Health Care reform from a Doctors perspective

[aspawloski4th]

Now how would you like it if the government forced you away from that activity and forced you to provide care to another person whom you felt was less in need?

I would like the governemnt helping me help her, because they have more resourses than I do.

 

[royal_archer]

I would like the governemnt helping me help her, because they have more resourses than I do.

Unfortunately that isn’t how it works. first the nation is over 12 trillion in debt with the debt skyrocketing so they don’t exactly have resources to spare. What they do is they take resources and redistribute them in a way that empowers elected officials.

But the crux of the situation is highlighted by this response. To many people want the government to contribute to them and their immediate acquaintences.

 

[aspawloski4th]

Unfortunately that isn’t how it works. first the nation is over 12 trillion in debt with the debt skyrocketing so they don’t exactly have resources to spare. What they do is they take resources and redistribute them in a way that empowers elected officials.

But the crux of the situation is highlighted by this response. To many people want the government to contribute to them and their immediate acquaintences.

Which is more important Well being or money? I’m getting the impression you think money. By the way when you add up all American public and private debt it far out numbers the money supply. So the debt is impossible to payoff. I do not worry about trying to do impossible things.

 

[royal_archer]

Which is more important Well being or money? I’m getting the impression you think money. By the way when you add up all American public and private debt it far out numbers the money supply. So the debt is impossible to payoff. I do not worry about trying to do impossible things.

neither well being ro money is an absolute it is a balance each person has to make on their own, not something to be dictated by a large central government. I’ll spare you the ecconomics lesson since it is irrelvant to the thread.

 

[wabrams]

I don’t care about percentages, a billion dollars is a billion dollars whether it 1% profit or if it99% profit.

We all know you don’t, as you have mentioned in this thread and others. Interesting you make that comment but went on ad nauseum in another thread that you knew how to run a business.

 

[Bluegoat]

And in a Catholic society, this is what happens. Unfortunately, we don’t live in a Catholic society, and because we do not, we will not have the types of institutions which would care for the sick without recompense.

There are lots of health care systems that are non-profit for essential services. They don’t use private insurance companies for them. Of course health care workers are paid, but hospitals and medical practices are essentially non-profit.

They aren’t all what I would describe as Catholic societies, so I am not sure I would say that was the defining characteristic, though one would hope a Catholic society would operate that way.

 

[aspawloski4th]

We all know you don’t, as you have mentioned in this thread and others. Interesting you make that comment but went on ad nauseum in another thread that you knew how to run a business.

Well some around here don’t get points very well, which puts me in a different type of mode for getting a point accross. I think the point that governement is evil is said adnauseum around here. I happedn to think in this day and age both government and business are evil. Just that big business now acts more evil. You just don’t like that I dont have your Rush Limbaugh view of the world, so that makes it that I can’t say anything correct. So snivel on I don’t really care.

 

[Libertarian_FL]

Who says doctors need to go to school for so many years. In Greece people enter medical training right in university and its around six years to be a general practitioner. Then after ten years they can apply fora specialist program. It would be far cheaper than the way we do it now. And I will add a nurse with a good computer and basic tests could handle most mundane cases in an office with some proper training a medical doctor should handle cases out of the norm in my opinion. Take a standard urinary tract infection the tests and symptoms are well known so why is a doctor needed for routine ones - as an example.

But I will add I love doctors I just think malpractice reform is needed I might suggest if a prudent doctor would not have done anything different under treatment and testing they should not be able to be sued. Maybe have a medical panel decide a standard battery of practice and review such cases to see if they should be sued. And perhaps have the government cover malpractice insurance. Sort of a limited form of sovereign immunity.

But we must try to reform the system as it is the poor in the US are suffering and what are we to do nothing? Doctors might lose income or might not lose income but its clear as is is not enough.

 

[St_Francis]

There are lots of health care systems that are non-profit for essential services. They don’t use private insurance companies for them. Of course health care workers are paid, but hospitals and medical practices are essentially non-profit.

They aren’t all what I would describe as Catholic societies, so I am not sure I would say that was the defining characteristic, though one would hope a Catholic society would operate that way.

Used to be that convents and monasteries functioned as society’s “safety net,” providing help for the poor, the elderly, the sick. Because the staff had taken vows of poverty, and because others in the same society provided charitable aid, this was how these services were provided even for those who could not afford them.

 

[St_Francis]

I would like the governemnt helping me help her, because they have more resourses than I do.

You say that the government has more resources than you do. The government has *no *resources of its own. The government has only what it obtains from you and me.

Do you remember the story of the goose who laid the golden egg? Every morning, her owner picked up an egg of gold. One day he decided that he wanted more, so he killed her and opened her up, thinking he’d get all the eggs at once. The increases that the government is putting on us will kill the goose.

…By the way when you add up all American public and private debt it far out numbers the money supply. So the debt is impossible to payoff. I do not worry about trying to do impossible thing

The debt is not impossible to pay off; the spending spree will be paid for one way or another. The problem is that it is not us who will be paying for it but our children and grandchildren.

 

[royal_archer]

Who says doctors need to go to school for so many years. In Greece people enter medical training right in university and its around six years to be a general practitioner. Then after ten years they can apply fora specialist program. It would be far cheaper than the way we do it now. And I will add a nurse with a good computer and basic tests could handle most mundane cases in an office with some proper training a medical doctor should handle cases out of the norm in my opinion. Take a standard urinary tract infection the tests and symptoms are well known so why is a doctor needed for routine ones - as an example.

But I will add I love doctors I just think malpractice reform is needed I might suggest if a prudent doctor would not have done anything different under treatment and testing they should not be able to be sued. Maybe have a medical panel decide a standard battery of practice and review such cases to see if they should be sued. And perhaps have the government cover malpractice insurance. Sort of a limited form of sovereign immunity.

But we must try to reform the system as it is the poor in the US are suffering and what are we to do nothing? Doctors might lose income or might not lose income but its clear as is is not enough.

It is nice to hear something other than the standard “punnish the working class, they have to much money” routine.

If someone were to be a doctor, do you think they really need to spend 12 years in basic education? If we allowed students to move at their own pace through basic school subjects we might be able to get them into college sooner and reduce the total cost to educate them.

Why don’t all doctors start out as Nurses and then get additional responsibilities as they gain experience finally moving up into the realm of surgeon or whatever other specialty. I could see qualifying nurses in CFR and greatly reducing the need for full doctors. (CFR- Cold, Flu, Runny nose. A nurse could easily address basic sicknesses and refer unusual symptoms to a doctor.)

 

[royal_archer]

Used to be that convents and monasteries functioned as society’s “safety net,” providing help for the poor, the elderly, the sick. Because the staff had taken vows of poverty, and because others in the same society provided charitable aid, this was how these services were provided even for those who could not afford them.

People were much more willing to offer support when those receiving were realy needy. With the government giving away billions to those who don’t need it, it is easy for people to assume charity is no longer needed. With the damage the government has done to the Christian charity network, they are just building more and more depenency on themselves.

 

[royal_archer]

The debt is not impossible to pay off; the spending spree will be paid for one way or another. The problem is that it is not us who will be paying for it but our children and grandchildren.

Your not actually implying money in the private sector can be used more than once are you?

 

[Bluegoat]

.

But I will add I love doctors I just think malpractice reform is needed I might suggest if a prudent doctor would not have done anything different under treatment and testing they should not be able to be sued. Maybe have a medical panel decide a standard battery of practice and review such cases to see if they should be sued. And perhaps have the government cover malpractice insurance. Sort of a limited form of sovereign immunity.

There are a number of ways this is handled outside of the US. In some places they use a no-fault system. Here, all doctors get their malpractice insurance from a co-op. Their policy is that unless there is clear negligence or fault, they will always fight a court battle, even if it is more expensive than settling. This has ultimately resulted in much lower insurance costs, as well as more freedom for doctors to practice according to the principles of good medicine. But, it would mean getting rid of private insurers competing for doctor’s business.

 

[wabrams]

You just don’t like that I dont have your Rush Limbaugh view of the world, so that makes it that I can’t say anything correct. So snivel on I don’t really care.

How do you even know I listen to Rush Limbaugh? It’s not that I don’t like you b/c we don’t hold the same world view, I just really dislike the fact the government should give everyone handouts and the fact you claim all businesses are evil but have no comprehension how they are run.

You are the one snivelling for government handouts.

 

[wabrams]

Who says doctors need to go to school for so many years. In Greece people enter medical training right in university and its around six years to be a general practitioner. Then after ten years they can apply fora specialist program. It would be far cheaper than the way we do it now.

b/c in the US, to get into medical school, you have to take a couple of years worth of chemistry and biology to get the foundation to tackle the curriculum. You can’t just jump into a doctorate level physiology, pharmacology or biochemistry class w/o already having a firm grasp on the subject.

And I will add a nurse with a good computer and basic tests could handle most mundane cases in an office with some proper training a medical doctor should handle cases out of the norm in my opinion. Take a standard urinary tract infection the tests and symptoms are well known so why is a doctor needed for routine ones - as an example.

Why don’t all doctors start out as Nurses and then get additional responsibilities as they gain experience finally moving up into the realm of surgeon or whatever other specialty. I could see qualifying nurses in CFR and greatly reducing the need for full doctors. (CFR- Cold, Flu, Runny nose. A nurse could easily address basic sicknesses and refer unusual symptoms to a doctor.)

The last thing you want is a nurse working in the capacity of a doctor. To begin with, their training is completely different. Nurse take 8 hours of combined undergraduate level anatomy & physiology, microbiology and an all-in-one chemistry/biochemistry class before they get into nursing school. As mentioned earlier, docs have to have more science background. All a nurses training is undergraduate.

You want a nurse to handle “routine” things? Without extensive training, they can easily miss simple symptoms that could lead to more problems or prescribe meds for that “standard” UTI that could adversely react w/ meds the patient is already on.

 

[royal_archer]

The last thing you want is a nurse working in the capacity of a doctor. To begin with, their training is completely different. Nurse take 8 hours of combined undergraduate level anatomy & physiology, microbiology and an all-in-one chemistry/biochemistry class before they get into nursing school. As mentioned earlier, docs have to have more science background. All a nurses training is undergraduate.

You want a nurse to handle “routine” things? Without extensive training, they can easily miss simple symptoms that could lead to more problems or prescribe meds for that “standard” UTI that could adversely react w/ meds the patient is already on.

Not working at the capacity of a doctor and not with the same training system we have now. With Nurse Pratictioners, residents, interns, orderlies, attendings, physicians assistants, etc It does seem like there should be some ability to get a future doctor more expertise in one field so they can start “practicing” in that narrow field under the auspices of a full doctor. I did assume Doctors and nurses had much similarity in their basic training. It would seem someone could pick up a nursing degree on their way to becoming a full doctor. For instance when people go through the seminaries they become transitional deacons on their way to becoming priests and those in Officer Training Programs are enlisted until they get promoted to O-1s.

By the way, we had a lot of physicians assistants on active duty and seldom saw a full doctor. Those PAs handled all of the routine cases and knew enough to call in the doctor when something was out of the ordinary. I am not sure if nurses as we know them now would fit the “CFR” mold. But I do think there is potential to train people to fill that role in less time than it would take to train a full doctor.

 

[wabrams]

Not working at the capacity of a doctor and not with the same training system we have now. With Nurse Pratictioners, residents, interns, orderlies, attendings, physicians assistants, etc It does seem like there should be some ability to get a future doctor more expertise in one field so they can start “practicing” in that narrow field under the auspices of a full doctor. I did assume Doctors and nurses had much similarity in their basic training. It would seem someone could pick up a nursing degree on their way to becoming a full doctor. For instance when people go through the seminaries they become transitional deacons on their way to becoming priests and those in Officer Training Programs are enlisted until they get promoted to O-1s.

The nurses and doctors do not have any similarity in their training. Some doctors have started out as EMT’s, nurses, respiratory therapists, radiologic technologists, etc., but in the end they still had to go back and load up on science courses to get into med school. When they do become doctors, their approach to medicine is different.

What peopl don’t realize is that nurses practice holistic care, treating the whole person; doctors and physician assistants follow the medicla model.

By the way, we had a lot of physicians assistants on active duty and seldom saw a full doctor. Those PAs handled all of the routine cases and knew enough to call in the doctor when something was out of the ordinary. I am not sure if nurses as we know them now would fit the “CFR” mold. But I do think there is potential to train people to fill that role in less time than it would take to train a full doctor.

PA’s go through the first year and a half of med school, then skip the biochemistry and go straight into clinical training. It is primarily a masters level degree w/ almost identical undergradute requirements as med school. PA school uses the same model of training that med schools used to train doctor’s in WW2. PA’s where originally meant to fill the family practiced role. Problem is, their training is so thorough and their knowledge base so great, they have branched out to just about every area of medicine. They are now beginning to offer surgery resident programs for PA’s.

 

[Bluegoat]

Why don’t all doctors start out as Nurses and then get additional responsibilities as they gain experience finally moving up into the realm of surgeon or whatever other specialty. I could see qualifying nurses in CFR and greatly reducing the need for full doctors. (CFR- Cold, Flu, Runny nose. A nurse could easily address basic sicknesses and refer unusual symptoms to a doctor.)

Nurses and doctors actually do quite different jobs. A nurse is not a cheap doctor.

However, there is actually a lot of the idea you are talking about being implemented. So, for example, one now sees physicians assistants, who train in particular things and can do certain jobs that doctors then do not have to do. Or nurse practitioners, who can meet many patient needs as well as a doctor (my husband had a nurse practitioner as his assigned “doctor” when he was in the military, and she was really great.) Considering the best way to set up a medical practice is another way to look at it. In some, the patient may well first see a nurse who will handle things like blood work, taking vitals, things like diabetes or sexual health education - all of which many nurses are better at.

As well, in many places all medical care is co-ordinated through a GP. If a patient wants to see a specialist, they get a referral. This solves a lot of difficulties with patients who misdiagnose their problems, use a more expensive doctor when a GP would work as well or better, and also means that someone is looking at the big picture of the patient’s health (and ideally of the whole family.)

Doctors are not always very keen on these kinds of initiatives, I think because of money, and also power. Even in places with socialized medicine they often resist, but in such cases they can be made to change to some extent.

Where I live, there has recently been resistance to the introduction of nurse practitioners and midwives, despite evidence that both result in better care and more economical care. Some doctors actually refuse to work with them, or try to set up a system where they have so little leeway that the benefits are largely lost.

 

[Bluegoat]

The last thing you want is a nurse working in the capacity of a doctor. To begin with, their training is completely different. Nurse take 8 hours of combined undergraduate level anatomy & physiology, microbiology and an all-in-one chemistry/biochemistry class before they get into nursing school. As mentioned earlier, docs have to have more science background. All a nurses training is undergraduate.

I don’t think this is the case with nursing programs everywhere, though I could be mistaken. In any case, I agree that a regular RN and a doctor do different jobs, though a nurse practitioner, who is indeed a nurse, is a different story.

Though not having any expertise does not seem to stop doctors from offering opinions. Many women go to their doctors for advice about breastfeeding, and the doctors give it, despite having only about an hour of non-practical teaching in modern programs. Older doctors have none at all unless they pursue it themselves. The same often goes for complaints that really ought to go to a physiotherapist or nutritionist.