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post #21 of 30 (permalink) Old 10-12-2020, 14:52
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I liken the American health system to our pet insurance. If you have a pre existing condition then hard luck. You also have to find the first part of the bill. My sister-in-law just swerved a situation that would have bankrupted them. She was diagnosed (very late) with breast cancer. She had just joined my brother's policy which covered all but the initial co payment. Her policy original policy called for her to pay about 30% of the bills. Her bills ran to hundreds of thousands of dollars.
I do, however, like the system they have which asks for $25 up front each time you consult your doctor. Our GP's would like something similar I am sure.
We pay 25 to visit the GP equivalent unless you have a long term existing condition that has been accepted by the State.

The difficulty and opposition towards such a charge in the U.K. stems from two points;

1. The 1947 Act said "free at the point of delivery" for Health Care, but that seems to have been overlooked as regards dentistry for many years.....

2. GP's are concerned that, while it might reduce "time wasters" and "DNA - Did Not Attend" incidences it may also stop people with serious concerns who cannot afford it (Benefits Claimants, those close to or already destitute etc) - it is interesting to note that many such people can still afford Sky Sport, or smoking, or drinking or similar.....

My daughter (a GP) says that DNA's on extended hours appointments eg Saturday mornings or afternoons, can approach 70% of those booked.... (grotty area near Southampton), even though those people requested and booked such appointments, often the afternoon before.... This was before the pandemic though, I have no figures from recent times.

Something needs to be done to severely stop such an appalling waste of time - those appointments could have been of major benefit to others who were, perhaps, unable to get such an urgent appointment. You cannot suggest a charge is levied against a bank card, as often such people are not in such a fortunate position to have such a thing...
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post #22 of 30 (permalink) Old 10-12-2020, 15:08
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Both my eldest brother (UK resident) and my mother were guilty of time wasting. The least little niggle and they were at the doctors'. My brother even invented chest pain to get a heart check! My mother would walk out of one appointment with the GP having been told that "everything is fine" and go to reception to book another one for next month. When challenged by me her answer was "he likes to keep an eye on me". Both intelligent people but with phobias about being ill. I am sure that if they had to pay even 5 they would have reconsidered their actions.

My Grandmother was alive before the advent of the NHS. She was in her eighties before she visited a doctor. Try as we might to insist that she should go and that it was free she refused. Only if death threatened did her generation trouble the doctor.
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post #23 of 30 (permalink) Old 10-12-2020, 15:17
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I could recount an incident where we were called to an elderly lady who had had a heart attack and sadly, died.

We were stuck there for four HOURS with the Police and a full Paramedic crew because no Doctor could find her on their computerised records.....

She had last visited that Dr just to register more than 50 years previously.

Only when they searched the paper records were they prepared to attend and sign a death certificate. Until that happened, we sat and drank tea with the family.

So yes, some people did not visit their Doctor often....
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post #24 of 30 (permalink) Old 10-12-2020, 15:47
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I think the new gp phone and video appointments are a great idea and I hope they continue after covid. Not always suitable but for many things they are. I booked one this morning as I think I need an X ray on my knee. She called me up on a video link half an hour later went over it all and I could have gone for the hospital tomorrow if I wanted to but decided to wait until next week.

There must be loads of stuff where you don't need to be face to face. My chickenpox in April was diagnosed by video link. Doctors is a 15 mile round trip as well.
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post #25 of 30 (permalink) Old 10-12-2020, 16:11
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I think the new gp phone and video appointments are a great idea and I hope they continue after covid. Not always suitable but for many things they are. I booked one this morning as I think I need an X ray on my knee. She called me up on a video link half an hour later went over it all and I could have gone for the hospital tomorrow if I wanted to but decided to wait until next week.

There must be loads of stuff where you don't need to be face to face. My chickenpox in April was diagnosed by video link. Doctors is a 15 mile round trip as well.

Yes they can work well, when my BP went crazy after my stroke all the meds adjustment was done with weekly telephone consultations based on my home taken readings. This morning I had a physio phone consultation re my arthritic shoulder pain, shes emailing me an exercise sheet and will follow up in the new year. Im happy to stay clear of hospital and GP environments at the moment.

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post #26 of 30 (permalink) Old 10-12-2020, 16:51 Thread Starter
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As far as I know we dont have that here, but Im in a pretty clear area, I dont know what its like in other lands/states, there are 16 all together and all have slightly different arrangements..
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post #27 of 30 (permalink) Old 10-12-2020, 17:34
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Same goes for Hospital consultant appointments really. Michelle goes through the system year after year over her Kidney stones which has been going on for years. Initially they wanted her to come in and she said no way so they then started doing the consultancy bit over the phone. Ok you have to go in for a scan etc but then there is often a follow up appointment to discuss the results. What is the point in driving 32 miles round trip and struggling to find somewhere to park when it can all be done over the phone?
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post #28 of 30 (permalink) Old 10-12-2020, 18:52
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We have had telephone consults for things like medication review and it seems to work well. You do have to realise though that some people are not very observant over medical matters.

Also with daughter being a physio she laughed when Chris said he was having a telephone consult for physiotherapy. It is a hands on job and they need to see the range of movement you have etc. Some people will say "oh it's fine" when asked while others will exaggerate the symptoms for the sympathy. I almost always go on important consults with Chris because he tells the consultant that he is "fine" when I know that he is not. I married the opposite to my mother and brother
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post #29 of 30 (permalink) Old 10-12-2020, 19:25
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I have very clear evidence from the work that we did with the Ambulance Service that people do not tell the truth, the whole truth and nothing but the truth....

They tell each person in the chain what they think they need to know and that's it, nothing more unless specific directed questions are asked,

So the first wider gets a response, the Paramedic gets more information allowing them to make a better diagnosis, the A&E Nurse gets a third level of response then the Dr gets even more information.

I had very clear examples of that which I used as experiences in teaching Ambulance staff...... you would be shocked to see how true that is - please think about it for yourself and those that you care for even if "care" is not meant by having the same role as a nurse, but "only" as a lifetime partner or parent.
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post #30 of 30 (permalink) Old 10-12-2020, 20:46
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Im reasonably happy

Telephone consultations with consultants , expect they often are not, Im happy not to go to the hospital now or in the future, unless

Alberts consultants consult on the phone but make clear if he feels he needs a face to face consultation just let them know

The Gp, will they relinquish their role , even if its at the end of the telephone

Do you need antibiotics?, do they know what that lump is, will they refer based on your explanation

Its a new way of consultations

I think many will slip below the net, cancers will go undetected, is it indigestion or a heart attack, how many have already died with indigestion

Some of us are aware but even then its hard to get GPS to accept what is an effect self diagnoses

If it was simple many who see the doctor would still be alive if they had referred earlier

Sandra
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