People Have Stopped Going to the Doctor. Most Seem Just Fine.

[Demovictory9]

People Have Stopped Going to the Doctor. Most Seem Just Fine.
Do Americans really need the amount of treatment that our health care system is used to providing?

https://www.nytimes.com/2020/06/22/opinion/coronavirus-reopen-hospitals.html?action=click&module=Opinion&pgtype=Homepage

As stay-at-home orders ease and cities reopen for business, many doctors and hospital administrators are calling for a quick return of health care to pre-pandemic levels. For months now, routine care has been postponed. Elective procedures — big moneymakers — were halted so that hospitals could divert resources to treating Covid-19 patients. Routine clinic visits were canceled or replaced by online sessions. This has resulted in grievous financial losses for hospitals and clinics. Medical practices have closed. Hospitals have been forced to furlough employees or cut pay.

Most patients, on the other hand, at least those with stable chronic conditions, seem to have done OK. In a recent survey, only one in 10 respondents said their health or a family member’s health had worsened as a result of delayed care. Eighty-six percent said their health had stayed about the same.

Admittedly, postponing health care had terrible health consequences for some patients with non-Covid-19 illnesses, such as those with newly diagnosed cancers that went untreated because outpatient visits were canceled, or because patients avoided going to the hospital out of fear of contracting the coronavirus. The spike in deaths in major cities like New York during the crisis almost certainly includes such patients.

Still, a vast majority of patients seem to have fared better than what most doctors expected. It will probably take years to understand why. Perhaps patients mitigated the harm of delayed care by adopting healthful behaviors, such as smoking less and exercising more. Perhaps the huge increases in stress were balanced out by other things, such as spending more time with loved ones.

[sop]

1. The 3rd leading cause of death in this country, behind cancer and heart disease, is medical error.

Doctors and hospitals have fewer opportunities to make mistakes when they don't treat patients.

[SlogginThroughIt]

28. Is that really true?

[sop]

32. Links:

https://www.usnews.com/news/articles/2016-05-03/medical-errors-are-third-leading-cause-of-death-in-the-us

https://www.cnbc.com/2018/02/22/medical-errors-third-leading-cause-of-death-in-america.html

[Hoyt]

2. There's an old axiom that 70 - 80% of medical problems are self-limited and will resolve themselves.

Seems a bit high, but even chronic problems can go months without significant exacerbation, especially if one continues medications or other treatments.

[Aristus]

3. No. That's about right. In fact, my Adult Medicine instructor in PA School said it was closer to 90%

I can't count how many patients I have who rush to the clinic the minute even the tiniest symptom develops. Once I've ensured that it's nothing serious, I let them know that it's okay to give these things a little time to resolve.

[Hoyt]

4. I originally said 80%, but was concerned I'd get bashed by those you describe.

I will probably be like my uncle who had a heart attack and died in his recliner smoking a cigarette, setting the house on fire (although, I don't smoke).

[lagomorph777]

8. Chronic problems are completely baffling to medicine. They treat a number and create other problems

So I won't be surprised if the net result of reduced doctor visits for an extended period is enhanced survival and health.

[exboyfil]

11. Getting a prescription for antibiotics

You don't do that and you will find yourself in trouble pretty quickly.

[Hoyt]

13. Certainly makes life easier, but for things like strep, etc., vast majority will survive.

Sure it could spread, become bacterial pneumonia, etc. But, still, vast majority will survive.

I'm not suggesting forgoing care.

[exboyfil]

17. Heart damage a big risk factor from strep

In addition it could slow your recovery time (you get better a whole lot slower). For someone who went through strep several times in high school and college, I am speaking from experience. I was not aware of the available on campus clinic (or it wasn't as formalized as it became later). I definitely should have gone in earlier more than once. When I did start treating early on with antibiotics, my recovery time was much quicker.

[tblue37]

25. So is kidney failure, which is how Emily Dickinson died--it's called Bright's Disease.

Beth in Little Women died of heart disease from untreated strep.

[Tipperary]

23. I cannot remember the last time I needed antibiotics.

Thank god.

[Crunchy Frog]

29. I got an antibiotic prescription for a UTI early in lockdown.

I just called my Dr's office and spoke with the triage nurse, and told her what worked last time. Half an hour later they called me back to tell me that it had been called in to my pharmacy. It worked out very well, and cut out a lot of unnecessary procedure that I normally have to go through.

Of course that won't work for something that requires culture and sensitivity study, but it mostly works when there are pretty standard symptoms and treatments.

[Wellstone ruled]

5. The last City we lived in,

a running joke from the local's was,do not go to the local Hospital unless you want to die. MERSA was the big issue.

[stopdiggin]

27. I've lived in a number of places

where a large percentage of the local population just trashed (reputation of) the health care system, providers and facilities. Actively promoted travel to much more distant facilities for treatment, care or surgery.

I was amazed (dumbstruck actually), and somewhat appalled. I have no idea what was at root there .. but I began to suspect low information (and low income) recipients ...? Just a guess. But perhaps trashing health care is much more prevalent that I assumed.

[Ohio Joe]

6. Yeah... I think i'll continue with preventative medicine...

Not really having it for a few months does not make it unneeded. Sorry, I don't buy this non-sense.

[Ohiogal]

10. I agree

[Tetrachloride]

7. Quote: admittedly ... "some patients" had "terrible health consequences"

In my extended family

1. One with permanent lung damage. Sent home from hospital because there was no room.

2. My favorite honorary aunt dead of cancer 6 days ago. Maybe the family will tell me how many hours she lay alone before being discovered, assuming she died at home.

I find the article annoying at the very least.

[DarthDem]

22. So sorry to hear this :(

RIP to your family members.

[Tetrachloride]

26. Ty. I appreciate it.

[Ohiogal]

9. The co-pay with my insurance

Costs me $60 to see my family doctor and $120 to see a specialist

So I don’t go to the doctor unless it’s something serious anyway

[Grins]

20. No! I used to think that.

NEVER seriously sick my entire life and I’m old.
Only medication I ever took was a vitamin or aspirin.
So like you I stopped going.
For more than 8-years.
And I finally did “just because” it had been a long time and I was a lot older.
I was great!
Everything was great.
But there was just this one more test...!
Colon cancer.
And my life changed BIG TIME!

Two friends felt the same as you.
A little pain but NBD. So they skipped doctors.
Then they did see a doctor.
First one - pancreatic cancer and dead in 3- months.
The other - liver cancer and he hopes he has 5 years.

And I know a 4th and 5th who found out they had heart problems because they tried on a friend’s Apple watch that fired up with their atrial fibrillation.

If you go to a dentist 2x a year you can see a doctor 1x a year.

[Ohiogal]

24. Thank you for your concern

I survived stage 3 cancer 12 years ago ... I had Medicaid back then ... I don’t have Medicaid any more. I am trying to limp along with my current health insurance until I can get on Medicare. I don’t go to the doctor for every sniffle or cough but if I’m really sick, I’ll go and pay the co pay. Trouble is, this system really makes you deliberate with yourself, am I sick enough to see a doctor? 60 bucks may not seem like a lot to some folks, but if the doc orders tests, or refers you to a specialist, or if you need a prescription, it adds up fast! I’m not so reckless that I never go .... my late father in law was like that, hadn’t been to see a doctor in like 20 years...I keep up with the annual visits but really I wish that ability to pay was never an issue for anyone to consider before seeking medical attention.

[stillcool]

12. Republicans have been saying that for years...

If people have access to affordable healthcare, they'll go to the doctor for a sniffle. No, better they not go at all. Leave the Doctors offices for the people that can afford Health care.

[MoonlitKnight]

14. We could save a lot

By adopting the model of much of the rest of the world when it comes to prescription drugs. You should be able to get most medicines straight from the pharmacist and not have to see a doctor every six months to renew prescriptions.

[unitedwethrive]

15. The consequences of poor preventive care are not going to be seen in 3 to 4 months.

The whole point of preventative care is to keep patients healthy for years to come, there’s usually not an immediate strong outcome, which would be more expected from treatments for a specified illness.

[unitedwethrive]

16. Pediatricians are very worried about the consequences of delayed vaccinations

It is quite possible that we will see pertussis and measles outbreak’s this coming winter because so many people have skipped or delayed vaccinations for their children.

[Crunchy Frog]

30. If the kids are socially isolating, it's unlikely that there will be a problem.

I expect most of the parents in question will get their kids caught up once they feel safe to do so.

If my kids were in that age group, I'd be delaying vaccinations too.

[unitedwethrive]

31. This assumes strict, long-term social isolation, which I agree would work, but even having a parent

go grocery shopping once a week could lead to exposure of these highly contagious diseases. And remember, it is herd immunity that works in these diseases, and even small areas of non-compliance have yielded bad outcomes.

[PoindexterOglethorpe]

18. While some things do need care, a lot of other things

will resolve readily enough.

From what I understand, older people in this country take a lot more medications than do same age people in other countries. It seems to me that when some one of your meds has a side effect you need to take another medication for, you and your doctor might need to rethink at least some of what you're taking.

[KY_EnviroGuy]

19. IMO, the elephants in the room are neglect of mental health care and....

routine checkups, both of which do pay off for society in the long term. We should not let complacency set in with those two areas.

Considering the stress of a global pandemic and economic worries across society, it's no wonder we're seeing increases in domestic violence and street violence with guns, along with a resurgence of right-wing nuttery.

KY........

[sarisataka]

21. The question is, are these people really fine or

Are they applying Trump's Covid reduction plan to other health issues.

[GeorgeGist]

33. Fucking liar ...

Less than Half Of Americans Delayed Medical Care Due To Pandemic.


https://khn.org/news/nearly-half-of-americans-delayed-medical-care-due-to-pandemic/

[Ms. Toad]

34. Unfortunately, there are a lot of health conditions

that don't ostensibly impact health until they are too late to cure. That's the point of regular doctor's visits - to catch things while they can make a difference.

And - far too many doctors cause problems with the recommended treatment partly because they expect patients to be non-compliant (perhaps even with keeping regular appoints). So they over-medicate - and figure they can give you more medication to counter the damage done by the first. My doctor is currently hot on the all-diabetics-should-be-on-statins kick. I'm not personally at the risk level where it makes sense for me to take statins (even with treating diabetes as a separate risk factor, which it is). Statins although they are extremely effective at lowering the bad cholesterol, they also prevent production of lots of other things the body actually needs (which can result in side effects such as dementia, hardening of the arteries, depression, muscle loss/impairment (including to the heart muscles)). But - that needs to be monitored, since diabetes is generally considered a chronic progressive disease. I'd be just fine not seeing the doctor (in connection with diabetes) as regularly . . . until I was suddenly not fine because - absent monitoring - I shifted from not being a good candidate for statins to being one who should be on a high dose.

If I'm not seeing a doctor regularly - statins make more sense because they help head off the big dramatic risk (and they can supplement with the other things statins block productions of (like horomones, coenzyme Q10) and medicate me for depression if it results. Off statins, however, I need the regular visits to determine at what point my need for statins changes, if it does.

That said, I'm in favor of allowing telemedicine to replace many actual visits. I did two during the period of closures (One cancer check-up - post mammogram and breast exam by a different member of the team. Absolutely no reason for an in-person check up every 3 months now than I'm 4 years out from an uneventful initial treatment. One for a second degree burn with no apparent complications.) My daughter did one (flu - rule out COVID 19 prior to testing availability) and my spouse did one (discuss routine bloodwork); Even if doctors charge the same, it minimizes inconvenience for all concerned.