this post was submitted on 05 Sep 2024
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236
Why are doctors so hands off and unhelpful in the USA? (lemmy.world)
submitted 1 month ago by [email protected] to c/[email protected]
105 comments fedilink hide all child comments
 

I remember when I was a kid, doctors were so interactive and really took time to get to know you and talk to you, learn about what you're going through and explain things. Now as an adult, it's been nearly impossible to find a doctor who is willing to take any amount of time to sit down, explain things, show any sort of compassion or empathy at all.

I suffer from acid reflux, and in order to diagnose that, they basically put a tube down your throat, it's called an endoscopy. You have to be fully sedated with anesthesia and take nearly an entire day off of work because the way the anesthesia affects you, you can't drive and someone has to drive you. Well for many years now we've had this other procedure which is a tube, but they put it through your nose instead. There's been lots of research papers about the use of it, it's used in other countries as a procedure regularly. So I asked several gastroenterologists if they offer the procedure and every single one of them said no, and would not provide any additional information or insight as to why you have to be completely sedated and pay thousands upon thousands of dollars for expensive anesthesia. I am simply blown away. It makes no sense. A research tested method that has been written about for about a decade now in actual research studies by board certified medical physicians, and no one offers it. Literally no one, and they won't even consider it.

I've also been through at least several primary care physicians because the ones I have seen are so short and don't really take time to get to know you at all. They just pop in, ask you a handful of questions and leave, if your test results come back with anything abnormal, they say it's nothing to worry about, they don't want to take any extra time to help look into anything or diagnose you.. like wtf?

It just seems like doctors these days are out to get you to spend as much money as possible and do the absolute bare minimum for you in return. And now we have direct primary care options where you can circumvent insurance entirely, pay your doctor thousands upon thousands of dollars a year for the same level of care that we had in the '90s. But now you have to pay out of pocket for that in addition to your insurance. Wtfffff

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[–] [email protected] 5 points 1 month ago

U. S. medicine is corporatized. You are visiting a corporate store front, not a doctor's office.

If you want personalized medicine from doctors who give a shit, you'll either need to find a small clinic that gives a shit or you'll need to get your procedures done for cash while on vacation in Europe.

Medical tourism can sometimes be the same price (including travel) as staying in the U.S and dealing with insurance.

[–] [email protected] 2 points 1 month ago

Afaik it has to do with licensing regulations and litigations...

A doctor is licensed to practice by the state, and must carry insurance on a state-by-state basis to acquire a license to practice.

The problem is that if you get sued 3 times you get blackballed by the insurance industry in your state and the insurance companies won't insure you.

You see a lot of doctors moving states often, its often because they became un-licensable in their former areas.

I have limited industry experience and have talked to quite a few doctors who were indeed a bit distant and hands-off in their practice for this reason alone.

[–] [email protected] 11 points 1 month ago

Finding a good physician is as difficult as finding a good romance or a good therapist. You need to shop around to find the right fit. After years of struggling with horrible Healthcare I finally found the perfect fit - a middle aged lesbian Nurse Practitioner working out of a health center that caters to lower income folks and the LGBTQ community. Every time I go in we chit chat for a few minutes, then she spends at least half an hour with me going through all of my concerns. She's very thorough and has made a dramatically positive experience in my health. I can even shoot her an email any time and she gets back to me within a day.

I think it helps that the health center's board of directors is entirely staffed by the physicians working there, overseen by an elderly doctor who spent his entire career helping the needy in his community.

Keep trying. It's frustrating, but the right fit is out there.

[–] [email protected] 47 points 1 month ago (1 children)

When you go to a doctor in the USA, you're really being treated by their lawyer and insurance company.

[–] [email protected] 9 points 1 month ago (2 children)

And the practice. In most cases are doctors are now essentially hair stylists working for some larger entity. A larger entity with shareholders. If you want somebody that cares you probably need to go see a family practice with only one or two doctors. The problem is places like that run out of spaces to see people quickly.

[–] [email protected] 1 points 1 month ago

Chrissie Hynde..."I hate anything official"

Good guiding principle right thete.

[–] [email protected] 2 points 1 month ago* (last edited 1 month ago)

Corporations, now. Can't even really call it a practice. They are businesses that employ doctors. In law, most civilized places, you can't own stake in a law firm unless you are a member of the bar. Makes for a more service focused industry.

Another thing I haven't seen mentioned is the way people find doctors now has changed. People look online, and there are plenty of sites that are just aggregators for data about doctors. Anyone can scrape that info and then setup a webpage to rate doctors. So now doctors are finding that they aren't getting patients if they aren't getting good ratings, so now we have doctors just telling patients what they want to hear, prescribing what they want to be prescribed. Gotta keep up that 9.8/10 rating to keep patients coming in.

[–] [email protected] 9 points 1 month ago* (last edited 1 month ago) (1 children)

Doctors are not individual practitioners and cannot normally decide to go off on their own doing a procedure that they were not specifically trained to do (doctors are trained in procedures during their residency and in CTE). Unless they are offered a course in this new method, the hospital would not authorize them to perform that new procedure. The best way to get this care would be to travel or to lobby the hospital to train staff on this new methodology.

[–] [email protected] 3 points 1 month ago (1 children)

Ten years in medical school and still can't think for themselves!

[–] [email protected] 0 points 1 month ago

Most people never become auto-didacts. Most auto-didacts still benefit from formal training because above average gross performance can mask subtle mistakes until the mistake becomes root cause for a significant error.

Under significant pressure (like a well-written dramatic fiction, but almost never IRL), most doctors will be willing to perform a procedure without formal training, but under normal conditions, they know it is not worth the additional risk.

[–] [email protected] 9 points 1 month ago (1 children)

I’ve also been through at least several primary care physicians because the ones I have seen are so short and don’t really take time to get to know you at all. They just pop in, ask you a handful of questions and leave, if your test results come back with anything abnormal, they say it’s nothing to worry about, they don’t want to take any extra time to help look into anything or diagnose you… like wtf?

Because we're not people to them. They're incentivized to treat us like cars. Repair as fast and as many as you can to get the most money.

[–] [email protected] 7 points 1 month ago (2 children)

Insurance companies have control over what the doctors can do and over their schedules. They are only allowed to spend certain amounts of time with patients or they get in trouble. All the doctors I've talked to hate this. Blame insurance companies and the hospitals for prioritizing profit, not the doctors.

[–] [email protected] 0 points 1 month ago

They can spend as much time as they want with the patient. The insurance simply caps how much is billable.

[–] [email protected] 4 points 1 month ago

Yes, but to clarify: the time constraints are imposed by for-profit healthcare businesses trying to optimize billable time because insurance will only reimburse for so much time, rather than being imposed by the insurance companies directly. (It's generally not quite as silly in the non-profit sector.) I work in healthcare in the US: we all hate how it works. The system sucks and it interferes with the quality of care that can be provided, leaving patients worse off just so that greedy can be fed. It's just asinine that anyone who has no medical knowledge/training is making decisions about how patient care can be implemented, especially where there's a profit motive involved. We really need to pivot to single-payer or national healthcare system, and abolish for-profit ownership of hospitals.

[–] [email protected] 48 points 1 month ago (1 children)

Because medical care in the US places profit over people

[–] [email protected] 6 points 1 month ago (1 children)

In the US, unlike most other countries, medical doctors are most at risk for suicide.

[–] [email protected] 4 points 1 month ago (1 children)

Source?

[–] [email protected] 7 points 1 month ago (1 children)

I'm not the person you asked but I just did a quick search. I don't know if it's more prevalent in the US or not, but here is a scientific journal on the subject:

"The medical profession faces a critical challenge with the mental health of its practitioners, leading to an alarming increase in suicide rates among healthcare workers (HCW)."

[–] [email protected] 1 points 1 month ago

The CDC reports rates pretty well below the general average, at least for 2021.

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