More Big Brother...........

[britechguy]

I suppose I'm one that liked the way your GP diagnosed issues back when I was younger,
He would listen to your chest, press here, feel there, ask you "does that hurt" etc and at the end give you his professional diagnosis and usually a script.

Now it's 3 mins max, a few questions, google and take this to the chemist.

Medicine has changed in most of the world, it seems, from a "human service" to an assembly line.

I am certain I have mentioned that after I had been in IT full-time for a bit over a decade I was burned out and decided to do a 180-degree career change. I went back to graduate school and got my master's in speech and language pathology. I went on to work in a school for special needs kids (as an assistive technology specialist) and then as a cognitive rehabilitation therapist in a brain injury services program at a vocational rehabilitation center. In the latter position, the clients I was seeing were all well beyond the acute stage of injury, so therapy was not considered (and appropriately so) medically necessary, but was necessary to set up compensatory systems so the individuals might be able to work and otherwise manage aspects of their lives. I liked both of these positions because my clinical judgment was what dictated the course of treatment, as well as its duration. None of this was controlled by what insurance would or would not cover.

One of the main reasons I am no longer in clinical practice is that the insurance companies are entirely in charge of the medical industry here in the United States for all practical intents and purposes. In the case of most patients I would be seeing, were I still seeing them, in the post-acute phase, treatment that would have any real and meaningful effect for them would generally be a months-long process. If you can get even six weeks these days, and not daily treatment, either, you can consider yourself very, very lucky. And if you are unfortunate enough to work in a skilled nursing facility, you're constantly being asked to screen clients that everyone knows are inappropriate for further treatment and to add them to your caseload. Then, in the case of my profession, you cannot bill for any time that is not face-to-face with the client, and when you're doing evaluations the testing part of those, which is the only part you do face-to-face, takes minimal time. Scoring and interpretation of the results, treatment planning, etc., are not billable. Even for treatments, a very great many are doing their paperwork for their last session with their last client while trying to work with the current one. It's insane, and it's wrong.

I knew I couldn't be a part of "assembly line" medicine. I have no regrets for dropping out, or I'd have lost both my soul and my sanity.

 

[GTP]

Medicine has changed in most of the world, it seems, from a "human service" to an assembly line

Its unfortunate, but everything these days seems to be geared toward the "assembly line" way of thinking.
After-all we are just another product; another cash earner for a corporation.
The personal touch has long since gone.

By not adopting modern ways we are accused of "living in the past" but the past was a great place to live..

 

[britechguy]

but the past was a great place to live..

Not that I don't get your point, and in context, agree with it. But, as a broad statement beyond that context, I'd advise you to rethink that.

As a gay man "of a certain age" I can most assuredly tell you, that for "members of my tribe" and many others, for other reasons, the past was undeniably not "a great place to live." I've shaken the proverbial dust from my sandals as far as many things from the past. That doesn't mean I don't mourn the passing of things that were better.

 

[GTP]

Not that I don't get your point, and in context, agree with it. But, as a broad statement beyond that context, I'd advise you to rethink that.

As a gay man "of a certain age" I can most assuredly tell you, that for "members of my tribe" and many others, for other reasons, the past was undeniably not "a great place to live." I've shaken the proverbial dust from my sandals as far as many things from the past. That doesn't mean I don't mourn the passing of things that were better.

I was speaking with regard to how services are provided to people.
The past was definitely not a nice place for a multitude of other reasons, which don't need to be aired here.

Btw, my younger brother is a gay man happily married to his partner for over 30 years now.
I saw the struggle first hand.

 

[NJW]

It's not just insulin that's required for one... for two, everything you just stated comes in direct opposition to type 1 UK residents that find there way to me here in Phoenix.

Yes, I understand that it's more complicated than can be addressed in a forum post, but your suggested monthly costs just don't apply to an insulin-dependent diabetic resident in the UK, no matter who told you.

In my albeit brief research, the only large expense that might be passed on to the end-user is an insulin pump (retail cost: £2000-£3000 – one-off capital expense, not a rental), but these are also available for supply by the NHS – I don't know what the qualifying conditions are, but probably very unstable blood sugar control, requiring continuous monitoring.

Most of the consumables (test strips, prick test units, insulin pen needles, ...) are available on prescriptions, the costs of which are covered by the exemptions certificate. Insurance and many consumables are not covered for privately bought insulin pumps – I guess that situation is seen as elective and not essential for treatment, but it's just a guess; possibly for a patient that isn't able to monitor and inject (WAG).

Never underestimate the motivation of an expat Brit to denigrate their native land, especially if they've voluntarily relocated to Arizona. Most of my response information has come from diabetes.co.uk and diabetes.org.uk, plus NHS sites, so you're welcome to verify.

 

[Sky-Knight]

@NJW I'll happily concede that one. The one I can't is in Canada. I work with a guy that lives in Toronto who pays $2500 / month out of pocket.

Canada made insulin over the counter! No prescription required to get it, or the supplies required to administer it. Now they do have a "better" price on this stuff than we get in the states, but it's still not great.

But you're right in that my sources on my UK and AUS related comments are VERY skewed. I had hoped someone around here would have first hand knowledge of actually living with any sort of chronic condition in these respective nations.