A Little Bit of Humor ...

TWO DIFFERENT DOCTORS' OFFICES

Boy, if this doesn't hit the nail on the head, I don't know what does!

Two patients limp into two different medical clinics with the same complaint. Both have trouble walking and appear to require a hip replacement.

The FIRST patient is examined within the hour, is x-rayed the same day and has a time booked for surgery the following week.

The SECOND sees his family doctor after waiting 3 weeks for an appointment, then waits 8 weeks to see a specialist, then gets an x-ray, which isn't reviewed for another week and finally has his surgery scheduled for 6 months from then.

Why the different treatment for the two patients?






The FIRST is a Golden Retriever.
The SECOND is a Senior Citizen.

Next time take me to a vet!

Slinky wrote: Why the different treatment for the two patients?

The second patient (senior citizen) seeks treatment in a market that is heavily regulated and funded (about 50%) by the Federal government.

The first patient (Retriever) seeks treatment in a market which the Federal government has not interfered in.

Markets unencumbered by governments produce far better results for consumers.

roster wrote:

Slinky wrote: Why the different treatment for the two patients?

The second patient (senior citizen) seeks treatment in a market that is heavily regulated and funded (about 50%) by the Federal government.

The first patient (Retriever) seeks treatment in a market which the Federal government has not interfered in.

Markets unencumbered by governments produce far better results for consumers.

To build on Roster's thought:

The second patient (the senior citizen) gets treatment, as do all senior citizens with similar complaints.

The first patient (the golden retriever) is one of the lucky few with an owner who can afford the treatment. The vast majority of golden retriever's with such complaints are euthanized.

Sad, but true.

Not to be too much of a buzz kill, but the more I think about this joke the less truth it seems to embody. First, no human being wants to walk into a doctor's office with a limp and have a hip replacement the next day. A hip replacement is serious business that calls for thoughtful planning. Most candidates for hip replacement (other than those with traumatic injury) have chronic conditions that they have been talking to their doctors about for years. As the pain gets worse and other options become ineffective they decide to it's time to go with the hip replacement. I think I'm typical. I have mild hip pain and a CT scan says I have arthritis in both hips. It is no big deal now, but maybe in ten years I will need surgery. So I don't think beginning parts of the joke -- the initial appointments and x-ray -- reflect the actual human process of deciding on surgery. Okay, what about the next part: time from decision to incision? Does it really take six months to get surgery scheduled in the U.S. under the dysfunctional, 50 percent government-financed system Rooster blames? I've never heard of that. I'll bet that plenty of people in this forum have had hip replacements or have family members who have had them. DId anyone have to wait six months from the decision to operate until the surgery? As I think about the people I know who have had these in the last few years, including my father, I can't think of anyone who complained of an excessive wait. It was more like six weeks. And for humans, it is a pretty busy six weeks. I just looked at the web site of Illinois Bone and Joint Institute, which is a big clinic in my area, and they have a long list of things the patient is supposed to do starting six weeks before surgery. They include donating blood and stopping certain medications six weeks in advance; getting lab work and other testing and starting iron supplements four weeks in advance; getting clearance from a primary physician and a cardiologist if necessary three weeks in advance; with more steps counting all the way down to the day of surgery. Considering that people need to time their surgery so that they can take a month or so to recover, scheduling a few weeks in advance just makes sense. So honestly, I don't think that the joke illuminates any genuine problem, and Rooster's explanation of the cause -- federal regulation -- is just his standard explanation for any purported problem whether it actually exists or not.

PST, Your argument has cherry-picked one clause in the story to pick on:

and finally has his surgery scheduled for 6 months from then

and glosses over the real problem:

sees his family doctor after waiting 3 weeks for an appointment, then waits 8 weeks to see a specialist, then gets an x-ray, which isn't reviewed for another week

At the initial encounter with the human medical care system it is not known why the patient is limping and it takes 12 weeks to find out - not a wait any of us would want to endure.

But I will grant you the story is likely far from the truth.

It is a story that has circulated on the internet. I think it is safe to assume that someone, who takes the same view of governments' role in our lives as I do, wrote an answer similar to my answer first. Then he created a story to fit the answer.

BTW, euthanizing a Retriever that needs a hip replacement is often the humane way to treat an animal.

On another related topic, i would have had to wait 6 months for a sleep study in the US, whereas in europe i got my study in less than 6 weeks. In addition, the study only cost 1500 euro, from which my co-pay was only 10 euro. Similarly, i got a bill for $200 for the sleep consultation in the US, in europe the fee was part of the entire sleep study. I pay approx 450 euro per year for my entire health insurance And it has very good coverage. I pay about 28 euro for a doctor's appointment and get back about 18 euro per bill. Most doctors here do not have malpractice insurance, and their fees are also regulated (i would pay the same fee for a doctor's visit or sleep study in any city here). So in this case, I would say government regulation AND lack of insurance-inflated costs keep healthcare costs pretty low where I'm currently living. I even think pre-condition exclusions are not allowed when you get a new insurance. We also have mandatory, regulated, but not government-backed, ie private health insurance. Waiting times for medical procedures are pretty low. Anyway, somethings work well, other things not so well, in Europe. But definitely food for thought!! Ok sorry for the rant, slightly OT for this post. I always have to counter Rooster

One Euro = approx. $1.30

Slinky wrote:Why the different treatment for the two patients?

Not only is the response better for the dog, the cost is way cheaper for the dog. I had a dog with serious illnesses. I paid for all of her treatments, even several nights in the hospital and multiple emergency room visits, out of pocket without insurance, and didn't need insurance in order to be able to afford it. Some of her medications were IDENTICAL to what humans take but were still cheaper (this was before the $4 meds you can get now on a regular basis). Just about any medical care you can imagine that applies to both a dog and a human is way, way, way cheaper for the dog.

We have a vet school here. It's hard to get in. The applicants to vet school that can't get in often can get into medical school. Perhaps that says something. Plus, a vet's patients can't talk, so vets have to have better clinical skills. Medical care, for the most part, is outstanding where I live, but you can find bad doctors even here. I have yet to find a bad vet in this area. There is something about competition and an unregulated market that rachets up the quality.

LoQ wrote:We have a vet school here. It's hard to get in. The applicants to vet school that can't get in often can get into medical school. Perhaps that says something. Plus, a vet's patients can't talk, so vets have to have better clinical skills. Medical care, for the most part, is outstanding where I live, but you can find bad doctors even here. I have yet to find a bad vet in this area. There is something about competition and an unregulated market that rachets up the quality.

So true! At my university this was also the case - much more difficult to get into vet school than med school. Grade requirements, among other things, were higher for the vet school.

much more difficult to get into vet school than med school

That had been my impression, too. But 5 minutes on Google revealed (for the US):

5750 applicants for 2650 first-year vet school positions, so 46% acceptance.

37,000 applicants for 19,000 first-year med school positions, or 48% acceptance.

However, there are only 28 vet schools in the US, and only 23 are state schools. Most state schools are in ag. colleges, and legislatures exert some pressure on those to produce sufficient vets for livestock. Most students who want to be small animal vets have to seek admission to private schools, or apply to be admitted to state schools as out-of-state students, and I suppose those positions are more competitive than average.

LoQ wrote: There is something about competition and an unregulated market that rachets up the quality.

That is so true and add to it that in veterinary services the consumer is directly paying for the cost of the service.

1) When the consumer pays for the costs of the services he consumes, he will be careful how he spends his money.

2) Now add that the supply side of the market is lightly regulated and free of government interference to choose what services to offer, in what locale, and at what prices.

Put those two together and the consumer will use discretion in spending his money. He will ask how much things cost and what the alternatives are and how much they cost. He will make careful judgments about the quality of the services he is paying for. He will shop around. The veterinary service supplier will 1)respond with higher quality and competitive costs; or 2)fail and leave the business.

This situation does not exist when the government is paying most of the costs (50% by Rooster's numbers) and the industry is highly regulated.

I was recently very shocked to read in my local paper about a (human) hospital who had applied to the government to build an emergency facility in my community and were turned down. It seems the government's "hospital board" determined that there was enough emergency room capacity in surrounding communities to fulfill the needs. The "little gods" on the government board are stifling competition and protecting the entrenched hospitals. An egregious example of government taking actions to hold the costs high and the quality of the service down for the citizens.

Here we had a group of investors who wanted to spend their own money to build a hospital, compete, and serve the community, however the government stands in the way!

This kind of @#$%^ is going on all across our great country in many diverse industries. You need to wake up to how government bureaucrats and politicians (Republican and Democrat) are meddling forcefully in many aspects of your life and screwing you and padding their own nests with your money.

roster wrote:PST, Your argument has cherry-picked one clause in the story to pick on:

and finally has his surgery scheduled for 6 months from then

and glosses over the real problem:

sees his family doctor after waiting 3 weeks for an appointment, then waits 8 weeks to see a specialist, then gets an x-ray, which isn't reviewed for another week

At the initial encounter with the human medical care system it is not known why the patient is limping and it takes 12 weeks to find out - not a wait any of us would want to endure.

But I will grant you the story is likely far from the truth.

It is a story that has circulated on the internet. I think it is safe to assume that someone, who takes the same view of governments' role in our lives as I do, wrote an answer similar to my answer first. Then he created a story to fit the answer.

I don't want to beat a dead horse here, especially since we are discussing veterinarians, but I did discuss the pre-decision delays. I said I think the story is unrealistic, because people don't suddenly develop a limp and proceed to hip replacement. They develop sore hips due to arthritis and wait years before the condition becomes bad enough that they and their doctors decide that the time has come for hip replacement. In real life, people don't rush to have hip surgery, they delay in the hope of only needing one in their lifetime. In any event, since we all agree that the facts are simply made up, there isn't much point discussing what they mean. Does it really take eight weeks to get in to see an orthopedic surgeon? I haven't needed one of those lately, but I've needed an allergist and an ophthalmologist, and it only took a week or so. And while we're at it, I don't ever recall seeing a veterinarian the same day except in an emergency. You make an appointment just like for a human doctor (or should I say doctor for humans).

Which reminds me of an old joke. A man walks into a veterinarian's office with a limp and lifeless hamster in his hands. "Doc, you have to help me," he says. "Spike doesn't look so good."

"I'm afraid that hamster's dead," says the vet after examining him.

"I can't believe he's gone. I have to be sure. Isn't there a test you can do?"

"Well there is," replies the vet, "but it isn't necessary in this case."

"Go ahead doc," the man replies. So the vet whistles, and into the room through a pet door comes a labrador retriever who hops up on the table with the hamster and proceeds to sniff him carefully from snout to tail. The dog then barks twice, jumps to the floor, and leaves the way he came in.

"That confirms it," says the vet. "Your hamster is no more."

"Not good enough," says the man. "There must be some way to be absolutely certain." So the vet calls for his cat, who enters through the pet door and hops onto the table. He gently bats the hamster's limp little body a few times and pushes it with his nose. Then he sticks his tail straight up, jumps down, and marches out of the room.

"There is no arguing with that," says the vet.

"Oh, all right," says the man. "I guess Spike's really dead. How much do I owe you?"

"$1,700," says the doctor.

"$1,700? You've got to be kidding me! $1,700 to tell me my hamster's dead? That's outrageous!"

"Don't blame me," said the doctor. "My fee is only $50. Most of that is for the lab work and the cat scan."

So, if jokes are equivalent to proof, then this proves that the strictly private fee-for-service model of veterinary medicine is broken and must be scrapped.

PST wrote:
But I will grant you the story is likely far from the truth.

It is a story that has circulated on the internet. I think it is safe to assume that someone, who takes the same view of governments' role in our lives as I do, wrote an answer similar to my answer first. Then he created a story to fit the answer.

I don't want to beat a dead horse here, especially since we are discussing veterinarians, but I did discuss the pre-decision delays. I said I think the story is unrealistic, because people don't suddenly develop a limp and proceed to hip replacement. They develop sore hips due to arthritis and wait years before the condition becomes bad enough that they and their doctors decide that the time has come for hip replacement. In real life, people don't rush to have hip surgery, they delay in the hope of only needing one in their lifetime. In any event, since we all agree that the facts are simply made up, there isn't much point discussing what they mean. Does it really take eight weeks to get in to see an orthopedic surgeon? I haven't needed one of those lately, but I've needed an allergist and an ophthalmologist, and it only took a week or so. And while we're at it, I don't ever recall seeing a veterinarian the same day except in an emergency. You make an appointment just like for a human doctor (or should I say doctor for humans).

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I will agree that one doesn't all of a sudden develop the need for a hip replacement (unless it is an accident case). But in today's medicine there are immediate needs which aren't being met. Yes it can take upwards of 12 weeks to get into a specialist (it took 13 weeks for me to get into a neurosurgeon for a second opinion). From that appointment, it took another 3 weeks to schedule surgery and that was a miracle because the doctor wanted it to get scheduled asap. With his regular schedule, it would have been more like 6-8 weeks to wait. Now between fighting the insurance company and waiting for appointments, I wasted almost 16 weeks for something that was known over a year ago that needed surgery.

Now we had to take our dog in for shots so that we could board him while I had surgery. I called around to three different vet's. They ranged in price from $70 to $140 for the same office visit, shots and record keeping. The $70 was at the veterinarian college at Cornell, about 25 miles away. So I asked for an appointment and was expecting a 2 week wait but was surprised that I could get him in that afternoon. If I wanted him neutered, I could have left him that day and picked him up 2 days later.

Allen

funny but when my mother had hip replacement she wasn't placed in the third cage up with her litter box in a room full of howling other animals like my cat was after she tried to eat metalic thread and required surgery to remove it.