samboct
Posts: 1817
Joined: 1/17/2007
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"Huh? For one, the Mayo Clinic is pretty close to North Dakota, in Minnesota. And wasn't one of the claims of conservatives that we had the greatest health care system in the world? If North Dakota really has such poor health care, maybe there is a real problem here."
If you have to drive 6 hours to get to a doc- that's a problem. In terms of the claims of conservatives that we had the greatest health care system going- well, that ain't me, so I fail to see the relevance. My comment is that we spend more money than anybody else and get mediocre health care- except for the few at the top.
"Realistically, though, the army of pharmaceutical sales reps visits pretty much all of the USA"
No- they don't. It's a business and they stick to the population centers where there's a high enough concentration of patients to afford the newest toys. Drug salesmen may be a different story and I can't comment. It's also not relevant- physicians should be prescribing drugs based on patient needs, not on whether they like the detail person from the pharma company. Furthermore- my point was that a doc in a rural area needs a different business model than a doc in a population center- you can't expect the same level of care in a cancer clinic that you'd find in Podunk Idaho, than say the Fred Hutchinson Center in Seattle.
"Primary data gathering? Enough docs? How many cities and states have you visited, how many docs have you interviewed, what methodology did you use?"
I've done market research for a number of years. Primary data gathering involves interviewing selected subjects on a topic- secondary are publications ranging from mainstream literature to scientific journals. Often primary data gathering can be more accurate than publicly collected information- a good market research report will be both more informative and more accurate than data collected using SIC codes in a number of cases. I have personal connections to the medical establishment. Were this a different board, I'd identify myself, so you couldn't claim I'm hiding behind a wall of anonymity. I've talked to several dozen docs. You can certainly claim that I don't have a representative sample and you'd be right. Nevertheless, I'll bet my extrapolation is closer to the truth than your CBO study.
"Please substantiate that claim. I have only found one single lawsuit against that hospital, and that was clearly legitimate from a horrendous case in their psychiatric ER."
My data as noted earlier are from primary interviews, not mainstream media, which tend to report on things that will sell newspapers. That you could only find one lawsuit involving a major hospital should have sent alarm bells ringing- the number is way too low. Look at all the ads for ambulance chasers on late night TV. Do you think those lawyers are making no money? Which docs are getting sued? How could a major metropolitan hospital have only one lawsuit in the hundreds of thousands (millions?) of patients treated?
"Quite honestly, that's BS. Medical liability lawsuits are about deviating from accepted standards of care, not about all possible tests under the sun."
ABSOLUTE NONSENSE!!
Medical liability lawsuits are about making money- nothing more.
From the hospital that you say only has one lawsuit-
Elderly woman with money walks into see a plastic surgeon- wants a scar fixed. She's a vain old lady. She's also on coumadin (sp?)- a blood thinner to prevent stroke. The surgeon tells her he can fix the scar, but there's a risk involved since she has to stop taking the drug. She assents- and strokes out. There are heirs, some of whom are unhappy with the will- and needless to say- there's a lawsuit against the doc who took her off the drug. Yet the surgeon did nothing wrong- assuming that informed consent means anything. Everybody knows this- but there's still a lawsuit.
You want an example of how lawsuits hobble development? A nationally recognized hand surgeon hung up his practice after his last lawsuit. He worked out of DC, and occasionally saw some inner city patients. He developed some new techniques to increase mobility in fingers damaged by scarring that had limited bone growth involving cutting the bone, using splints and spreaders to force the bone to grow. Not a pretty or a painless process, but the end result was a hand that had far more utility than other methods. He told a patient that it was unlikely to solve her problem with a single operation- odds were that whe'd need more than one. He did the first- patient was unhappy with the outcome since she needed a second- and she sued. He hung it up- that was the straw that broke the camel's back.
That docs get sued when practicing good medicine is a major factor driving up the costs of health care today. Docs don't operate in an information vacuuum, this knowledge gets disseminated and is chilling. Hence my comment that all docs are scared of lawsuits- or they're idiots. OK, their are probably a few specialties where it's not a problem like pathology. Furthermore, the threat of lawsuits along with the rising cost of a medical education and its increasingly narrow focus (they don't teach gross anatomy any more) has been pushing eager young med students to specialize early on. But a doc practicing in a rural area or even a suburban area where travel times prohibit using a center of excellence really need a good basic grounding in the fundamentals of medicine. In short, we need more G.P.s and internists- and the threat of lawsuits is one more reason why students aren't going there. Fear of lawsuit probably leads to more mistakes and certainly leads to wild overkill in the testing done.
From your previous post that you want the doc to order tests for you when your sick that cover all the bases....
Well, let's use the restaurant analogy because it works well. Ten people go out to a restaurant, half order steak and wine, the others order burgers and beer. From one of the steak eaters comes the suggestion- let's split the bill which comes to $25/head. The steak eaters say great- I got a steak and wine for $25- what a deal! The burger eater says- Man, I just had a $25 burger and beer- this sucks. Next week, 7 people order steak, and the bill comes to $30 a head....
If you don't have to pick up the cost of the extra tests yourself- you're happy to have them done. I'm not- yet the system makes me pay for your extra tests. There's no incentive for you not to make such a demand and there needs to be be.
Sam
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