Author Topic:  (Read 392 times)

0 Members and 1 Guest are viewing this topic.

Online mystery-ak

  • Owner
  • Administrator
  • Hero Member
  • ******
  • Posts: 259,002
« on: April 13, 2014, 10:53:34 AM »

Support the USO

Offline Oceander

  • Technical
  • Hero Member
  • ****
  • Posts: 48,272
  • TBR Illuminati
« Reply #1 on: April 13, 2014, 11:34:36 PM »
Hmmm, one more nascent tyrant/social engineer.

Online truth_seeker

  • Hero Member
  • ****
  • Posts: 20,025
  • Common Sense Results Oriented Conservative Veteran
    • The place where argument addicts can go
« Reply #2 on: April 14, 2014, 12:23:47 AM »
Last July I went by ambulance to a top hospital Emergency Room, with a shattered shoulder, and possible head-neck injuries.

I did NOT see an MD that evening at all, but instead a PA, with the result that I go home and see an orthopedic shoulder specialist in the morning. (an issue being the need for repair, or replacement--got repair).

Throughout 8 months of follow-up treatment, I've seen the PA as much, as I've seen the MD that performed the necessary surgery.

In my household, we try to use medical services sparingly only when needed, and NOT go to the ER for every non-urgent situation.

I'm okay with that. I don't feel shortchanged or discriminated against.
"God must love the common man, he made so many of them.�  Abe Lincoln

SPQR

  • Guest
« Reply #3 on: April 14, 2014, 01:46:05 AM »
Last July I went by ambulance to a top hospital Emergency Room, with a shattered shoulder, and possible head-neck injuries.

I did NOT see an MD that evening at all, but instead a PA, with the result that I go home and see an orthopedic shoulder specialist in the morning. (an issue being the need for repair, or replacement--got repair).

Throughout 8 months of follow-up treatment, I've seen the PA as much, as I've seen the MD that performed the necessary surgery.

In my household, we try to use medical services sparingly only when needed, and NOT go to the ER for every non-urgent situation.

I'm okay with that. I don't feel shortchanged or discriminated against.

I would of checked WebMD first. They seem to have a comprehensive list of doctors in all the different parts of the country.
« Last Edit: April 14, 2014, 01:49:21 AM by SPQR »

Offline Oceander

  • Technical
  • Hero Member
  • ****
  • Posts: 48,272
  • TBR Illuminati
« Reply #4 on: April 14, 2014, 08:14:57 AM »
Last July I went by ambulance to a top hospital Emergency Room, with a shattered shoulder, and possible head-neck injuries.

I did NOT see an MD that evening at all, but instead a PA, with the result that I go home and see an orthopedic shoulder specialist in the morning. (an issue being the need for repair, or replacement--got repair).

Throughout 8 months of follow-up treatment, I've seen the PA as much, as I've seen the MD that performed the necessary surgery.

In my household, we try to use medical services sparingly only when needed, and NOT go to the ER for every non-urgent situation.

I'm okay with that. I don't feel shortchanged or discriminated against.

What's a PA?  (forgive me my ignorance).

Offline aligncare

  • Hero Member
  • ****
  • Posts: 20,042
« Reply #5 on: April 14, 2014, 08:25:48 AM »
Physician's assistant. They are more than a nurse but less than a doctor, so to speak.
NeverTrump wants to deny you YOUR voice, YOUR presidential choice.

Offline Oceander

  • Technical
  • Hero Member
  • ****
  • Posts: 48,272
  • TBR Illuminati
« Reply #6 on: April 14, 2014, 08:35:19 PM »
Physician's assistant. They are more than a nurse but less than a doctor, so to speak.

Thanks!  I am in agreement that people like PAs and RNs should start providing a lot more of the frontline care than they do now.  It seems to me that one of the things nurses are good at (amongst many, many other things) is triage:  making quick decisions about who desperately needs a doctor's undivided attention, who should be examined by a doctor in fairly short order, who has injuries that don't require primary examination by a doctor, but examination and diagnosis by a PA or RN, followed by a review of the proposed treatment by a doctor, and who really just needs some TLC:  a little hand-holding, some antiseptic cleaning, removing a little grit from a skinned knee, a couple of bandages, and a lollipop.

One of the things that I've noticed have just begun sprouting up around LI are the "urgent care" clinics.  We took my daughter to one last fall when she said she could barely hear out of one ear after she had a short but strong cold.  We walked into the clinic, waited for half an hour, and were then seen by someone - in this case a doctor - who did a quick examination, made a diagnosis, and suggested that we follow up with her pediatrician when we could but without a lot of delay.  I was very impressed because it was exactly the sort of care we needed in that situation:  we needed to be seen by someone quickly, in case there was some real damage to her hearing, which wouldn't happen if we had tried to schedule a visit with the pediatrician, but we didn't need the full-bore examination we would have gotten in the emergency room and, in any event, we would have spent half the day, or more, waiting for her to be seen if we'd gone to the emergency room.  We saw her pediatrician a week and a half later and she confirmed the urgent care doctor's diagnosis and his prescribed treatment.

It seems to me that this sort of clinic should be the first place almost all ambulatory patients go to first because I think they would be very good at triaging the patients, deciding who needs to go to the emergency room to get the full exam treatment, and who can be safely treated at the clinic, either with or without a prescribed follow-up with the patient's own doctor.  Not only would that reduce costs tremendously, it would get more practical care more quickly to a greater number of people, and it would take a lot of the pressure off the emergency rooms, freeing them up to treat the serious cases more efficiently and more quickly.

How we get to there from here, however, I'm not so sure of.  However, I think that a very aggressive advertising campaign - and some of them are advertising aggressively on their own - would start to put them into peoples' consciousness as a resource they would generally look to in the first instance.  I would prefer to avoid trying to force people into them, like having the law require insurance policies force their clients to go to an urgent care clinic first in order to have any of their expenses covered, not only for the individual liberty concerns but also to prevent creating an artificial distortion in the market that could be arbitraged by bad-faith clinic operators to extract uneconomic payments out of the system.

Online truth_seeker

  • Hero Member
  • ****
  • Posts: 20,025
  • Common Sense Results Oriented Conservative Veteran
    • The place where argument addicts can go
« Reply #7 on: April 14, 2014, 08:43:29 PM »
One of the things that I've noticed have just begun sprouting up around LI are the "urgent care" clinics. 

My wife and I have been self-insured, until the last year. We have therefore used what we call "walk-in clinics" for the most part.

Since we are known to be cash customers from the start, they give you their diagnosis, quick and cheap, including recommended drugs, and other follow up treatments.

Now that we have insurance, with different companies for now, we need to know the "walk ins" and nearby ERs that our doctor groups use, etc.

As a well informed medical consumer, why should I take up space in an expensive ER for every sniffle and bruise, when that space can be kept available for uninsured, illiterate, illegal immigrants--and other Obama voters?
"God must love the common man, he made so many of them.�  Abe Lincoln

Offline sinkspur

  • Hero Member
  • ****
  • Posts: 28,691
« Reply #8 on: April 14, 2014, 08:50:25 PM »
I haven't seen our primary care physician in two years, even for physicals.  The PA does it.

I can get in to see the PA, if urgent, the same day.  I like this arrangement .  Doctors are for very sick people, not for earaches or joint issues that will require off-site X-rays or a visit to an Orthopedist anyway.
Roy Moore's "spiritual warfare" is driving past a junior high without stopping.


Share me

Digg  Facebook  SlashDot  Delicious  Technorati  Twitter  Google  Yahoo
Smf