All of what you said is true but let's not forget the other side of the coin, which is that:
1. The average patient is not (at the outset at least) accessing doctors with either real or pretend "expertise," but a series of midlevels*, halfwits, and Pajeet imports who are more like Jiffylube techs for the human body than any kind of engineer.
2. The system has made it so that when you are able to access any care at all, the odds are very high you will NOT be seeing that same person again, for better or for worse. Which means that every doctor comes at your history blind.
3. The system has shown itself to be profoundly corrupt and uncaring during the past 4 years with things like coldly mandating an untested, experimental treatment, and telling patients that they really ought to be left to die if they refuse it. People with GBS being denied medical exemptions...the list could go on for pages.
4. Before that people already knew that doctors were getting some kind of perverse incentive to always prescribe the trendy drug rather than look into any kind of alternatives. Vioxx, the low-grade slow-burning scandals around SSRIs and AAPs...the whole "bipolar kids" thing...
5. Opiates. First they were stupidly throwing them at the average normie by the case, for a twisted ankle. Now they treat you like a criminal if you beg for a shot of so much as Toradol during a kidney stone.
Hardly any wonder people feel distrust, and hardly any wonder the mentally less stable end up resorting to absurd measures accordingly.
*the damage done by FNPs and PMHNPs alone is catastrophic and overwhelming to describe. And that's who you will see when you roll up, desperate, to the urgent care with that cough that won't go away or the flank pain that feels like you're being Wiley Coyote'd by a piano.
IDK that any of this is the other side of the coin. It's all more symptoms of the same goddamn problem. The American healthcare system is beyond fucked.
Midlevels are an absolute abomination. If you need a license to practice medicine - if you need to prove that you completed medical school, passed weeks' worth of standardized testing, and completed a residency where you worked 80+ hours/week for a bare ass minimum of 3 years straight - then why the FUCK does Brittani Knowsnothing get to do the same job with nothing more than an undergrad degree and a 2 year online "degree" where she didn't lay hands on a single patient? It's absolutely criminal how incompetent they are. But they're a little cheaper than hiring a trained physician, so what the hell? Staff every ER, urgent care, and primary care practice with nothing but fucking midlevels. What could possibly go wrong?
If we have any prayer of fixing the system, we gotta take perverse financial incentive out of it. That's how Big Pharma got the upper hand, how the opioid crisis came to be, how midlevels took over within the last decade. And it's not the doctors' fault. It's the administrators. The insurance companies. The middlemen. Trust me, no doctor wants to see nothing but new patients all day long. It's impossible. It's exhausting. You want to see patients you know, who you're familiar with, who you can help over the long term, because most medical problems are NOT a quick fix. Used to be that doctors overwhelmingly worked for themselves in private practice, so they could set the rules and the schedule. Not anymore! Now, most physicians are employed. That means the administrators set the schedule. They have control over who you see, when you see them, how long you have, what you can prescribe, what you can and can't do at an office visit, etc. The system controls everything.
But patients don't see the admins fucking around. They're behind the scenes. All they see is the doctor, who has no control over
their own schedule, who tells the patient they're really sorry they can't address their 5 major problems during one 15 minute visit and that they'll have to make another appointment. Also, sorry that we can't even make that appointment today, because there aren't any openings in the next 3 months, so you'll have to call the appointment line daily until you can find something. And since everyone is doing this, and the appointment line is understaffed, you'll be on hold for an hour each time you call. Sorry. Oh and also I can't remove that bothersome cyst/lipoma/ingrown toenail, because we don't have the equipment at this clinic. I'll have to send a referral to the minor procedure clinic, which insurance will deny, and we'll have to appeal, and that will take a month, and THEN you can call the appointment line daily for an hour of hold music in hopes that in 3 more months, maybe we'll have an opening.
Maybe.
Of course, the munchies only exacerbate these problems by sucking up time and resources. Because we're all beholden to patient satisfaction scores, she who reeeeeees the loudest gets the most and the fastest care.
) Kind of funny that's where the threads originally started.
en.m.wikipedia.org
