100 lb. Club - An honest doctor
09-02-2010, 10:38 AM
Yesterday, I went for my annual check-up. This is the doctor who told me to lose weight in the first place. Anyway, I suggested it would be good for his office to have an email address where patients could send in their weekly weight and receive a quick, even automatic, response from the office. He said they had done that a few years ago, but by phone. He said it was very effective. I asked why they stopped. "Well," he said, "The medical system (hospital) felt it wasn't a very effective use of our staff hours." I responded, "But it was effective? Is it a better use of staff time for you to be doing open heart surgeries on these patients who can't lose weight?" He responded, honestly, "Well, yes. The hospital makes A LOT of money when I do open heart surgery. They don't make anything if you lose weight."
I appreciated his honesty. He's a great doctor. But it made me so sad to have an insider confirm how insidious the medical system can be.
09-02-2010, 10:41 AM
Oh wow. We hear so much about how if American's would lose weight it would save millions in medical expenses, but then the hospitals themselves are working against us. That's very disconcerting. What a shame.
09-02-2010, 11:09 AM
It is a shame. I have a similar story. When I first decided that I had to lose weight, I went to a doctor that specialized in non-surgical weight loss and had her practice within the local hospital. When I went for my check three months later, she told me that the hospital was closing her practice because she was not making enough money. She said that the money was in WLS, not non-surgical weight loss. So sad.
09-02-2010, 11:32 AM
I spent two years working as a nanny for two Norwegian doctors. They went to med school in Oslo, and were doing their residency at Yale (surgery, and med-peds.) It was really interesting to hear them talk about the differences between the two systems (Norway has one of the best socialized healthcare systems in the world, but also the country is waaaay more in the black financially since they struck oil in the seventies, so it's hard to compare.) Anyway, what always struck me, and frustrated them is that where they come from, because the government is paying for this care, prevention is a HUGE part of the system. It's cost effective to prevent costly visits to the hospital, prescriptions, time off work (because the government has a lot to do with sick pay and comp as well). Curing disease and preventing disease saves the system money.
In the US, where healthcare is a business, and not a service, and everyone in it is there as a capitalist, trying to make money, the prevention of disease is not "cost effective." Healthy people don't spend money on healthcare. Why cure cancer when x company stands to make billions of dollars providing chemotherapy drugs?
My bosses finished their residencies and moved back to Norway to practice. They stood to make more money in the states, but can live more than comfortably as a doctor there, and as one of them said: "I went to school to be a doctor, not a businessman. I just want to treat patients."
I have a lot of respect for them.
09-02-2010, 11:50 AM
Wow! This makes me so sad...
09-02-2010, 11:58 AM
Yes. It's absolutely true. WLS is a HUGE business that generates thousands of billable hours, and hospitals are falling all over themselves to set up bariatric wings...
But, at my facility, the employee wellness program got cut.
09-02-2010, 12:37 PM
I know that many people are terrified of socialized medicine, but personally "big business" medicine terrifies me more. Profit and ability to pay shouldn't be the first concern when it comes to receiving medical treatment.
Just my own experience has been an eye opener. When I had great private insurance through my husband's job (90% coverage for everything, and 100% coverage for many things) I never gave my healthcare costs much thought. Then when I had to go on medicare I had to reduce my medication costs and fast. I had always assumed that my doctors prescribed the best medications, and instead I learned that there were $4 medications (The Sam's and Walmart list - Kmart and Target also have similar lists) that weren't inferior to the meds I had been on, just older. Why don't doctors as a matter of course, prescribe the cheapest drug that is safe and effective (unless side effects make the cheaper drug the lesser option). I found that some of these $4 drugs worked BETTER than the $150 per month ones I had been on, and the others worked just as well. The only "difference" in one of them was an extended release that meant almost $200 a month to take one capsule a month as opposed to taking the slow-release older version that required me to take two pills a day for $4 - You bet I was willing to take an extra pill every day in order to save $195 every month.
The system really has to be overhauled, and it isn't going to be easy. If you take away all of the profit in health care, it will also take away the motivation to make advances in healthcare, and even the motivation for people to choose healthcare as a career. If there is no money in it, especially with the litigious mentality, no one in their right mind would become a doctor. There has to be other enticements for doing a good job at a fair price.
Quite frankly I don't see much of an option except nationalized or at least governmental control and regulation of healthcare. The problem is there are more ways to screw it up, than there are ways to do it right.
09-02-2010, 03:25 PM
I agree with some PP's. This is why I'm glad we're taking baby steps in the direction of socialized health care. Big Business health care is crap.
09-02-2010, 04:42 PM
so sad. i never thought of it that way.
09-02-2010, 05:22 PM
(rant) This has been a major beef of mine for as long as I've been aware of it. As long as there is major $$$ to be made off the population's ill health, we will not see our Nation's priorities (at all levels) shift to one that actively promotes and fosters health and values prevention over 'treatment'. As things stand now, we will never become 'proactive' vs. 'reactive' when it comes to Health Care. Not. Gonna. Happen. From big Agribusiness that has corrupted our food supply, to fast food/Frankenfood, to sugar/HFCS/Trans Fat laden crap, it's no wonder we are a nation of marginally healthy to downright unhealthy people, while Big Pharma and the weight-loss and for-profit "Health care" systems rake in the dough treating the inevitable results of the polluted American lifestyle. A healthy population is far less profitable overall, in the short term - and let's face it, the businesses making all the money could care less about anything other than their quarterly reports. It's beyond sad - it's downright heinous. And I fear that the only way it will ever change would be a MAJOR revolt... and let's face it, most of the country is too fat, unhealthy, overworked and/or brainwashed to have the time/energy/awareness/motivation to do it. We're kept just healthy enough to be complacent. It really sucks. (/rant)
09-02-2010, 08:54 PM
I totally agree. While I personally don't believe in socialized medicine on a lot of levels, I cannot understand for the life of me why there aren't more options for help with those of us that want to lose weight. I heard some insurances will pay for gym memberships as long as you swipe your card at the gym so many times a week. But have not heard of anyone's insurance actually doing this.
I don't understand why these insurance companies don't realize that they would have a LOT less claims in the long run if they would provide help to those who are interested in losing weight. Even my DH's company, they have an on site gym, but you have to pay for it? Why not give your employees an option to work out if they can't afford a gym membership?
I really just don't understand the thought process on a lot of things that happen, especially in America....and honestly I don't see it changing anytime in the near future.
09-02-2010, 09:03 PM
I agree with everyone else. I once heard that a hospital near where I live let a man die in the ER waiting room of a heart attack because he could not fill out his paper work for his insurance. I think it's horrible that they are more worried about the money than saving a life.
09-02-2010, 10:03 PM
I actually asked my dc to fill out a prescription for me to exercise so that I could get insurance to cover it. WHen I called, they said they would not cover the gym unless I was going to physical therapy there following surgery or an injury. So, apparently, going to avoid surgery or an injury is not acceptable.
It really does make me sad.
09-03-2010, 03:54 AM
I don't know about gym memberships, but my insurance company is paying (their portion) for visits to a dietician at the doctor's office. She said insurance is willing to pay because it's to attempt preventing (the cost of) going onto medications. I'm using HMO insurance. When HMO's were originally formed, the idea was that they paid for illness prevention up front to reduce illness and the cost of illness later. I know my doctor's office has had to work hard with the insurance companies for more compensation since her entire practice is wrapped around health and disease prevention. I am very fortunate I found a doctor with this approach.
09-03-2010, 01:57 PM
I really, truly am frightened for all the people who don't have health insurance at all. My best friend is in that boat (she's 58, self employed and really struggling in this economy) and one good injury or illness can easily wipe her out. None of our three kids have insurance as their employers don't offer it and if any of them get seriously ill or injured, well... I shudder to contemplate. It makes me sad.
09-03-2010, 03:40 PM
knits of five, you have a very honest doctor indeed...Until I needed this hip replacement I have NEVER even had a doctor tell me to lose weight!
On the other topic that has come up here:
If someone becomes seriously ill or injured many state medical plans will cover the emergency retroactively so catastrophic illness is not the biggest problem when a person is uninsured.
The problem is that uninsured people can not afford wellness care and routine care that could lessen or even prevent the major stuff.
Pap smears, eye exams and especially simple blood pressure and blood sugar checks would save more lives that all emergency interventions combined.
09-03-2010, 04:19 PM
I have no insurance. I applied for private insurance when I aged out of my parents' insurance a few years ago and got denied by all kinds of companies because... I'm overweight.
Now I don't know that I can afford it even when I do lose the weight. And being without it weighs on me like a lead jacket. I've become such a hypochondriac knowing how screwed I'm going to be when I get sick or hurt myself.