Comments on: Nick And The Not So Happy Hospitalist http://www.nickscrusade.org/happy-hospitalist/ "Injustice anywhere is a threat to justice everywhere" -- MLK Thu, 22 Jul 2010 21:47:42 +0000 http://wordpress.org/?v=2.9 hourly 1 By: NickDupree http://www.nickscrusade.org/happy-hospitalist/comment-page-1/#comment-3756 NickDupree Sat, 08 Aug 2009 03:18:48 +0000 http://www.nickscrusade.org/?p=954#comment-3756 Third party payers (whether government or private insurance) now pretty much uniformly WILL NOT cover second opinions. So what do we do now? Third party payers (whether government or private insurance) now pretty much uniformly WILL NOT cover second opinions. So what do we do now?

]]> By: FisCon http://www.nickscrusade.org/happy-hospitalist/comment-page-1/#comment-3755 FisCon Sat, 08 Aug 2009 02:55:27 +0000 http://www.nickscrusade.org/?p=954#comment-3755 Nick--doctors have a lot of information asymetry between themselves and the truth. People used to get second and third opinions. When you could pick your own doctor, word of mouth allowed you to find doctors you could trust and switch at will. <br><br>Information asymetry between doctors and patients isn't going to get better as the power of the force standing in between them gets stronger--it's going to have goals all of its own, and remove paths, but it certainly isn't going to bring much insight. Nick–doctors have a lot of information asymetry between themselves and the truth. People used to get second and third opinions. When you could pick your own doctor, word of mouth allowed you to find doctors you could trust and switch at will.

Information asymetry between doctors and patients isn't going to get better as the power of the force standing in between them gets stronger–it's going to have goals all of its own, and remove paths, but it certainly isn't going to bring much insight.

]]> By: AlisonHymes http://www.nickscrusade.org/happy-hospitalist/comment-page-1/#comment-3754 AlisonHymes Sat, 08 Aug 2009 02:33:12 +0000 http://www.nickscrusade.org/?p=954#comment-3754 That should be uninformed don't live as long as informed..... :) That should be uninformed don't live as long as informed….. :)

]]> By: AlisonHymes http://www.nickscrusade.org/happy-hospitalist/comment-page-1/#comment-3753 AlisonHymes Sat, 08 Aug 2009 02:32:28 +0000 http://www.nickscrusade.org/?p=954#comment-3753 As a kidney patient the answer was always fellow kidney patients who have developed great listservs and bulletin boards and education programs full of information so one can be more informed when making such decisions. I still belong to a transplant listserv now and learn things all the time from it. Not sure if other health conditions have as many resources, since you are a kidney patient for life once you are a kidney patient there is more time for development of knowledge. There is the thought that uninformed dialysis patients don't live as long as uninformed ones but I don't know if there has been a study to prove it yet. Certainly the informed dialysis and transplant patients I have known have outlived expectations....... As a kidney patient the answer was always fellow kidney patients who have developed great listservs and bulletin boards and education programs full of information so one can be more informed when making such decisions. I still belong to a transplant listserv now and learn things all the time from it. Not sure if other health conditions have as many resources, since you are a kidney patient for life once you are a kidney patient there is more time for development of knowledge. There is the thought that uninformed dialysis patients don't live as long as uninformed ones but I don't know if there has been a study to prove it yet. Certainly the informed dialysis and transplant patients I have known have outlived expectations…….

]]> By: NickDupree http://www.nickscrusade.org/happy-hospitalist/comment-page-1/#comment-3752 NickDupree Sat, 08 Aug 2009 02:17:24 +0000 http://www.nickscrusade.org/?p=954#comment-3752 I'm strongly in favor of giving patients skin in the game, through things like Cash & Counseling, but what can be done about the radical information asymmetry between doctors and patients? i.e. the doctor says you need a stent in your heart, but how do you know it can't be treated fine with medications alone but the doctor is recommending a stent procedure because the fee structure provides him/her an overwhelming financial incentive to do procedures? I'm strongly in favor of giving patients skin in the game, through things like Cash & Counseling, but what can be done about the radical information asymmetry between doctors and patients? i.e. the doctor says you need a stent in your heart, but how do you know it can't be treated fine with medications alone but the doctor is recommending a stent procedure because the fee structure provides him/her an overwhelming financial incentive to do procedures?

]]> By: AlisonHymes http://www.nickscrusade.org/happy-hospitalist/comment-page-1/#comment-3751 AlisonHymes Sat, 08 Aug 2009 01:59:08 +0000 http://www.nickscrusade.org/?p=954#comment-3751 Um, he has time to post 2 to 3 times a day to a blog but complains about patients taking up his time? I'm sorry, I don't get it. And I'm really tired of this trope : "you hate the rich", nobody hates the rich, the rich hate the poor and our society reflects that in every way. We could do with a little more actual hating the rich instead of falling for the trap of thinking some day we will be one of them as so many do and fight an inheritance tax they themselves would never ever pay. Good for you speaking up Nick. Um, he has time to post 2 to 3 times a day to a blog but complains about patients taking up his time? I'm sorry, I don't get it. And I'm really tired of this trope : “you hate the rich”, nobody hates the rich, the rich hate the poor and our society reflects that in every way. We could do with a little more actual hating the rich instead of falling for the trap of thinking some day we will be one of them as so many do and fight an inheritance tax they themselves would never ever pay. Good for you speaking up Nick.

]]> By: FisCon http://www.nickscrusade.org/happy-hospitalist/comment-page-1/#comment-3750 FisCon Fri, 07 Aug 2009 23:34:26 +0000 http://www.nickscrusade.org/?p=954#comment-3750 Cutting through the hyperbole on both sides of this debate, I think both sides are right--which can only happen in a flawed system. . .a collectivist system, that is: where everyone is a free rider of sorts, and everyone is also a victim of sorts. <br><br>Unless and until doctors and patients must deal directly with each other, rather than appeal to a nebulous master who tries (but fails) to keep all of the plates spinning, you get everyone working harder to keep the same-sized slice of a shrinking pie, all the while more folks are invited to the table to get a 'free' slice.<br><br>This problem will get worse, not better. You're both right, but we're ALL wrong! Cutting through the hyperbole on both sides of this debate, I think both sides are right–which can only happen in a flawed system. . .a collectivist system, that is: where everyone is a free rider of sorts, and everyone is also a victim of sorts.

Unless and until doctors and patients must deal directly with each other, rather than appeal to a nebulous master who tries (but fails) to keep all of the plates spinning, you get everyone working harder to keep the same-sized slice of a shrinking pie, all the while more folks are invited to the table to get a 'free' slice.

This problem will get worse, not better. You're both right, but we're ALL wrong!

]]> By: NickDupree http://www.nickscrusade.org/happy-hospitalist/comment-page-1/#comment-2653 NickDupree Fri, 07 Aug 2009 20:18:48 +0000 http://www.nickscrusade.org/?p=954#comment-2653 Third party payers (whether government or private insurance) now pretty much uniformly WILL NOT cover second opinions. So what do we do now? Third party payers (whether government or private insurance) now pretty much uniformly WILL NOT cover second opinions. So what do we do now?

]]> By: FisCon http://www.nickscrusade.org/happy-hospitalist/comment-page-1/#comment-2652 FisCon Fri, 07 Aug 2009 19:55:27 +0000 http://www.nickscrusade.org/?p=954#comment-2652 Nick--doctors have a lot of information asymetry between themselves and the truth. People used to get second and third opinions. When you could pick your own doctor, word of mouth allowed you to find doctors you could trust and switch at will. <br><br>Information asymetry between doctors and patients isn't going to get better as the power of the force standing in between them gets stronger--it's going to have goals all of its own, and remove paths, but it certainly isn't going to bring much insight. Nick–doctors have a lot of information asymetry between themselves and the truth. People used to get second and third opinions. When you could pick your own doctor, word of mouth allowed you to find doctors you could trust and switch at will.

Information asymetry between doctors and patients isn't going to get better as the power of the force standing in between them gets stronger–it's going to have goals all of its own, and remove paths, but it certainly isn't going to bring much insight.

]]> By: AlisonHymes http://www.nickscrusade.org/happy-hospitalist/comment-page-1/#comment-2651 AlisonHymes Fri, 07 Aug 2009 19:33:12 +0000 http://www.nickscrusade.org/?p=954#comment-2651 That should be uninformed don't live as long as informed..... :) That should be uninformed don't live as long as informed….. :)

]]> By: AlisonHymes http://www.nickscrusade.org/happy-hospitalist/comment-page-1/#comment-2650 AlisonHymes Fri, 07 Aug 2009 19:32:28 +0000 http://www.nickscrusade.org/?p=954#comment-2650 As a kidney patient the answer was always fellow kidney patients who have developed great listservs and bulletin boards and education programs full of information so one can be more informed when making such decisions. I still belong to a transplant listserv now and learn things all the time from it. Not sure if other health conditions have as many resources, since you are a kidney patient for life once you are a kidney patient there is more time for development of knowledge. There is the thought that uninformed dialysis patients don't live as long as uninformed ones but I don't know if there has been a study to prove it yet. Certainly the informed dialysis and transplant patients I have known have outlived expectations....... As a kidney patient the answer was always fellow kidney patients who have developed great listservs and bulletin boards and education programs full of information so one can be more informed when making such decisions. I still belong to a transplant listserv now and learn things all the time from it. Not sure if other health conditions have as many resources, since you are a kidney patient for life once you are a kidney patient there is more time for development of knowledge. There is the thought that uninformed dialysis patients don't live as long as uninformed ones but I don't know if there has been a study to prove it yet. Certainly the informed dialysis and transplant patients I have known have outlived expectations…….

]]> By: NickDupree http://www.nickscrusade.org/happy-hospitalist/comment-page-1/#comment-2649 NickDupree Fri, 07 Aug 2009 19:17:24 +0000 http://www.nickscrusade.org/?p=954#comment-2649 I'm strongly in favor of giving patients skin in the game, through things like Cash & Counseling, but what can be done about the radical information asymmetry between doctors and patients? i.e. the doctor says you need a stent in your heart, but how do you know it can't be treated fine with medications alone but the doctor is recommending a stent procedure because the fee structure provides him/her an overwhelming financial incentive to do procedures? I'm strongly in favor of giving patients skin in the game, through things like Cash & Counseling, but what can be done about the radical information asymmetry between doctors and patients? i.e. the doctor says you need a stent in your heart, but how do you know it can't be treated fine with medications alone but the doctor is recommending a stent procedure because the fee structure provides him/her an overwhelming financial incentive to do procedures?

]]> By: AlisonHymes http://www.nickscrusade.org/happy-hospitalist/comment-page-1/#comment-2648 AlisonHymes Fri, 07 Aug 2009 18:59:08 +0000 http://www.nickscrusade.org/?p=954#comment-2648 Um, he has time to post 2 to 3 times a day to a blog but complains about patients taking up his time? I'm sorry, I don't get it. And I'm really tired of this trope : "you hate the rich", nobody hates the rich, the rich hate the poor and our society reflects that in every way. We could do with a little more actual hating the rich instead of falling for the trap of thinking some day we will be one of them as so many do and fight an inheritance tax they themselves would never ever pay. Good for you speaking up Nick. Um, he has time to post 2 to 3 times a day to a blog but complains about patients taking up his time? I'm sorry, I don't get it. And I'm really tired of this trope : “you hate the rich”, nobody hates the rich, the rich hate the poor and our society reflects that in every way. We could do with a little more actual hating the rich instead of falling for the trap of thinking some day we will be one of them as so many do and fight an inheritance tax they themselves would never ever pay. Good for you speaking up Nick.

]]> By: FisCon http://www.nickscrusade.org/happy-hospitalist/comment-page-1/#comment-2639 FisCon Fri, 07 Aug 2009 16:34:26 +0000 http://www.nickscrusade.org/?p=954#comment-2639 Cutting through the hyperbole on both sides of this debate, I think both sides are right--which can only happen in a flawed system. . .a collectivist system, that is: where everyone is a free rider of sorts, and everyone is also a victim of sorts. <br><br>Unless and until doctors and patients must deal directly with each other, rather than appeal to a nebulous master who tries (but fails) to keep all of the plates spinning, you get everyone working harder to keep the same-sized slice of a shrinking pie, all the while more folks are invited to the table to get a 'free' slice.<br><br>This problem will get worse, not better. You're both right, but we're ALL wrong! Cutting through the hyperbole on both sides of this debate, I think both sides are right–which can only happen in a flawed system. . .a collectivist system, that is: where everyone is a free rider of sorts, and everyone is also a victim of sorts.

Unless and until doctors and patients must deal directly with each other, rather than appeal to a nebulous master who tries (but fails) to keep all of the plates spinning, you get everyone working harder to keep the same-sized slice of a shrinking pie, all the while more folks are invited to the table to get a 'free' slice.

This problem will get worse, not better. You're both right, but we're ALL wrong!

]]> By: midwest woman http://www.nickscrusade.org/happy-hospitalist/comment-page-1/#comment-2634 midwest woman Fri, 07 Aug 2009 13:00:49 +0000 http://www.nickscrusade.org/?p=954#comment-2634 thanx for stopping my blog. I got your point. Happy's mind must be like a meter ticking off when he enters a patient's room. The irony of tthe cars and uncompensated time was certainly not lost on me. A lot of these docs seem disappointed they're not hauling in the big money. I don't think I've ever seen a doc go bankrupt. Glad I found your blog. You're a remarkable person. thanx for stopping my blog. I got your point. Happy’s mind must be like a meter ticking off when he enters a patient’s room. The irony of tthe cars and uncompensated time was certainly not lost on me. A lot of these docs seem disappointed they’re not hauling in the big money. I don’t think I’ve ever seen a doc go bankrupt.
Glad I found your blog. You’re a remarkable person.

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