Canadians are one in a million -- while waiting for medical treatment

[bcking 3,157]

I should also add that many schools are now adding it to their curriculum, as are residencies. Just wasn't a thing when I went to school.

 

To be honest though I'm not sure how they'll really fit it in. Many interns show up after medical school quite clueless about even basic clinical care. If they didn't learn the core of their profession in medical school, not sure how they are going to find time to learn about coding.

 

Edited June 15, 2018 by bcking

[TBoneTX 43,058]

5 hours ago, bcking said:

1.  I should also add that many schools are now adding it to their curriculum, as are residencies. Just wasn't a thing when I went to school.

 

2.  Many interns show up after medical school quite clueless about even basic clinical care. If they didn't learn the core of their profession in medical school, not sure how they are going to find time to learn about coding.

1.  Sounds as though there still might be a market for recorded, downloadable seminars or guides about how to start up an independent medical practice, deal with insurers, etc.

 

2.  Man, isn't that true... and this segues into the whole other topic of curricula, mandatory work hours (and limits), and other issues involved in Medical Education.  That would be a fascinating stand-alone thread.

[bcking 3,157]

1 hour ago, TBoneTX said:

1.  Sounds as though there still might be a market for recorded, downloadable seminars or guides about how to start up an independent medical practice, deal with insurers, etc.

 

2.  Man, isn't that true... and this segues into the whole other topic of curricula, mandatory work hours (and limits), and other issues involved in Medical Education.  That would be a fascinating stand-alone thread.

Absolutely. The other problem I didn't initially think about was the majority of medical education occurs in large academic centers (makes sense). So even if training was incorporated, it would be mostly geared to that practice environment. They would have to bring in people from private practice (who often don't have academic appointments and don't regularly teach) to talk about their unique circumstances. Then you have to deal with the fact that each individual trainee will ultimately usually go into one arena or the other (private or academic), and they only infrequently swap. 

 

A brand new July is just around the corner, with fresh faced medical students, residents and fellows. Stay out of the hospital  (Though in reality things are MUCH better than they used to be, in America. Trainees are probably over-monitored at this point, to the point where they have very limited responsibility).

[Steeleballz 7,550]

6 hours ago, bcking said:

I should also add that many schools are now adding it to their curriculum, as are residencies. Just wasn't a thing when I went to school.

 

To be honest though I'm not sure how they'll really fit it in. Many interns show up after medical school quite clueless about even basic clinical care. If they didn't learn the core of their profession in medical school, not sure how they are going to find time to learn about coding.

 

 

  Move to Canada. No coding, no billing.

 

  Actually, last time I worked in Canada, I had a sinus infection and had to see a doctor. After I was done, I asked if there was a copay or anything. They laughed and asked when I had moved from the US. Hard to break old habits sometimes. 

[bcking 3,157]

2 minutes ago, Steeleballz said:

 

  Move to Canada. No coding, no billing.

 

  Actually, last time I worked in Canada, I had a sinus infection and had to see a doctor. After I was done, I asked if there was a copay or anything. They laughed and asked when I had moved from the US. Hard to break old habits sometimes. 

My uncle fell and need stitches the day before my wedding in the UK. He went to the A&E and got treated. He asked the same question on the way out. The hospital didn't even have a "billing department". Just doesn't exist.

[OriZ 3,157]

To be fair after spending a few years in the US my impression of the healthcare system is pretty terrible. Not only the hoops insurance companies make you jump through but even the quality of care. I don't think a private company that you pay thousands a year to should have a right to decline ANYTHING. That is so backwards it's not even funny.

[Voice of Reason 10,298]

25 minutes ago, OriZ said:

To be fair after spending a few years in the US my impression of the healthcare system is pretty terrible. Not only the hoops insurance companies make you jump through but even the quality of care. I don't think a private company that you pay thousands a year to should have a right to decline ANYTHING. That is so backwards it's not even funny.

Not sure where you are getting your care, but there are zero insurance hoops that I have to jump thru.  Other than moving and having to establish a new PCM, but that is on me.

 

I have been cared for in a few other countries, but most of those Drs. were US educated, so the level of care has been about the same, minus some  older equipment.

[Steeleballz 7,550]

36 minutes ago, IDWAF said:

Not sure where you are getting your care, but there are zero insurance hoops that I have to jump thru.  Other than moving and having to establish a new PCM, but that is on me.

 

I have been cared for in a few other countries, but most of those Drs. were US educated, so the level of care has been about the same, minus some  older equipment.

 

  Sounds like you are in the 1%. The 1% of people who still have a decent health insurance plan. 

 

  In 4 years, our insurance has gone from half-decent to half-baked. I hope yours doesn't end up that way.

[bcking 3,157]

My wife's experience so far in the US Healthcare system has been hit and miss.

 

Positive - She made an appointment and saw an OBGYN within around 2 months of arriving. Now partly she got an earlier appointment because I work with the doctor and emailed them and got her in, but still in all her years in the UK she has never actually seen an OBGYN. Always a GP or a nurse practitioner. Now did she actually need to see an OBGYN? No, her needs were quite standard so you could argue that the level of access was actually wasteful. She was able to get the form of birth control that she uses without much fuss, while in the UK every new GP she sees she has to explain and convince why she can't just be put on the standard. The OBGYN didn't really care (I'm sure she cared, but she just didn't have time and didn't have any pressure to prescribe the standard) so she gave her what she wanted. 

 

Negative/Surprising - The wait time for any other type of doctor has been longer than she expected. I think she assumed since we are paying for insurance, we can just waltz into an office. She had private insurance offered through her work in the UK and if you went through that system (which she rarely did), you had essentially no wait for anything. However here any specialist was 3-4 months. She has migraines and I wanted her to see a neurologist. I called in May and their "first available" was in September. This is in Houston where access to care is quite good. The only specialist without much of a wait was dermatology, though she saw a PA there. Similarly we are now expecting in January and her care has been essentially the same as her friends in the UK. She had her first ultrasound, and will have another one next week but in between those she can't go in for additional appointments or anything extra what she would have had in the UK. On the positive side though she sees the OB each time, but again if everything is going well does she really need to? Not really. MFM will do the anatomy scan which seems nice in some ways, but is probably overkill in other ways.

 

Once we do deliver however the care will be different. In the UK people still stay in large wards with curtains after having the baby. Here in Houston she'll have a private room, large TV, room service etc... Though we'll still end up paying a few thousand dollars. Her friend in the UK delivered last month and walked out the next day with a great big fat zero bill.

[TBoneTX 43,058]

1 hour ago, bcking said:

we are now expecting in January

 

[Umka36 781]

We've have pretty good service through my employer based health insurance for the most part, so we've been fortunate.

 

An area of concern for my wife is the waiting period to get ABA therapist for our son (6 month waiting), but it has nothing to do with the insurance as they approved the referral request. Unfortunately there just isn't enough licensed ABA therapist, but we are lucky as the wait list could be over 2 years if you only had Medicaid coverage (this is due to limited funding).

 

My dental coverage is free, but it doesn't cover all that much. They focus more on the preventative measure, so it can be costly if you need major dental work. How are other countries dental plans? My wife's country (it's free) don't focus on prevention, so if you teeth hurts they just remove it.

 

 

Edited June 19, 2018 by Umka36

[AshMarty 359]

There are positives and Negatives of Health Care here (not saying the US health care system is great by any means). I work at a Rehab Hospital that is associated with Johns Hopkins. About 30% of my caseload will be from patients from around world that are sent to our Hospital through their embassies or special visas. In the past 6 weeks I have seen patients from Brazil, Canada, 2 Saudi Arabia patients, and a handful of other patients from the UAE. 

 

The patient from Canada's child was cut off from public Rehab services because they feel she has met her potiential, so she travels to our hospital 3 x a year for equipment updates, medicals,and rehab updates. If you talk to people from different countries they will tell you their personal experiences both positive and negative.

 

My patient from Brazil said they would not trust their public system ( and his grandfather was an MD in Brazil) but thought it was weird that each hospital had a different self pay price for an MRI when they had to call around for estimates in the states. 

 

We have Australian Physical Therapists (Private sector) come to observe our clinic once a year for about two weeks. They are always amazed by the equipment we send our patients home with and tell us how no one in their clinics would ever be approved to take home the equipment that a lot of our patients are approved for. 

 

On the opposite end my husband needed a heart surgery in Australia before he migrated to the US. He was a tier 2 case and received his surgery within 6 months of his diagnosis (Wolfe Parkinson White Syndrome). I had a cardiologist ready in the states thinking he would get surgery when he arrived, we would have to have paid about $500.00 with our insurance for the surgery,  he got it completely for free in Australia. 

 

Also interesting fact: Canada and Australia don't believe in the diagnosis of Lymes disease so if you receive that diagnoses in the public systems you are out of luck and your treatments will not be covered. 

 

It you talk to people with chronic diseases from other countries you will begin to see the positive and negatives of each system. Again not saying the US is a great system at all but if you dive into each system there will be flaws. 

Edited June 20, 2018 by AshMarty

[*Snowdrop* 603]

If you have great insurance then the American healthcare system is pretty amazing. We have very low deductibles and great coverage for everything. But even then a lot of the co-pays are a bit of a shock coming from the UK and the NHS system. My birth experience as great and our insurance meant no bill at all - no copays for all the prenatal treatment and nothing for the birth in a fancy birthing center which sent us home with loads of baby supplies and a special new parent gift basket with food and commemorative glasses.

 

But - living here has really made me appreciate how lucky we are in the UK to have the NHS - it really is an amazing resource:

 

I may just have been very lucky with my experience of the NHS but my experience spans six different counties across the whole of the UK and multiple health care centres and it has always been amazing for me and my family. None more so than when my mother was diagnosed with a fast growing terminal cancer. She had the most amazing care over the last three months of her life. Our family doctor visited twice a week and sat with my Mum and then my Dad and me for over 30 minutes talking through everything. We had nurses visiting at first once a day, the three times a day for the last month. Medical equipment and a special bed shipped to my parents' house, and bags and bags of drugs and medications - all without any charge or copay or any worry about cost. After my Mum died there was a regular check up from the local hospice for several months for my Dad to see if grief counseling was needed. It was as kind and supportive end of life care as you could ever wish for in that situation. The nurses who came to take care of my Mum would also spend time with me, and check on if I needed anything, they took time to interact with my 2-year-old daughter who was running around (as we'd come back from the US to be with my Mum until she died) - they cared for the whole family. 

 

And during this terrible experience, there was no worry about cost or bankruptcy or stress about taking loans out to cover care, or calling around to find a provider who would take us. 

 

And two years later when my Dad needed a heart bypass - his doctor told him it was advisable but not urgent and then three weeks later he got a call to say they could take him in 2 days - and then a week later he was back home recovering from the bypass operation with amazing aftercare and support - again - no worries about cost or providers. And as he's a pensioner he doesn't have to pay anything at all for his medications.

 

 

 

 

 

[AshMarty 359]

On 6/15/2018 at 2:45 PM, bcking said:

 

 

A brand new July is just around the corner, with fresh faced medical students, residents and fellows. Stay out of the hospital  (Though in reality things are MUCH better than they used to be, in America. Trainees are probably over-monitored at this point, to the point where they have very limited responsibility).

Oh Man. When I was on a clinic rotation for PT school in a big health care system in the South, I remember being horrified when the new residents would come up and ask me for advice for their treatments (and not the rehab advice) of course I remind them I am a PT not a medical doctor     I was horrified . Stay out of the Hospitals during the month of July! 

Edited June 20, 2018 by AshMarty

[The Nature Boy 7,659]

I had a doctor recode a preventive colonoscopy to a procedure , because  he decided to take a sample of some kind that was a big nothing burger.

 

However insurance pays 100% for a preventive colonoscopy,  but when it turned into a procedure the bill went thru roof.  Yearly deductibles,  out of pockets. Etc. The difference was huge.