced customer service reps could call the corporationsā outsourced customer service department and argue with each other over how much we have to pay.
