Does your doc have your best interests in mind?

[Captain Save]

I saw this post on the front page and thought it would be a good discussion


it's funny how the govt put so much emphasis on financial advisors being fiduciaries ( and I applaud the concept , not necessarily the rules) but we just had a healthcare reform .. .and doctors have no incentive to cure diseases.. .

The pharmaceutical industry has no incentive to offer treatments that cure diseases


There was a year where I kept having abscesses and I kept going to the doctor to fix it to no avail... every time I visit he gets paid... if he would have fixed the problem the 1st time he would have gotten paid 10 times less .. the system is a joke... Furthermore Consumers don't even bother looking at prices because the "insurance" pays for it and we wonder why insurance is so high...

I can keep going on a rant but I'll stop here ..


By the way, anyone seeing a neurologist , should see a chiropractor who focuses on correcting the spine (not all chiropractors are great) .. chiropractors know a lot more about the nervous system and how to heal it without drugs ...

Check out this guy "John Bergman" on Youtube .. you might no agree with everything he says but he does a great job explaining the effect your nervous system has on your overall health ..

[TexasHusker]

You raise several good points.

However, it is certainly not true that pharma has no incentive for drugs that cure diseases. In fact, there are a countless number of drugs currently that do in fact cure diseases, and ten times that many that alleve symptoms and/or forestall disease advancement. So that conspiracy theory goes into the same bucket as man never landed on the moon.

Fee-for-service medicine has its problems, but medicine has no analogous profession. If a plumber doesn't fix your leak, he comes back free of charge. Unfortunately the human body doesn't work like a leak - a stomach problem for example can be caused by any of a hundred or more sources. It might be diagnosed at the first visit and successfully treated, or it might take two years of visits to a multitude of doctors, and finally a trip to Mayo Clinic when the patient is at death's door, before it is finally diagnosed (hint: personal experience).

Of course, this in no way points to physician incompetence nor malpractice, but rather to the sheer complexity of the human body. While fee-for-service seems sometimes a ripoff, we can't very well expect providers to accept payment only when they make us feel better.

As for chiropractic, I believe that there is little-to-no science behind it. It is modern day voodoo medicine. You see chiropractors peddling everything from Amazon tea to weight loss pills to transcendental meditation to popping your back to cure your cancer. Obviously, chiropractors are heavily incentivized to treat not only you, but "the whole family". I use the term "treatment" loosely since it's all really more akin to a magic act, complete with props and sound effects, mixed with a dose of medical gibberish. Showmanship makes for a profitable "practice".

The primary causes of runaway healthcare costs are:

1. Governmental tampering with the healthcare system (Medicare), including the implementation of arbitrary and artificially low provider reimbursements, resulting in the providers "cost shifting" to the rest of us to pay the bills.

2. Related to number 1, very little free market competition among hospitals, resulting in price gouging of sensational proportions. This is a direct result of the FTC allowing the hospitals in most communities to merge with one another, thereby creating a virtual monopoly by which they can quite literally charge what they want. Even the largest MSAs in the US have been reduced to two or three healthcare systems. That's not free market.

Finally, as a general rule, when the government begins tampering with the free market - housing, college, cash-for-clunkers, healthcare - the result is usually runaway inflation, because the government has imposed artificial pricing and/or rules that interrupt the free market and create market imbalances. Government tampering with free markets is a very dangerous thing, because it ultimately can lead to full-on government takeover to correct the crisis, when in fact the government was its author.

[cooliemae]

The primary causes of runaway healthcare costs are:

1. Governmental tampering with the healthcare system (Medicare), including the implementation of arbitrary and artificially low provider reimbursements, resulting in the providers "cost shifting" to the rest of us to pay the bills.

Excluding Medicare for the moment, the free market also cost shift payments. I have private insurance and through my plan, I have access to negotiated pricing which is substantially lower than the 'full ticket' price. For those still without insurance, they end up paying the 'full ticket' price which helps the bottom line.

As for medicare, the reimbursements are based on the actual cost of procedures plus an administrative fee versus an arbitrary amount set for the provider. So the only cost that gets shifted is the profit that the companies want to see and know they won't get from medicare.[/QUOTE]

2. Related to number 1, very little free market competition among hospitals, resulting in price gouging of sensational proportions. This is a direct result of the FTC allowing the hospitals in most communities to merge with one another, thereby creating a virtual monopoly by which they can quite literally charge what they want. Even the largest MSAs in the US have been reduced to two or three healthcare systems. That's not free market.

I understand where you're coming from on this and I would generally agree, however, in a free market information is king. The fact that with a few exceptions, I can't easily find out how much a procedure will cost from one clinic to another. This prevents me from making an informed decision and provides no incentive for competition.

Another problem outside the consolidation of the hospitals is the lack of competition in the insurance field or limited access. Hospitals have no incentive to change their price if most of the patients they see are on a small number of insurance plans. So while hospital A might have a CT scan for $500 because my insurance plan isn't accepted, I need to go to hospital B which cost $800, though my out-of-pocket may be the same.

Finally, as a general rule, when the government begins tampering with the free market - housing, college, cash-for-clunkers, healthcare - the result is usually runaway inflation, because the government has imposed artificial pricing and/or rules that interrupt the free market and create market imbalances. Government tampering with free markets is a very dangerous thing, because it ultimately can lead to full-on government takeover to correct the crisis, when in fact the government was its author.

"Sarcastically" I can't think of any area of the economy that the government was hands off with and nothing bad happened. "coughing...housing" So the government's laissez faire attitude and the investors greed led to a collapse of the housing market which extended into the primary banking system.

To Captain Save's point about the fee-for-service formula, I generally would agree with him. I think we can do better at paying our medical professionals to take care of us and know they're there for our best interest and not just ordering test for increased revenue. I don't think this is generally the case, but when management continues to add patients to doctors schedules, whether you want to admit it or not the quality of service will decrease.

[disneysteve]

I will never understand the thought process of conspiracy theorists.

When is the last time you heard of anyone coming down with polio or small pox? How about the last time anyone you know died of AIDS? Or hepatitis C? I'm willing to bet you know dozens of people who didn't die from the cancer they had. Just since 1960, the average life expectancy in the US has gone up from 69 to 78. I think the medical and pharmaceutical industries have an awful lot to do with that.

If you feel that your doctor has no interest in making you better, find yourself a better doctor. There are plenty of great ones out there, though I certainly won't deny that there are some lousy ones, too.

[rennigade]

As for chiropractic, I believe that there is little-to-no science behind it. It is modern day voodoo medicine. You see chiropractors peddling everything from Amazon tea to weight loss pills to transcendental meditation to popping your back to cure your cancer.

Is it possible to slip a disk? Is it possible to have a bulging disk? Can these bulging disks press against nerves causing pain? I believe all of these mentioned can and do happen. Now is it possible to move those disks back into place and take tension off of nerves? I believe this is also possible through a chiropractor. If you move a certain way and your back all of the sudden hurts because something shifted or moved...why couldnt that area be put back in place? We know for a fact that you can dislocate your shoulder...and that it can be "popped" back into place...is that also voodoo?

Not sure why chiropractors get such a bad rap. Ive only ever been to 2 different ones in my life. I go maybe 2 times a year. Ive never been peddled anything. I dont think they go around pretending they're miracle workers and they can cure cancer. Sounds like you had a very trippy experience.

I will never understand the thought process of conspiracy theorists.

We know the gulf of tonkin is true...it took us into vietnam. That was a conspiracy. We know operation northwoods is true...where the CIA was going to commit acts of terrorism against american civilians and blame it on cuba...this was a conspiracy and is 100% true. Mk Ultra is also real (mind control project in the 50's.) Operation paperclip (where we recruited nazi scientists who committed horrible war crimes...their records were wiped clean.)

These are the only ones I can think of at the moment. Thats why these theories exists...because some are true. Unfortunately when people hear someone is a conspiracy theorist they turn a deaf ear and automatically assume the person is crazy.

[disneysteve]

Not sure why chiropractors get such a bad rap.

I think a lot of this is self-imposed. I also think a good chiropractor (or osteopathic manipulative specialist) can do wonders. I'm an osteopath myself. I also see a chiropractor periodically when needed and he has never failed to fix the problem I was having.

The problem is that a lot of chiropractors are quacks. They get into some really out there stuff, push a lot of products, and have people come for treatment way, way too often, frequently several times per week. I even had a chiropractor tell one of my patients that she needed to be seen 3 times a week for 12 weeks and needed to pay for that course of therapy up front. First, what doctor charges you for 3 months of therapy in advance? Second, how could he possibly be sure that it would take 12 weeks to fix the problem? It's stories like that that have given the field a bad rap.

[StormRichards]

Not sure why chiropractors get such a bad rap. Ive only ever been to 2 different ones in my life. I go maybe 2 times a year. Ive never been peddled anything. I dont think they go around pretending they're miracle workers and they can cure cancer. Sounds like you had a very trippy experience.

I had one that claimed she could solve just about every medical problem I had. Her hands were wonderful and I felt better after every visit, but I just couldn't take her BS anymore.

I went to a middle aged guy that was much much better when it comes to discussing his profession. Sadly he took on a young guy as a partner and he diagnosed my severe back pain without an xray. Told me that if the pain doesn't improve after 3 or 4 visits he would take an xray. Just came off as someone trying to maximize the $$$ he could get from me.

And that woman I first mentioned, she told me that once I used up all the appointments covered by insurance that we would work something out. That came off shady as well.

That all being said, I do believe that they can do a lot of good if they understand their limitations and don't try to rip people off.

[disneysteve]

he diagnosed my severe back pain without an xray. Told me that if the pain doesn't improve after 3 or 4 visits he would take an xray.

I'm not sure what your point is on this particular story. An x-ray shouldn't be done until after at least a month of conservative treatment (medication, physical therapy, exercise, etc.). The only exception would be if there was trauma such as a fall or auto accident. So if the chiropractor wanted to treat you a few times first to see if you got better, that's exactly what the guidelines say should happen.

[TexasHusker]

The government was front and center in the housing crisis: It was Congress which chose to dramatically relax traditional lending standards, and bullying the banks to lower down payment requirements and qualification standards so that "more Americans could become homeowners." Not only that, they GUARANTEED most of these loans through their various programs.

That led to runaway inflation in home prices, as well as providing homes to millions of people who couldn't afford it.

After the fact, it was the same government which conveniently blamed EVERYONE ELSE for the crisis - it's never their fault.

[TexasHusker]

The entirety of chiropractic resolves around this term: Vertebral Subluxation.

It sounds really medical and sophisticated, but the term, which supposedly describes "mis-alignments" of the vertebrae, has absolutely no basis in science and fact. It is a perpetuated myth, not unlike George Washington's supposed wooden teeth.

If you are looking for "saving advice", avoiding chiropractors is the lowest hanging fruit there is.

[disneysteve]

no basis in science and fact.

There is a very big difference between "science" and "fact". "Science" generally refers to large scale, double-blinded, placebo-controlled studies. It's very difficult to come up with a methodology to do that for spinal manipulation. You'd need to find a large cohort of patients suffering from identical or nearly identical issues, treat some of them with manipulative therapy and treat the others with fake manipulative therapy (whatever that would be) and compare the results.

I can't quote any specific studies but I can tell you that I have seen manipulative therapy work hundreds of times in my career, both when I was the provider and when I was the patient. I've had times when I was literally doubled over in pain and a quick visit to the osteopathic provider or chiropractor totally relieved my pain and allowed me to get back to work and normal activities. I've also had patients who were having ongoing symptoms that hadn't responded to medication, heat, ice, or exercise. I treated them once and their pain resolved immediately. Is that fantasy or placebo effect? I suppose that's possible but their pain went away and never came back. I'm okay with that.

[rennigade]

I've also had patients who were having ongoing symptoms that hadn't responded to medication, heat, ice, or exercise. I treated them once and their pain resolved immediately. Is that fantasy or placebo effect? I suppose that's possible but their pain went away and never came back. I'm okay with that.

Steve...you said youve treated patients above...did you adjust their spine/hip etc? I know chiropractors go to some sort of schooling/training...is this also something you've learned along your way?

[disneysteve]

Steve...you said youve treated patients above...did you adjust their spine/hip etc? I know chiropractors go to some sort of schooling/training...is this also something you've learned along your way?

Yes. I'm an osteopathic physician.

http://www.osteopathic.org/osteopathic-health/about-dos/what-is-a-do/Pages/default.aspx

I am trained in spinal manipulation similar to what a chiropractor does. I don't often use it in my practice but I do from time to time, and I periodically treat my wife and daughter.

[FLA]

since getting sick two years ago, I have a team of docs that I believe are truly working in my best interest. It took a while to get some of the players right but once I did, they were willing to all work together. This, I think, is rather rare in medicine. For instance, my first cardiologist never read the letters and notes in his compatible electronic medical record pleading with him to stop meds that were making me sicker. He just kept refusing to stop them until I said in a visit, "could you please read notes x,y,and z from my other doctors." He was embarrassed and still refused to stop the meds. I switched to one of his partners who specializes in what I have and it's been pretty smooth sailing dealing with everybody now. I feel incredibly lucky, I didn't see this kind of collaboration often when I worked as a nurse. But I do think the vast majority of doctors have your best interest at heart.

I think Big Pharma is a necessary evil but we have a problem when patients have to pick between eating and paying for their meds. Having worked in homes the majority of my career, I don't think doctors have a clue about how many patients don't fill their scripts or don't take meds as directed because of money. I am tired of the argument that Big Pharma needs to charge so much because of R&D and the fact they provide meds cheaper in third world countries. They are making a huge profit and I hope we get socialized medicine and this changes. Leave them a reasonable profit and money for R&D but stop raping the average consumer.

[rennigade]

I am tired of the argument that Big Pharma needs to charge so much because of R&D and the fact they provide meds cheaper in third world countries. They are making a huge profit and I hope we get socialized medicine and this changes. Leave them a reasonable profit and money for R&D but stop raping the average consumer.

Feel free to head over to a third world country and view the facilities that create these wonderful cheap drugs. It wont take you long to figure out why they're so cheap. Start looking at the label of the drugs you take. If its anywhere outside of the US...specifically india or china...good luck.