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Subject: Re: Small Town Doctor Author: Cindi [ Next Thread | Previous Thread | Next Message | Previous Message ] Date Posted: Saturday, March 27, 2010, 05:44: pm In reply to: numbers to Gina 's message, "Re: Small Town Doctor" on Tuesday, March 23, 2010, 11:54: am In small communities, there is often a lack of decent medical facilities, because the fact is that the majority of doctors are in the profession to make megabucks. It's the rare individual that will spend time and money on medical school, and consider working in a rural area as a reward. These small towns have a tendency to be economically depressed, and don't have conveniently located hospitals, with cutting-edge technology. If you live near a large city, then you can be better assured of receiving decent treatment. This can be critical in a life-threatening situation. If I knew that a doctor wasn't up to date on their knowledge, elderly, and in failing health, or had an antiquated practice, I would think twice. It might be best to drive several miles, or better yet, move away. You don't have to accept second best when it comes to your body. [ Next Thread | Previous Thread | Next Message | Previous Message ]

Replies:

[> [> [> [> Subject: Re: Small Town Doctor Author: To Cindi [ Edit | View ] Date Posted: Sunday, March 28, 2010, 05:47: am I disagree that there is a lack of DECENT medical facilities. There may be a hospital with no cardiologist or neurologist, but that doesn't mean that it is not a decent facility. A hospital is expensive to run. If the community cannot support a cardiollogist, there won't be one. doctors have bills too, and most Americans feel they shouldn't have to pay anything for healthcare. I have patients who ask me to write prescriptions for tylenol so medicaid will pay for it so they don't have to. My patients who pay their own premiums have to buy their own tylenol, but medicaid patients pay for nothing - no office visit copay, no mediations, no nothing. We should all have access to health insurance, but we should all have to pay for it too. [ Post a Reply to This Message ]

[> [> [> [> [> Subject: Re: Small Town Doctor Author: Cindi [ Edit | View ] Date Posted: Sunday, March 28, 2010, 11:22: am You write prescriptions for tylenol? I thought that was sold over the counter. Anyway, the healthcare issue isn't going to go away. Fact is that the Republicans are selfish,greedy, and want nothing for anyone who is deserving. Only the wealthy and powerful should enjoy life, according to them. My belief is that as working Americans, our tax dollars should be paying for our services, including healthcare. It isn't entitlement, we've earned it, and we should have received it decades ago. Do you think that it's fair for a patient, through no fault of their own, to be sick or injured, then to be punished again, by losing their home, and/or being placed in a lifelong financial hell because some arrogant, greedy doctor feels entitled to earn millions of dollars? That attititude has destroyed this country. It's high time that justice and equitable fairness prevail. How can we build a system that works for the public good, when a few demogogues want the whole pie for themselves? [ Post a Reply to This Message ]

[> [> [> [> [> [> Subject: Re: Small Town Doctor Author: Cindi- to poster [ Edit | View ] Date Posted: Sunday, March 28, 2010, 11:33: am Oh, and btw, how can you have a hospital without a cardiologist or neurologist on the staff? Something doesn't add up here.(And you're a healthcare provider?). The reason many people wind up in the hospital is due to heart attacks, strokes, and injuries, so what would be the point in having a non-functioning medical facility? But, somehow, you equate that with decent medical care!!?? [ Post a Reply to This Message ]

[> [> [> [> [> [> [> Subject: Re: Small Town Doctor Author: to Cindi [ Edit | View ] Date Posted: Sunday, March 28, 2010, 09:03: pm Yes - medicaid will pay for tylenol if the Doctor writes for it. Medicaid covers it 100%. No copay - no nothing. Just government pays for it. My 86 year old grandmother pays almost $400 for her meds a month and the people on Medicaid pay nothing. This isn't about doctors being greedy or making millions. I see uninsured pts in my rural clinic for a $20 copay. And to answer your other question - I'm not sure where you live, but there are thousands of small community hospitals without cardiologist or any other kind of specialists. there are hospitals without even one surgeon. These people have to be paid, not because they are greedy, but because they have house payments and children to clothe and feed and send to college. If the community can't support the specialist, they won't be there. If someone is having a heart attack they are transferred to a larger hospital in a nearby larger town that has specialists. And -- the specialist in that hospital has to ACCEPT my patient who is having a heart attack. I can't just ship them over - the receiving physician has to accept them before the ambulance or helicopter will leave my hospital. This is not unique to my community. It's everywhere. [ Post a Reply to This Message ]

[> [> [> [> [> [> [> [> Subject: Re: Small Town Doctor Author: Leo [ Edit | View ] Date Posted: Sunday, April 01, 2012, 02:03: pm First, I agree with "to Cindi." Medicaid will often pay for OTC meds if you have a script. Second, many good hospitals do not have staff in every sub-speciality, such as neuro-surgery. Some may not have OB or dermatology. At our hospital, we have GI doctors who will not see Medicaid patients, so the fact that a specialist is on the staff doesn't mean he/she will treat you. Third, based on your initial post,. you seem to be arguing that it is preferable to see a doctor who went to the big medical centers to make "mega-bucks" than one willing to serve a small community taht reallly needs him or her, just because the big medical centers have expensive technology which is often over-used raising the cost of medical care. [ Post a Reply to This Message ]

[> [> [> [> [> [> Subject: Re: Small Town Doctor Author: an addendum [ Edit | View ] Date Posted: Sunday, March 28, 2010, 09:56: pm I am trying to be polite, but I get so frustrated with this arrogant, greedy doctor thing. Until you have walked a week in my shoes, you have no idea. I am on call 24-7-365. yeah, there are a couple of other docs who cover the hospital call and we take turns, but the nursing home patients' calls come to me - their doctor. Home health patient calls come to me - their doctor. 24-7-65. My kids go to bed some nights without having seen my all day - or the next day because I am in the hospital taking take of paitents who get online and talk about how greedy I am. I took my family to Disney recently and was called over a dozen times while I was there even though I was . on "vacation". I spend a ridiculous amount of my day thrying to figure out ways to help uninsured pts get what they need cheaply. I prescribe off the walmart $4 list which takes up more office time. I don't want a freking medal - I want a break. I want to quit hearing how I am the problem with healthcare today. No - here's the problem with healthcare today. The people who DON'T pay taxs and get their healthcare for free (including tylenol if the doc will write for it)while you and I pay health insurance premiums, have $35 copays and pay up to $50 copays for our medications. I am not the problem. The people who want something for nothing are the problem. [ Post a Reply to This Message ]

[> [> [> [> [> [> [> Subject: Re: Small Town Doctor Author: comment [ Edit | View ] Date Posted: Sunday, March 28, 2010, 10:45: pm I just happened to run across this post, and have to question the validity of what I've read. Now, this supposed hospital has a helicopter to transport paitents, but it can't afford a specialist, which would avoid the need to transport the patient in the first place. Hmmmmm. The nearest hospital is close by, which has a Cardiologist, yet, there's no ambulance service, but instead, a helicopter, standing by? And, if it's within driving distance of your hospital which lacks an essential staff, then why did they even build it in the first place? The other question is the 24/7 on call schedule. The only doctors with this type of schedule are typically medical students, while doing an internship. It may be feasible for a doctor to be on call for a specific rotation, once they have received complete certification, i.e., a cosmetic surgeon who is called to the ER to repair damage to a car accident victim, etc. Nonetheless, the account is very puzzling and inconsistent, and doesn't make much sense, but who knows? [ Post a Reply to This Message ]

[> [> [> [> [> [> [> [> Subject: Re: Small Town Doctor Author: Opinion [ Edit | View ] Date Posted: Sunday, March 28, 2010, 10:58: pm The healthcare issue is turning into a tug of war campaign between the haves and have nots. If our current healthcare system worked, then we wouldn't need change, but it has failed miserably. Today, because of the Republicans, many folks are without work, through no fault of their own, and many more are working for minimum wage. You can't tell me that these down on their luck people don't deserve help. If you blame them, then shame on you! Our tax dollars have paid for lavish parties, corporate ceo's mansions, mistressess, and blood for oil wars. So, the taxpayers are getting screwed. That attitude needs to change. People deserve to be taken care of. They've earned it, and paid for it. We're one of the wealthiest nations on the planet, yet one of the least concerned when it comes to people. [ Post a Reply to This Message ]

[> [> [> [> [> [> [> [> Subject: Re: Small Town Doctor Author: To Comment [ Edit | View ] Date Posted: Sunday, March 28, 2010, 11:23: pm No - our hospital doesn't have a helicopter. We have a helicopter pad. The helicopter has to be brought in from a neighboring town. We do have amublance service. Sometimes a patient can be taken by ambulance, sometimes it is more urgent and they need to go by helicopter. Sometimes weather conditions do not allow for helicopter transport. From my side of it, it seems like if the wind is blowing at all, and I need someone to go quickly, I am declined for weather. yes - doctors who take care of nursing home patients or home health patients are on call for those patients 24-7. docto As I mentioned before, doctors sometimes have call groups who cover hospital call, but for nursing homes/homehealth we don't. Medical student call and intership/residency call is NOT 24/7. There are new laws that preclude this from happening. Residendt can not work more than an average of 80 hours/week during a 4 week period. I honestly did not realize how uninformed the public is about the challenges faced by practitioners of rural healthcare. [ Post a Reply to This Message ]