Until it becomes a pulmonary embolism. And the list goes on. The majority of patients on dialysis are there due to high blood pressure and diabetes, but the US is probably the only developed country in the world that has untreated strep as a significant cause of kidney damage and other complications such as meningitis and hearing loss. A significant portion of our population doesn't have the health insurance to see a doctor when they have a sore throat or can't afford to take the time off to see one.

magical thyme

(14,881 posts)

8. K&R, with one correction...

Reply to bigdarryl (Original post)

Thu Nov 28, 2013, 01:20 PM

Nov 2013

At the small rural hospital where I work, on an afternoon when I am alone running the entire lab for a couple hours is rarely the slowest time of the year. Inevitably when 3:30 pm rolls around, the last morning tech will leave and as she's leaving, a couple hours before the night tech comes, the EDs start arriving en masse. On Thanksgiving, it will be chest pains, and although most of them will be indigestion, there is usually one that is not.

It rarely fails...

tblue37

(65,340 posts)

9. My daughter is a double boarded doctor. One of her specialties is emergency medicine.

Reply to bigdarryl (Original post)

Thu Nov 28, 2013, 01:21 PM

Nov 2013

As she explains it, ER doctors mainly do two things: (1) they stabilize acute cases long enough to get them to *another* doctor (one with the appropriate area of expertise), and (2) they perform triage--i.e., identifying which doctor to pass the patient along to, which medical specialty needs to perform the true diagnosis and treatment of the patient.

IOW, ER doctors manage the gate, directing traffic flow. They diagnose and treat only superficially and *temporarily*. The patient NEEDS to be able to GET to the appropriate doctor, the one the ER doctor recommends.

Vox Moi

(546 posts)

10. Note what the Doc said about linked Medical Records

Reply to bigdarryl (Original post)

Thu Nov 28, 2013, 01:30 PM

Nov 2013

This is a problem that Insurance company - employer model of health care cannot solve, even for people with good policies.
People move, change jobs, change insurance, go to different providers. The medical record is fragmented and is nearly impossible to put together. With each new arrangement, things start from scratch.
The ER Docs see the worst of this.
The ability to look a a patient over the course of their lifetime and the resultant data about the rise and treatment of conditions would both improve the science of medicine and the cost of delivering care.

The prescribed way to do that is via single-payer system.

To insist that the current system stay in place is also to insist that health care providers and researchers work with one hand tied behind their backs in order to accommodate a system that is based on the profit motive. It's for the money.

AuntFester

(57 posts)

11. isnt there a provision in the ACA that addresses this?

Reply to Vox Moi (Reply #10)

Fri Nov 29, 2013, 03:22 AM

Nov 2013

i know this has been takled about for years.

Vox Moi

(546 posts)

14. It does to a degree but ...

Reply to AuntFester (Reply #11)

Fri Nov 29, 2013, 12:40 PM

Nov 2013

The problem is that the data is held by the various providers and insurers and so it is scattered. There are privacy issues with moving data from one body to another and technical issues with combining data from different institutions. It s also extremely difficult to track individuals as they move from one plan to one provider to another. The Electronic Medical Record provision in the AMA is not a solution to that problem. It helps, a bit.

The big thing is that the data is generated primarily for billing purposes, as the first order of business in a for-profit industry is billing. It makes medical care a series of transactions: visits, hospital stays and so on that are called 'episodes of care.' This is the basic unit of medical care in our system … not the person … and this is often how it is evaluated. If you look at the 'Best Hospital' rankings in US News, for example, you see that the rankings are broken down by various clinical areas: Cardiology, Oncology and so on. That's not a bad thing but it reflects the way the system is oriented toward episode of care. Evaluation on readmissions or complications that show up later are much harder to make, in part because those subsequent episodes might happen at another institution. In fact, hospitals often have no idea what happens to a patient after discharge and an HMO looses sight of a member after they move on, leaving their data behind.

A single-payer system would address the problem directly and provide a means of looking at a person (persons grouped in various ways) over long periods of time lifetime no matter where the care was delivered.