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Personally, i think the entire medical industry needs an overhaul.  All of it.  Many we speak with feel the same. So much goes into facilities with all the Chihuly glass, art, massive atriums full of empty space, waterfalls, plants and furnishings. Half of our medical records or more have been lost during the transfer of paper to computer. Bedside manner is rushed at best. Symptoms are treated and patients get passed along from one doc to the next, from procedure to procedure, specialist to specialist, medication after medication and even after years of this the underlying cause is a complete mystery to the professional we trust to our care. Premiums continue to rise, the cost of service, medication. If i were to walk into a police station with similar information it would be considered robbery. Many people in the industry itself feel the same. 

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1 hour ago, Komorebi said:

Personally, i think the entire medical industry needs an overhaul.  All of it.  Many we speak with feel the same. So much goes into facilities with all the Chihuly glass, art, massive atriums full of empty space, waterfalls, plants and furnishings. Half of our medical records or more have been lost during the transfer of paper to computer. Bedside manner is rushed at best. Symptoms are treated and patients get passed along from one doc to the next, from procedure to procedure, specialist to specialist, medication after medication and even after years of this the underlying cause is a complete mystery to the professional we trust to our care. Premiums continue to rise, the cost of service, medication. If i were to walk into a police station with similar information it would be considered robbery. Many people in the industry itself feel the same. 

This is my issue with  the "AFORDABLE" health care act (besides the fact that you are allowed to opt out of it).   No one is going to fix anything until we get to the root of the problem- the cost..  I work at a non profit hospital which I think works hard to waste the money on new tile and bonuses so that they can claim they are non profit and then charges ridiculous amounts for routine care. Then there is the pharmaceutical companies..  Last week I had a middle class client with insurance that called me because he just started on insulin and the cost of ONE vial of insulin was $1300 which he had to pay cash for.  I can't imagine why one vial of insulin would cost that much.  Whats worse is the doctor didn't even warn him about it.  I don't think the doctors even pay attention to price of things.  It was a mixed insulin (long and short acting).  I would give myself two shots before I would pay that kind of money unless it absolultely was  necessary.  He just started him on oral insulin and we didn't know how it was going to work.  If you are going to prescribe something like that,  At least give me a heads up.

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I just had my semi annual argument with my internist yesterday! He's a fabulous physician, tuned into his patients. He actually listens, so I feel heard and respected. With him everything takes as long as it takes. I've never felt rushed.

That said, I needed an inhaler for an upcoming trip to Vegas (the cigarette smoke is so toxic for me, I cough for weeks after). I am on ACA until I hit Medicare in the Fall. It works well for me, at a reasonable price, but its a bit limiting and I'll be happy to be done with it. The stinkin' albuterol inhaler was $52....for a generic inhaler. I was appalled! The cost used to be around $10.

My next big chore is to chose a Medicare secondary (I don't do HMO) and a drug plan. Plan carefully, to change is a bureaucratic nightmare.

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In network, out of network. A hospital, considered in network, can and will provide out of network services and products and procedures that arent covered by your insurace. Some facilities that are not hospitals can charge hospital prices. A cat scan in a hospital costs more than a cat scan in a non hospital facility. Inhalers? Like albuterol, are no longer the same. The propellant was changed and the price of the new albuterol inhalers sky rocketed.  I believe over 100 bucks out of the gate, full price, if i am not mistaken. Its a racket. We have stumbled on a couple of nice doctors, but unfortunately for us, not them, medical opportunities are infinite in our region. No sooner do we develope a relationship with a gp, they move on to bigger and better things. We are now on our forth gp. Last year the second gp left, then the next. I just saw the new one yesterday. Rushed me right out the door. 

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I plan to keep both my physicians. I've been with the internist 17 years and although he is nearing retirement age, he says he has no plans to do so. I did have to get a new GYN in 2015 because my ob/gyn of 40 years passed away. We used to work together and were great friends...he delivered my daughter! I chose one of his younger partners, have seen her twice and am quite pleased. Having spent many years in medicine, I'm very selective about my personal physicians so no insurance company is going to "select" or "assign" my doctors.

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Do docs have private practices anywhere anymore?

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1 hour ago, Mame925 said:

My next big chore is to chose a Medicare secondary (I don't do HMO) and a drug plan. Plan carefully, to change is a bureaucratic nightmare.

Selecting our secondary/drug plans was difficult. The plans in our area are expensive, but our care is superb.

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8 hours ago, Komorebi said:

Do docs have private practices anywhere anymore?

Do you mean "private" as in "w/o any partners" or "private" as in "not part of a larger health group/ building?"

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My gyn is part of a large, multi-specialty group. That is the way things are going these days. My internist has a partner, but is also part of a large "health system".

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Private as in not part of a larger group in a big building that is owned by area hospitals or "health systems"- Where we live every facility/medical building is owned by one of the two area hospitals- Growing up, doctors practiced out of big old houses, or smaller houses, either alone or with say a couple of other pediatricians- But the practice itself was owned by them, not an area hospital- Sometimes a doc practiced alone in a little office building that housed other little businesses not related to medicine- 

I think doctors used to practice medicine by way of examining bodies and treating those bodies and not relying so heavily on technology to provide them with answers- Modern medicine is amazing, don't get me wrong- But something has gotten lost- The facility dictates how a doctor treats their patients these days, in conjunction with insurance companies- People come from all over the world to this area to be treated, which I think is saying something- But I've discussed treatment with some of the people that traveled here who left disappointed with the service they received- Point being, if they traveled here from other countries, what ever is happening with healthcare isn't just happening here-

 

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1 hour ago, Komorebi said:

Private as in not part of a larger group in a big building that is owned by area hospitals or "health systems"- Where we live every facility/medical building is owned by one of the two area hospitals- Growing up, doctors practiced out of big old houses, or smaller houses, either alone or with say a couple of other pediatricians- But the practice itself was owned by them, not an area hospital- Sometimes a doc practiced alone in a little office building that housed other little businesses not related to medicine- 

Where I live, we have both - the large groups in big medical facilities and the doctors in small houses, alone or w/ one or two other doctors. But, as time goes on, I think we may have more of the big medical facilities.

I think doctors used to practice medicine by way of examining bodies and treating those bodies and not relying so heavily on technology to provide them with answers- Modern medicine is amazing, don't get me wrong- But something has gotten lost- The facility dictates how a doctor treats their patients these days, in conjunction with insurance companies- People come from all over the world to this area to be treated, which I think is saying something- But I've discussed treatment with some of the people that traveled here who left disappointed with the service they received- Point being, if they traveled here from other countries, what ever is happening with healthcare isn't just happening here-

Sign...

 

 

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Currently our area has the best of both worlds. My internist is not employed by the "big system", he's just a member of the system. He's a no frills kind of guy, his office is located in the "old wing" of our local hospital, the exam room is also his office, very old school, but with every technology at his fingertips. His subspecialty is pulmonary critical care, so he's at the hospital all day every day where he can deal with a crisis as it emerges. DH saw him one time for what turned out to be pneumonia, DH was told he needed to be admitted, DH said "I don't want to", Dr. called transport before DH could argue much more and he was taken to the acute care wing and admitted without going outside or even needing the elevator....best of both worlds.

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You've definitely best of both worlds, Mame-

A doctor was usually affiliated with a local hospital, but practiced elsewhere in my home state- Now .. here, along with the state I grew up in, many of the old wings and buildings have been or are scheduled to be torn down and the faculty distributed though out the merging hospitals that bought them out and are constructing new facilities- I mean who knows, some of them old buildings could probably contain asbestos although I think that by law it had to be removed years ago- The old nursing school which was attached to the hospital I was born in? Gone- The old hospital here that my first GC, and her dad, were born in? Gone- (she is only 11) The hospital my children were born in in our home state? Gone- (my youngest is 22) And gone is the care, too- Now everything is rushed- Is it for the money or because more people are insured and need to be seen? And seen by not doctors but their student assistants with little experience while our premiums go through the roof? Oi ..

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DH was born in the old wing, died in the new wing...we are a community directed by an historical preservation society...the hospital isn't immune. One physician used to house his practice in the basement of a house across the street from the hospital. Most of the other medical offices are a few blocks away.

You can always research any physician you are considering online....google their name and zip code, all the info will pop up.

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