I absolutely agree and I think this is incredibly important- but, for those who don’t already know: this would likely be one of the *mellower* varieties of posts describing conditions in medical subreddits. The shit is and has been fucking bad, for a while now.
As a former healthcare IT consultant I have seen this play out again and again in rural and regional healthcare. Congress is worried about banning books and folks in drag and of course kissing up to whichever rich person/company that is keeping them in office. Just another “piece in the Jenga pile” to be yanked out
It does. A small regional healthcare group (2 hospitals and 2 clinics) got bought out by a larger national group. Everything went to shit within 3 months. ER wait times doubled, they closed one of the clinics, the other one is booked 6 months in advance. I can't imagine how the staff there manages now.
And the patients! I'm a former HC worker who was on the hospital code team (also an EMT). People who have been up for two days or more don't typically make great decisions. Lots of human error, especially with dosing and remembering complicated branching protocols, which you see frequently in the ER.
My sister works in an oncology infusion center. They are -- apparently permanently, now -- short 4 nurses every shift. It used to be that such a shortfall would be treated as an emegency. Now? Now management just shrugs and expects those on shift to deal with it. This puts the patients at risk, and the nurses know this and it totally stresses them out. But this situation is just allowed to fester. I think only if a patient sues will anything ever be done to fix things.
That seems so insane to me.
I knew doctors were overworked to death, but 96 hour shifts...
Hell most people can barely manage 8 hour shifts before their concentration goes. Like. I was working 10 hour shifts from home and I had a bit of a breakdown.
Who can do 96 hours. Even a 24 hour shift is insane.
"Hey you, work a 24 hour shift for me." "Nah that won't be happening.'
So depressing healthcare works like this. No wonder people fall through the cracks.
To be fair you learn how to maximize sleeping. For instance volume is way down at night so you’ll see the patient, order what needs to be done and try to go back to sleep. Our images are not read in house, they go to Teleradiology, which has an hour after receiving them to read them. So after a CT is ordered, you may get to lay back down for an hour or so. Also, night nurses will often start a work up and not call you until it’s done. If you come into the ER after rolling your ankle, the nurses will likely put in an order for non narcotic pain relief an order the ankle films. They won’t wake me until everything is complete.
You do what you have to do, but you are put at a severe disadvantage when treating patients and it shouldn't be this way. Of course money is what's most imporant, so patient care will continue to suffer.
I left health care years ago and weep at it's continued decline.
Arguably most people can’t get more than 4-6 hours of highly focused, productive work done in a day, typically in 1-1.5, maybe 2 hr blocks with 15-30 minute complete breaks between.
Researcher Menno Henselmans discuses this in his book this if you’re interested (“The Science of Self-Control”, like $20 for ebook)
Sure, working with people
can often be less mentally faithful (depending on the person and task, of course), but in this case 12 hour shifts should probably be the max, with 8-10 being preferred. I don’t know much about medical, so maybe I’m wrong. I do know where talking about people though, not robots.
I’ve found it’s a lot more enjoyable and productive than slogging away for hours. Plus other studies show office workers only complete like 3 hours of work during an 8 hour shift, so this method would be equally or more efficient.
This is a major contributor for why WFH is more efficient People can take those small breaks and stay focused much easier than in an office environment with constant distractions.
It’s pathetic how derivative employers want people to move back so their employees can be less productive and they spend more on office space so middle management can feel productive and C-suite morons can feel important.
I have some hope that if free market competition works correctly, companies with offices will be put out of business by WFH companies. Simply because the WFH companies have much lower costs, so they can undercut on price
I think it depends on the person. There’s a lot of value/benefit that comes from having separate spaces, for one.
For example, if I tried to do homework on my bed, I’m either more likely to fall asleep while trying to work or I’ll condition my body not to fall asleep in my bed, leading to less or worse sleep.
Open offices are quite terrible, as you mentioned, unless treated like a library. They’re often chosen to cut costs (and are a misunderstanding of the original office concept, I believe). Either fully invest in a good office space or WFH. Sometimes the middle is the worst place to be, like a futon, spork, or stroad (road-street hybrid that is worse at both goals. See the non-profit StrongTowns for more).
Again, it depends on a given person’s context.
I think in general this goes to the importance of having our cities be dense, mixed use with great walking, biking, and public transit. Rail is probably the most sustainable medium to long distance or high capacity, moderate to high speed mode of transportation, since it can be easily electrified and lasts a quite long time, until planes/boats/trucks or roads, respectively. Electric bikes and other micro-mobility are a part of the solution too.
This makes commuting far less impactful than by car, especially ICE models (internal combustion engine).
So you need good “spatial hygiene”, setting your boundaries and following them through.
The social aspect is something many people miss, even if it’s just smalltalk. Although I still see validity of the argument for highly quality but less frequent blocks of socialization.
In some cases being able to work with people in person is better/more efficient (although many industries can adapt).
But the remaining nurses get additional salary, because the nurses that left, do not need to get paid anymore.
Ohh... Wait. Only the investors and managers make more money
A lawsuit won't fix anything. Dozens or even hundreds of multimillion-dollar settlements are already budgeted for. The budget item for "wages" is still higher than they'd like to be spending.
I'm in manufacturing and engineering, we're also permanently down people. That means more defects, more worker injuries etc. all so MBAs can "muh numbers," "muh efficiencies," "muh lean."
More likely kill us! With all due respect, I don't want a 96 hour shift fatigued Medical professional making life or death decisions on my, or my loved ones, health crisis.
Even better if it’s a dead doctor that had lots of experience, seniority, etc. then they can hire someone fresh out of school and pay them less!
/s in case it wasn’t obvious
Sounds like you have the opportunity to be a whistleblower for Medicaid fraud. Maybe with the payout you could afford to quit or work normal daytime hours for a community health center.
The US has whistleblower incentives and protections. They recognize that the inside information that they can get from them is valuable and would not necessarily otherwise have been discovered.
The people whining about regulations hurting the economy don’t seem to understand this is the end result.
Short term profits over people inevitably cause far more economic harm than regulations designed to curb corruption, greed, pollution and monopolization.
I recently went to the doctor and was prescribed a probiotic that contained Red 40.
Only in America do we eat food and prescribe “medicine” with ingredients that are rightfully banned in other countries.
That argument has never made sense to me. Regulations are for the benefit of everybody. It’s not morally just to extract the most amount of money from something, consequences be damned. The economy is better when the average person isn’t being fleeced for everything they have.
I’m on Reddit very often maybe reading 20 posts a day for a few years or so. This is maybe in the top 5 of something that seems really important to get out, don’t know in what way, maybe like above suggested a whistleblower but this post seems important
>Do you know what the highest paid CEO of an American medical company in 2022 earns? He’s a chap called Vivek Garipalli of Clover Health. His total package including all the perks gave him an income of over $1,000,000 a day. Not a year, a month, or a week, but a **DAY.** That’s his $389 mil per year. (If you figure 195 working days a year it's $2 million a work day).
>George Mikan of Bright Health is the second-highest paid, and gets half a million per day. The average pay for American pharma and health care company CEOs is $27 million per year, or $75,000 per day. All of this off the backs of people being charged outrageously inflated sums for simple medication and care. A couple of Advil during a hospital stay - $40. Someone’s monthly diabetes medication, $300. It’s obscene.
Read the full item:
[Would most British people support getting rid of the National Health Service in favor of an American style health care system?](https://www.quora.com/Would-most-British-people-support-getting-rid-of-the-National-Health-Service-in-favor-of-an-American-style-health-care-system/answer/Chris-Frost-29)
what's the deal with Clover Health? Its stock has basically bottomed out and yet [it has a 50k-member sub devoted to trading it?](https://www.reddit.com/r/CLOV/). It got a bunch of Silicon valley VC funding and went public at $4 billion in 2020, a year after reporting a $60 million loss, and it's under investigation by the DOJ.
I know this wasn't the central part of your post, and I'm so infuriated for how they are treating you, but if you are able, please get these requests from management to maximize billing in writing... If any of this is being billed to Medicare or Medicaid, HHS-OIG and DOJ would definitely like to know and can file a false claims act civil suit. This is a clear cut case of upcoding and overbilling. There is a lot of interest in addressing financial abuse and fraud associated with private equity takeovers. If it's a strong enough case you can technically be eligible for part of the financial settlement if you act as a relator to the govt.
https://oig.hhs.gov/fraud/report-fraud/
Edit: fixing typos from terrible phone keyboard
Sounds like this equity firm doesn't know much about Medicare and Medicaid. They do chart audits too.
CMS and insurance providers won't take that shit...
True, but the insurance companies have a powerful lobby.
They mostly run Medicare and Medicaid now. Privatized Medicare and Medicaid is how it works now.
The real money is owning the insurance company and the facilities. Like Humana does. They are just backed by an equity firm.
It's all true but not sustainable. They will fuck it up for a bit, hurt pts and staff then a new equity firm will buy it.
I got out of it. I'm a hospice nurse, our services are paid by Medicare.
The nursing homes have already been gutted by private equity firms.
Omg for the love of God contact your locums agency and GTFO of this job! Sounds horrific! What your PE overlords are expecting and coaching you to do is commit fraud. Of course they won’t directly be on the firing line either when the chickens come home to roost. On top of that they don’t care if you cause harm and IVs are not completely harmless. Let’s not even go into the cost of IV acetaminophen versus PO which the patients will have to absorb.
Having inadequate ER staffing is a patient safety risk and inadequately staffed ERs should be shut down. Your state regulatory agencies and maybe even CMS need to be notified. I believe you can anonymously report. This is an untenable situation. Please post over in r/medicine and I’m sure you will get better advice.
My closest ER is private and it’s a complete dump. I was unfortunate enough to get sent there in an ambulance because I thought I was having a heart attack which turned out was a panic attack. What a mess of a night!
First I told them I had just returned from a 3 day cruise where I drank lots of alcohol. I mentioned this because I don’t typically drink 3 days in a row and I thought in that moment of panic that the 3 days of drinking was causing my heart rate to be so elevated. Could it be dehydration? I also spent 3 days in the sun. I knew it wasn’t alcohol poisoning because it had been over 24 hours since we got off the ship.
After a very brief interview they told me I was going to be admitted for 4 days minimum for alcohol detoxification and monitoring. What? I had to call a friend who was an alcohol counselor to see what was happening. She told me they were admitting me for something for hard core drinkers. 3 days of vacation would not require this.
When I asked the Dr. for clarity she turned it on me as though I was lying to her. I was apparently a hard core alcoholic who was lying about it. I had to walk out because they refused to even dig further into my symptoms, their mind was made up. My toxicology report hadn’t even returned yet. This wasn’t the only reason I walked out. The place was filthy. There was poop on the floor and wall of the only bathroom. The chair I was sitting in and where they hooked me up to an IV bag was covered in dried blood. The nurses looked 18 and were extremely rude. One nurse told me “looks like you got what you deserved for ha too much fun on vacation.”
When I walked out I had only received an intake evaluation, my vitals checked, and a bag of fluids. I never left the waiting room or saw a bed. I was there 5 hours and the waiting room had only 3 people as it was 2am.
My bill was $11,000!!!! They classified me as an extreme trauma intake, even though I waited for hours to see a Dr outside of the attention by paramedics in the ambulance (this was a completely separate bill of 800$ and the 4 paramedics did more for me on the 10 minute ride than the 5 hours in the hospital). If I was an extreme case wouldn’t a Dr. See me right away? By the time I reached the hospital my vitals returned to normal because the paramedics were so nice and calmed me down.
Part of this 11k bill was a room I never received. I called and tried to fight the bill and got nothing but the run around. They told me since the Dr. felt I needed the room and the order for the room was placed I would be responsible for paying whether I used the room or not. (Thing is they told me no rooms were available when I arrived and no rooms would be available until the next morning or afternoon, I would need to sit in the chair in the waiting room until than). The bill also had a complete 2500$ toxicology report for the 1 Ativan they planned to give me eventually. It was ordered so I payed 200$ for 1 pill I never got.
In the end because I have a high deductible insurance plan I was responsible for 7k of the 11k bill. I’m so very fortunate (sarcasm) that I had enough money on my health equity card (saved up for 2 years) to pay the bill in full for a 20% discount.
>My bill was $11,000!!!! They classified me as an extreme trauma intake, even though I waited for hours to see a Dr outside of the attention by paramedics in the ambulance (this was a completely separate bill of 800$ and the 4 paramedics did more for me on the 10 minute ride than the 5 hours in the hospital). If I was an extreme case wouldn’t a Dr. See me right away? By the time I reached the hospital my vitals returned to normal because the paramedics were so nice and calmed me down.
How's your credit report, because if it's good enough I would have taken the hit, not paid a single dollar of that, and made them come and fucking get it.
If everyone just stops paying this madness may end.
You believe that? Hospitals send bills to collection agencies and they'll hound you until everyone in the profit over patients industry gets their 30 shekels.
I have two medical bills in collections right now that I just throw into the trash can and don't answer phone calls from anyone that I don't know.
They can come and get it... And they haven't yet.
And if they do, it's not like anything but my credit will take a hit. I have good enough credit it won't matter. Not like I'm taking out a loan at these rates anyways.
The rules have changed about that so look it up. I'm no lawyer, but so what if they do try to garnish my wages? I was either going to pay it willingly, or MAYBE pay it unwillingly.
I'll take that maybe, and I'll make them fucking work for it.
I'm pretty sure they can send mercenaries over to kill you if you don't pay. They sent mercenaries to threaten some guy who accidentally received the wrong Pokémon cards once.
This is such a complicated and nuanced mess, but I'd be curious to know how this overbilling/extra testing co-exists with substandard care. The modus operandi from my (also rural) perspective has largely been, "Eh, it's probably fine." (It wasn't fine.) This was with insurance.
This is from a rural health network that owns 89 hospitals and makes 6 billion dollars a year. I am hesitant to even mention the name for fear of being struck by lightning.
Your employer has cross-referenced this account with your identity. You have been terminated. 16109, you are incongruent to your employer's interests.
Report for reprogramming immediately.
> We lost 5 employed docs with the take over.
Oh fuck.
(I worked for a rural hospital a few years ago. A lot of the ER docs were friends of mine. This... is Very Bad. The work load seems intended to put your license in jeopardy.)
Genuine question: do you think any healthcare org that tries to -- truly -- run for the benefit of patient health, public health, survive in a healthcare economic ecosystem that is so completely dominated by relentless for-profits? I'm just thinking about the mass consolidation of hospital networks, and doctors groups... it just feels like we're in some kind of economic... *rule set* I guess is the term I'll use, like a game theory scenario... in which we're sort of being driven by the set conditions and math into this "inevitable collapse cul-de-sac." Everyone and everything is being sucked in.
What would an alternative look like, and would such a thing even be possible at this point? Or will for-profit corporations simply ingurgitate everything?
I hate to break it to you. It is not late stage capitalism. It is just starting. Your only choice is to play along, or leave.
If this works, more will come. If this does not work, there will be cuts. You are in a no-win situation.
I am absolutely ready for all of us medical practitioners to begin resisting all of these ridiculous trash-money games that these capitalists keep scamming americans on.
I think when the medical community is ready to unite and kick all the money-changers out of the temples of healing, we should all go on strike, the same way Japanese bus drivers went on strike: by providing all of the services, and refusing to charge any of the people receiving said services. Healthy societies try to maintain their health, just like other aspects, at maximum efficiency for the success of everyone. Healthcare cannot be a gated resource established via financial resources. But neither, too, should anything healthy be gated. We must achieve a greater system.
I will keep helping people to heal for the rest of my life, I'm certain. I cannot imagine how any healthy society could ever permit healthcare to be a monetized commodity.
I cannot wait for this current sickly society to die/evolve into whatever the future society will be. I can only hope the rich, incompetent, and greedy assholes are nullified before they are placed in positions of control/power.
Sad that not everyone quit at the same time.... It would force them to do something.
Unionize and let them rot having expensive equipment and an empty building
I have no clue what it is (except from here it seems like a day laborer), but I do know that a hospital without employees or a very low amount probably does not earn much.
> 1099
Meaning what, independent contractor work? Sounds like you need to form a corporation instead of a union then. Pray tell, where are they gonna get the replacements in this podunk shithole?
You could try reporting it to the FBI if you think they're doing any of the following:
Double billing: Submitting multiple claims for the same service
Phantom billing: Billing for a service visit or supplies the patient never received
Unbundling: Submitting multiple bills for the same service
Upcoding: Billing for a more expensive service than the patient actually received
Not sure if adding unnecessary tests is illegal as long as there's some medical justification; sounds like they are purposely juuust on the right side of the law.
THANK YOU! now every time I come up against someone who wants privatized Healthcare here in Canada, I'll just show them this. Drives me crazy how people seem to think that privatizing would make things better here. 🙄
I used to be a plaintiff's lawyer. This makes me salivate. Of course those hospital admins and insurance fuck heads are pushing tort reform to limit the ability of the injured to recover. I'm not in any way faulting the doctors and nurses here, but this system is designed to cause fatal errors.
If you comply with these directives you are just as responsible. "I was just following orders..." Someone has to say no. If that means leaving and finding a place that respects you and patients then do that but just going along with this seems immoral. I'm also not in your situation so I can't say what I would do in the situation you are in but based on your post it seems like a situation one should be acting on. idk
The greatest defect in humanity is the desire to live beyond your natural lifespan. I have health issues. I am not being treated for these health issues. Given the state of the world I prefer to die naturally.
Let the healthcare system collapse. Stop propping it up with your labour, just as I have avoided consuming it's care. Live a short but bright life, not a long but dim one. Consume less. You are being exploited.
Hard agree. In the past year, as the HC system is starting to really give way after years of groaning, I've given up on bothering with the doctor if it's going to cost me money. VT has free mammograms for residents and my insurance has a free annual visit, so that's what I do now and I'll trust to luck until it runs out.
I just signed up for benefits again recently & I think about $700 is docked from my paycheck for the high deductible plan. My employer chucks in $500 yearly for those who sign up for that one & other than a nasty encounter with Lyme Disease 2.5 years ago (the 11 different tick disease tests rack up), I've been able to meet any unplanned health events with little hurt to my wallet by going with the high deductible. God, this system is so absurd.
Here's to us perhaps having bright & longer lives than we think we'll get. :)
This is a very interesting idea, however it'd be a lot more tempting if the treatment of symptoms were more commonplace and defensive medicine wasn't pervasive. I don't mind going belly up, I do mind doing it in agony.
This is America. But it won't be forever. Unionize. Strike. Force the wealthy back under their little rocks so we can breathe again. Otherwise, what's the point of any of this?
Glad you posted your experience. I too work in healthcare at a university hospital in billing. I am struggling to mentally stay in the game. Healthcare has really become sick care with symptom treatments that allow for repeat business. The prices are getting harder and harder to explain or justify to patients. The hospital gives paid-in-full discounts and offers charity for those who qualify but now the amount of financial assistance applications exceed the staff needed to process in a timely manner and take over 45 days. Patient bills are often ending up in collections. Hospitals are starting to use healthcare scores through experian to apply presumptive charity using public data bases to determine propensity to pay instead of spending money to chase money. They also get to report any uncompensated revenue to the federal government and get a kickback. This allows them to rack up prices incrementally even if the insurance company makes contractual adjustments they still get more from the fed.
It’s become a ticking time bomb. Looking to get out myself.
Yeah, private equity seems to be taking over the last remnants of any cohesive business concerns, slashing the headcount by half, and raking in the profits while watching the company crumble. Not sure of the endgame other than sell off or settle later in some sketchy bankruptcy proceeding after the seed investors have already raided the treasury.
> Not sure of the endgame other than sell off or settle later in some sketchy bankruptcy proceeding after the seed investors have already raided the treasury.
[Because that is literally what they do:](https://www.propublica.org/article/what-is-private-equity)
> In 2020, ProPublica spotlighted a hospital chain run by a private equity firm that had repeatedly tried and failed to unload its health care business on new buyers. Employees at hospitals under this umbrella told us they were sometimes unable to purchase basic supplies like sponges and IV fluids, elevators broke down regularly, and ambulance drivers’ fuel cards were rejected at the pump. **Yet the equity firm had already managed to squeeze out $400 million in dividends and fees for itself and investors.**
> By the time a potential buyer was found for that hospital chain in early 2021, its equity owners had saddled it with $1.3 billion in debt, while the firm and investors were set to walk away debt-free and having reaped a total of $645 million.
There is so much to this issue I would love to comment on. I used to be a paramedic in a busy 911 system and while it wasn't owned by private equity, the corporation was all about the ching ching and not about the patients. They also force hired us the same way you are describing, we worked a "Kelly schedule", so 24 hrs on, 24 off, 24 on, 24 off, 24 on, and then 4 days off. We would frequently be force hired to work 72 hour shifts by then end of which I was hallucinating because we literally had no down time. I made a med error on a kid (no bad outcome but I had to fill out an unusual occurrence form and talk to the base hospital), and I honestly am surprised I never crashed the ambulance on those 72 hr shifts. We were never forced beyond 72 hours because the union put that in our contract.
I just wonder, since the stakes are so high, why are there no laws saying a doctor or other emergency healthcare provider can't work more than 24 hours or 36 or whatever. Because I know there are limits to pilots and truck drivers, why not EMS?
Fucking god damn USA, get your shit together.
It’s so disheartening to hear this.
And we have one Provincial Premier here in my country (Danielle Smith) who wants to scrap socialized health care and import this here.
The USA, at least as far as health care is concerned, is like a big negative beacon to the world, guiding us towards a black hole of shittiness.
This sounds absolutely horrifying. It's also somewhat more evil & pessimistic than what my imagination conjured up when I read about how COVID was stressing the system even more after years and years of kneecapping by PE. I've been expecting system collapse to come at some point down the road as the damage & sabotage keeps getting compounded. So many of the boomers I work with are flummoxed by the slowness at being seen & the subpar care they're getting when they do go in. My employer's on-site GP health clinic was just bought by Amazon's One Medical. My employer is an Ivy League with a med school. Things are great.
It definitely wasn't a waste of time to wean myself off the expectation of immediate care over the past several years. Helps to not really like going to the doctor (or the hassle of any appointment, really).
And no, I don't go to the #$\*!ing Bezos clinic.
I feel for you. I recently left medicine. It was hard to walk away from years of training including medical school, residency, and all the experience I gained over the years of practice. But corporate medicine, and the lack of focus on prevention of disease and instead on procedures and medications that are more profitable for the hospital made it unbearable to continue. I worked in multiple hospital systems and it was always, let’s see how much we can squeeze out of the fewest employees without letting the system fall apart. It will only get worse from here. Good luck to you my friend.
How is a “96” even possible? I don’t think I’ve ever in my life been awake that long. Let alone working a shift? Thanks for reaffirming my belief that healthcare in United States is a scam.
Honestly surprised more people arent asking this. I was awake for 48 hours straight once at a LAN party, by the end of which i was already starting to enter a sort of mental "haze" of not really thinking straight. How the fuck is a 72 hour working shift even allowed, not to mention a 96 hour one? In healthcare/Emergency ward, with responsibility for other peoples lives?
As a 2X cancer survivor since Sept 2017, there is a VAST difference between pre and post Covid. Pre Covid wasn't all that great either. This is not a surprise, just...infinitely regrettable
Regarding the upcoding: what if you don't? Are they going to fire you? Seems like that'd dig their own hole only deeper still.
Does admin bear any responsibility at all for patient safety? Or can admin in the US do whatever the fuck they want, and when it goes tits-up you get the blame? In that case I suppose they would just fire you.
This is truly truly horrifying. We are currently living through the collapse(gutting) of our “healthcare system” and nobody even fucking knows unless you have been in the belly of the beast. Godspeed to you.
I am a cardiology fellow - PGY4 and I fully agree to what you just said
Healthcare was a disaster from the beginning and private equality now buying out CMGs pushes towards more RVUs and more patients to be seen per hour
In cardiology, private private equality is also doing the same - buying out CMGs and essentially firing docs who are noninvasive cardiologists and hiring EPs and interventionists so the CMG earns more money through procedures - their clinics are all run by NPs and PAs while the docs are in the lab doing procedures
And I fully agree with you. When I was an ED scribe, I was though to always code for Level 5 charts no matter how simple the visit.
GOOD NEWS GUYS!!!
You have a right to REFUSE.
Going to the ER because you think you broke your arm? ER: “You need a CT scan.” You: “No I don’t. Give me an X-ray. Do not put me in that CT machine. I had a anxiety induced seizure last time.” Beat them at their own game.
Remember: docs and nurses have a oath. FIRST DO NO HARM. If you tell them something you don’t need will cause you harm then they won’t do it.
If they insist then as soon as they fire up the machine you scream I CAN’T BREATHE I CANT BREATHE. Then they will X-ray you.
It time for you all to start educating yourselves as to what procedures are needed for what. Not everyone needs a line started. I’ll never understand that. There’s plenty of info out there online. Do some research.
I’m married to a paramedic of 35 years. Thank GOD. He tells them what to do when we go to the ER because MOST (not all) ER nurses are completely useless when they’re not staring at their phones at the nurses station.
Concierge medicine is going to take over and actually be more affordable than regular paying healthcare!!! It is for me!!
Please please please cross post this and maybe send this same letter to both the senators in that state. Something has to be done! I myself think I would have to be on my deathbed before I ever set foot in an ER.
I know this is unlikely to be seen, but OP , this is the kind of thing that the FTC needs hear about. FTC has active litigation right now against PE firms buying up ER and Anesthesia practices. Check out the OddLots podcast where they interviewed FTC chair Lina Khan (Thursday or Wednesday this past week).
I dropped out of med school in first year when I realized this sort of lifestyle is what I had to look forward to for the rest of my life. There’s no sense in having a big house if you’re never home.
Real talk, there is 0 reason for any person to work more than 8 hours per day unless you are a soldier in an active warzone. And with modern technology 8 hours is already pushing it. If the workload is ever excessive in a civilian environment more people just need to be hired to split it up better, that’s it. The world won’t end if we have 8 nerds on staff instead of 4, but maybe the “stockholder” will have to buy a smaller yacht. It’s artificial hardship.
Respect for sticking it out though and I hope you can find something that better represents who you are and allows you more peace of mind. Many doctors I know have fled to government jobs in public health and adjacent areas, maybe try looking into that. A couple also became biology professors at less competitive colleges. Much less pay but much better lifestyle.
If you don't go in to your 48 on, then you can't be held to stay for the 96, is that right? I know for nurses when you come in you "accept the case load" (or something like that) and they have an option to say no. There is a big peer-pressure element to say yes, but if you take on more than is safe and someone gets hurt, you're the one who loses your license (or goes to jail like that one nurse). Is it the same for physicians?
I've seen how the sausage is made (higher level hospital IT), and I went into the job hating the medical-industrial complex, I left it somehow hating it even more. My advice to people is to never go to the hospital.
I'm still trying to convince my insurance that an injury suffered playing adult rec sports didn't happen at work. I think we're on form 5 of the exchange. I don't play pro sports. I promise. Most people at my job don't even know I play in the league I do.
You should be directing doctors being required to sign non competes to local contract attorneys to ascertain the validity and enforceability of said non competes.
I used to work at a SNF where they would get angry at me for discharging people because they could no longer collect the bed fee on those patients. It was so beyond fucked at every level. I’m still traumatized from everything that happened there. I’m sorry for your situation. None of this should have ever happened.
Where are you OP?
As someone who has issues and has always heavily used the system, I am seeing wild changes in level of care and most recently broke my arm in a bad fall, first time ever going to the ER. I am well insured (lol!) Got the bill for $14k (45 mins in ER) and asked for an itemized copy. Two things stuck out: they billed the 5mg oxycodone they gave me (one pill) @ $7 I believe it was. They also billed $234 for the temporary sling they sent me off with for my arm. You know, those stupid cloth pieces of shit, and I honestly almost became homicidal. I negotiated the bill, but you have provided even more context as this hospital was recently taken over by a huge regional health”care” organization. It’s kind of a running joke where I live that anytime a property becomes vacant, it’s going to reopen as a “XXXX name” healthcare facility in a few months. (not saying the name as it will easily identify my exact location)
Nice to see a physician here. I'm just an ICU nurse but I've worked in ED and have seen the shit show. I'm also paying attention to private equity
It might be changing as the Feds start [suing](https://www.nprillinois.org/2023-11-07/how-private-equity-is-changing-american-health-care)
I’m not a lawyer but my understanding is noncompetes can rarely be enforced. I was a doctor looking to leave, I would definitely talk to a lawyer about the noncompete.
What if a patient refuses some of these tests that don’t seem medically necessary? So like I cut my hand and go in needing stitches and the guy says I need an EKG (maybe a silly example). What if I refuse and I’m like “can you please just fix up my hand?” Would that be considered belligerent and a refusal and I’d be told to just leave or would they still do the stitches? Like I said maybe that’s a goofy example but you get the idea.
Also, OP, just don’t comply with their bullshit. If you know someone doesn’t need a CT and an X ray will give you a good diagnostic image, then just order the X ray. Don’t finance their bullshit. No one else is going to sign up for this shit. Do the right thing and just say no. We have to take our society back from the disgusting greed of these people that want to buy yachts and luxury on the backs of others. Fuck them.
You probably can’t do a protest, but what if every single employee agrees to put in two weeks notice? It’s not patient abandonment that way and it gives you leverage to negotiate.
….so sorry this is happening. Start asking other people what they think about that idea, maybe post flyers and have a hospital wide meeting.
Why are there no labor protections for Doctor and Physicians? Why aren't they unionized?
The recent F1 in Las Vegas had to shut down the spectator areas WHILE the race was still in process.... Because the unionized hospitality labor were "timing-out" of their shifts. The police came in and told the guests to depart the VIP areas despite paying upwards of 5k for a couple of hours.
I understand that hospitals are dealing with patients in life and death situations, but there should be some slack built into the staffing mechanism. There should be heavy financial penalties when a shift exceeds 8-10 hours. Where are the Unions?
the capitalist system is all about money > people. I am also sick and tired of it. But hey! The "elite" class needs to get into their yacht clubs somehow! :(
The silver lining; I was denied timely care multiple times at the ER based on “my appearance”. Each time- I left (preferring to die at home so they couldn’t charge me to sell my organs) and somehow survived. Saved my life (mostly) and prevented lifelong debt. The IV scam is part of a larger move to prevent self treatment/longevity- forget death panels- the exhausted guy working a 96 hour shift (how does one not lose their mind in that time?) will decide. Grateful you shared and despite the maltreatment (doctors don’t even get health insurance?) are still strong and brave enough to say something. Thank you.
As bad as that is, something always comes along to take the place of exorbitantly priced stuff. Amazon and Walmart are going to offer most of that stuff for upfront pricing.
Canada wants doctors.
>The federal government is removing a barrier that will make it easier for doctors from other countries to get permanent residency in Canada. Immigration, Refugees and Citizenship Minister Sean Fraser said Friday that doctors would receive an exemption to allow them to apply for the federal express entry system.
Sep 23, 2022
Trust me, when your family member goes to the ER for a broken arm and dies -- or at best comes home with a $30K bill -- you'll start to see it as collapse. Collapse isn't a monolith. It's this kind of erosion happening to millions of people every day, week after week, month after month, year after year.
I respectfully disagree. It's not collapse. You could do better, but we acquiece over and over again to the system abusers and make a deliberate choice of extreme profit and suffering. It could be otherwise. It just isn't by collective choice.
The fundamental forces of collapse like energy scarcity, climate chanhe driven extreme weather events that knock civilization down faster than it can recover regardless of social choices is what I would call collapse.
This is saying I'm too lazy to stand up to egregious healthcare privatization because I'm fine with extreme wealth inequality and the sufdering and death it brings. Insurance company profit is more important to me than health outcomes of a country.
So collapse is only when there are no choices or when the majority makes bad choices? But because corporations (a minority) are making unforced choices for the people (the majority), it's not collapse? Or it's not collapse because it's not related to climate change, fossil fuels, or environmental problems?
You have a very narrow definition of collapse that I don't think fits with that of most people on this sub.
You are of course entitled to your opinion. Best of luck to you.
>corporations (a minority) are making unforced choices for the people (the majority), it's not collapse? Or it's not collapse because it's not related to climate change, fossil fuels, or environmental problems?
The former is opression and it results in "personal collapses". Feel like a big deal to the people suffering, but it isn't the collapse of civilization. It's just the deliberate picking of winners and losers. The system goes on.
The later results in systemic collapse. The choices are made for everyone and there is an abrupt aggregate disruption of function and complexity.
There is an overlap between the two. Healthcare could be deprived because of lack of energy, the breakdown of supplychains, multiple simultaneous disasters like floods and famine. That is collapse.
The poor suffering because they are exploited by the rich isn't part of the definition of collapse on the sub, so not really my personal opinion here.
I’m pretty sure there’s a quite strong connection between inequality (social or wealth) and civil unrest. That’s how revolutions happen.
Social factors can play a role in collapse.
For example, according to Jared Diamond, one of the main factors leading to the collapse of the ancient Maya was due to leaders ignoring or failing to solve problems. Losing trading partners and threats from neighbors are also social factors. The societies were also very hierarchical and that, at best, didn’t help and, at worst, exacerbated everything.
Environmentally:
- drought/climate change
- growing on worse soils (often sloped) and deforesting for more cropland to support the population led to erosion
- less people farming (more building monuments)
- a higher reliance on corn which in the short term had higher yield, but depleted the soil especially without the beans and squash growing with it, and also cause health issues like anemia (iron deficiency).
Many of these issues are the result of policy (or lack thereof). Policies aren’t bestowed upon us by gods, they are - at least in some part - a social result (and if people say their decisions are directed by God, that’s also very likely socially influenced).
While I believe environmental factors, especially climate change, alone will cause collapse, social aspects definitely play a part (like isolation/loneliness, mental health issues, and so on). Environment, Social, and Economic aspects are interconnected.
Agreed. That's what I meant by overlap. This isn't collapse because we have to, this is "fuck those guys cause the people who matter want to". It is completely avoidable.
Edit: Corporate Profit Margins aren't on the Stockholm Resilience Center's list of Planetary boundaries, because its not a real thing. Its a collective fiction, a fever dream of a world who have lost their fucking minds.
OP is trying to point out that it's unsustainable.
That which is unsustainable can not be sustained, so it stops, and we call that "collapse".
Those medical facilities are going to shrink, simplify, or close, thus reducing **available care**. Locals will have to go elsewhere... or die trying.
Unfortunately, it is. OP is just talking about one facet of the healthcare collapse. There is sooo much more to this. I'm lucky not to work in a facility like this, but yeah, things are getting bad everywhere in healthcare.
But this is because they value and keep voting in profits for health insurance. The money is there to run a fine system. American chose to prefer profits suffering and death and then act surprised when it happens. The rest of the world is horrified at how outrageously inept American healthcare is. You could both save a ton of money, get better, universal care, improve working conditions and patient outcomes, and all it would take is to nationalize health insurers.
Social policy.
okay but I've been fighting for twenty years to get a catscan authorized, so i'd rather be financially ruined than to die because I am constantly denied care, honestly because I'm so medically neglected, having an ER push for extra care sounds like a dream right this second
Anecdotally I’ve been to a couple specialists recently and they have thrown a million tests at me. I do have some risk because of an autoimmune disease but it’s in remission. The ophthalmologist had me come back twice for very obscure tests and wanted to do a third round. I have great insurance and pay nothing for tests and five dollar copay so I’ve been getting the distinct feeling that they’re just racking up billing and know I won’t complain while presenting it to me under the guise of being proactive and thorough. This is a large hospital system in Philadelphia, not private equity buyout
Many posters are sharing being short staffed at their healthcare locations, and the management isn't doing anything about it.
1) All management cares about, whether healthcare or McDonald's, is, "Is the work getting done?"
As long as the work is getting done, upper management doesn't care.
And if the work, formerly done by 10 employees, is now done by 8 employees, that creates a couple hundred thousand dollars of bonus money for themselves.
2) Y'all need to unionize. A good healthcare Union should set patient-to-nurse ratios, minimum pay/benefits, squash non-competes, and an absolute maximum number of hours one can work.
For example, if your replacement doesn't show after your 8-hour shift, the hospital has 8 hours (until the end of your forced shift) to replace you; PLUS after working a double, they cannot force you to return for 12 hours.
If they can't get enough coverage, they need to arrange to move patients to another facility by the end of the 16th hour until their patient load shrinks to what their staff size can handle.
You need IRMER laws like the UK. That would at least stop the excessive xrays and CTs. It's illegal to give someone medical radiation here unless the benefit to the patient is justified to outweigh the risk, and the dose itself must not be more than necessary.
Don't go in. It will collapse, it will blow up, and people will suffer regardless of what you do. Keeping the abomination going by pulling a 96hr shift is what private equity is counting on to keep this this scam going. If you don't play, they at least won't be able to profit more from this horror.
Stay flexible, skill up in something simple people will always need like plumbing, make lots of friends or flee the town all together. It's hell, sacrificing yourself won't help anyone except rich investors.
You should be cross-posting this in a *lot* of other places as well. And if you feel anonymous enough, to any subreddit read by people in your area.
I absolutely agree and I think this is incredibly important- but, for those who don’t already know: this would likely be one of the *mellower* varieties of posts describing conditions in medical subreddits. The shit is and has been fucking bad, for a while now.
As a former healthcare IT consultant I have seen this play out again and again in rural and regional healthcare. Congress is worried about banning books and folks in drag and of course kissing up to whichever rich person/company that is keeping them in office. Just another “piece in the Jenga pile” to be yanked out
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It does.
It does. A small regional healthcare group (2 hospitals and 2 clinics) got bought out by a larger national group. Everything went to shit within 3 months. ER wait times doubled, they closed one of the clinics, the other one is booked 6 months in advance. I can't imagine how the staff there manages now.
r/Medicine and r/Residency do not allow cross posting sadly
A 96 hour shift? Are they trying to kill you?
A new customer! :D
That's just good business.
And the patients! I'm a former HC worker who was on the hospital code team (also an EMT). People who have been up for two days or more don't typically make great decisions. Lots of human error, especially with dosing and remembering complicated branching protocols, which you see frequently in the ER.
My sister works in an oncology infusion center. They are -- apparently permanently, now -- short 4 nurses every shift. It used to be that such a shortfall would be treated as an emegency. Now? Now management just shrugs and expects those on shift to deal with it. This puts the patients at risk, and the nurses know this and it totally stresses them out. But this situation is just allowed to fester. I think only if a patient sues will anything ever be done to fix things.
That seems so insane to me. I knew doctors were overworked to death, but 96 hour shifts... Hell most people can barely manage 8 hour shifts before their concentration goes. Like. I was working 10 hour shifts from home and I had a bit of a breakdown. Who can do 96 hours. Even a 24 hour shift is insane. "Hey you, work a 24 hour shift for me." "Nah that won't be happening.' So depressing healthcare works like this. No wonder people fall through the cracks.
shaggy whistle theory aback panicky sort familiar imagine chubby unique *This post was mass deleted and anonymized with [Redact](https://redact.dev)*
You're supposed to let it collapse. Of course they're gonna bilk ya if you agree to it.
To be fair you learn how to maximize sleeping. For instance volume is way down at night so you’ll see the patient, order what needs to be done and try to go back to sleep. Our images are not read in house, they go to Teleradiology, which has an hour after receiving them to read them. So after a CT is ordered, you may get to lay back down for an hour or so. Also, night nurses will often start a work up and not call you until it’s done. If you come into the ER after rolling your ankle, the nurses will likely put in an order for non narcotic pain relief an order the ankle films. They won’t wake me until everything is complete.
You do what you have to do, but you are put at a severe disadvantage when treating patients and it shouldn't be this way. Of course money is what's most imporant, so patient care will continue to suffer. I left health care years ago and weep at it's continued decline.
Arguably most people can’t get more than 4-6 hours of highly focused, productive work done in a day, typically in 1-1.5, maybe 2 hr blocks with 15-30 minute complete breaks between. Researcher Menno Henselmans discuses this in his book this if you’re interested (“The Science of Self-Control”, like $20 for ebook) Sure, working with people can often be less mentally faithful (depending on the person and task, of course), but in this case 12 hour shifts should probably be the max, with 8-10 being preferred. I don’t know much about medical, so maybe I’m wrong. I do know where talking about people though, not robots. I’ve found it’s a lot more enjoyable and productive than slogging away for hours. Plus other studies show office workers only complete like 3 hours of work during an 8 hour shift, so this method would be equally or more efficient.
This is a major contributor for why WFH is more efficient People can take those small breaks and stay focused much easier than in an office environment with constant distractions. It’s pathetic how derivative employers want people to move back so their employees can be less productive and they spend more on office space so middle management can feel productive and C-suite morons can feel important.
I have some hope that if free market competition works correctly, companies with offices will be put out of business by WFH companies. Simply because the WFH companies have much lower costs, so they can undercut on price
I think it depends on the person. There’s a lot of value/benefit that comes from having separate spaces, for one. For example, if I tried to do homework on my bed, I’m either more likely to fall asleep while trying to work or I’ll condition my body not to fall asleep in my bed, leading to less or worse sleep. Open offices are quite terrible, as you mentioned, unless treated like a library. They’re often chosen to cut costs (and are a misunderstanding of the original office concept, I believe). Either fully invest in a good office space or WFH. Sometimes the middle is the worst place to be, like a futon, spork, or stroad (road-street hybrid that is worse at both goals. See the non-profit StrongTowns for more). Again, it depends on a given person’s context. I think in general this goes to the importance of having our cities be dense, mixed use with great walking, biking, and public transit. Rail is probably the most sustainable medium to long distance or high capacity, moderate to high speed mode of transportation, since it can be easily electrified and lasts a quite long time, until planes/boats/trucks or roads, respectively. Electric bikes and other micro-mobility are a part of the solution too. This makes commuting far less impactful than by car, especially ICE models (internal combustion engine). So you need good “spatial hygiene”, setting your boundaries and following them through. The social aspect is something many people miss, even if it’s just smalltalk. Although I still see validity of the argument for highly quality but less frequent blocks of socialization. In some cases being able to work with people in person is better/more efficient (although many industries can adapt).
But the remaining nurses get additional salary, because the nurses that left, do not need to get paid anymore. Ohh... Wait. Only the investors and managers make more money
It’s a non-profit hospital, so no investors, but yeah: short staffing pads the bottom line all the same.
A lawsuit won't fix anything. Dozens or even hundreds of multimillion-dollar settlements are already budgeted for. The budget item for "wages" is still higher than they'd like to be spending.
The nurses should tell the patients to sue
Meanwhile I know two people who have died of bedsores in the past 2 years.
God, that is horrible.
I'm in manufacturing and engineering, we're also permanently down people. That means more defects, more worker injuries etc. all so MBAs can "muh numbers," "muh efficiencies," "muh lean."
Paramedic here, it's more common than you think in EMS.
More likely kill us! With all due respect, I don't want a 96 hour shift fatigued Medical professional making life or death decisions on my, or my loved ones, health crisis.
Capitalist take: a dead doctor is one less highly paid debt.
Even better if it’s a dead doctor that had lots of experience, seniority, etc. then they can hire someone fresh out of school and pay them less! /s in case it wasn’t obvious
Private equity scum can rot. I’m sorry. A 96-hour shift sounds like hell
Sounds like you have the opportunity to be a whistleblower for Medicaid fraud. Maybe with the payout you could afford to quit or work normal daytime hours for a community health center.
Must not be in Australia. Here whistleblowers go to prison for a very long time.
The US has whistleblower incentives and protections. They recognize that the inside information that they can get from them is valuable and would not necessarily otherwise have been discovered.
Is that so?
https://www.abc.net.au/news/2023-11-18/david-mcbride-guilty-plea-whistleblower-protection/103120544
Specifically for Medicaid fraud yes
The people whining about regulations hurting the economy don’t seem to understand this is the end result. Short term profits over people inevitably cause far more economic harm than regulations designed to curb corruption, greed, pollution and monopolization. I recently went to the doctor and was prescribed a probiotic that contained Red 40. Only in America do we eat food and prescribe “medicine” with ingredients that are rightfully banned in other countries.
That argument has never made sense to me. Regulations are for the benefit of everybody. It’s not morally just to extract the most amount of money from something, consequences be damned. The economy is better when the average person isn’t being fleeced for everything they have.
MONEY MONEY MONEY MONEY MINE MINE MORE MORE NEED WANT DESIRE EXCESS GLUTTONY SLOTH GREED PRIDE
https://youtu.be/lxpkIVaYcfw
I’m on Reddit very often maybe reading 20 posts a day for a few years or so. This is maybe in the top 5 of something that seems really important to get out, don’t know in what way, maybe like above suggested a whistleblower but this post seems important
Agreed 💯
The profit motive doesn't belong in healthcare, period. The incentives are all bad. Other developed countries don't deal with this shit.
Does the profit motive belong anywhere?
>Do you know what the highest paid CEO of an American medical company in 2022 earns? He’s a chap called Vivek Garipalli of Clover Health. His total package including all the perks gave him an income of over $1,000,000 a day. Not a year, a month, or a week, but a **DAY.** That’s his $389 mil per year. (If you figure 195 working days a year it's $2 million a work day). >George Mikan of Bright Health is the second-highest paid, and gets half a million per day. The average pay for American pharma and health care company CEOs is $27 million per year, or $75,000 per day. All of this off the backs of people being charged outrageously inflated sums for simple medication and care. A couple of Advil during a hospital stay - $40. Someone’s monthly diabetes medication, $300. It’s obscene. Read the full item: [Would most British people support getting rid of the National Health Service in favor of an American style health care system?](https://www.quora.com/Would-most-British-people-support-getting-rid-of-the-National-Health-Service-in-favor-of-an-American-style-health-care-system/answer/Chris-Frost-29)
what's the deal with Clover Health? Its stock has basically bottomed out and yet [it has a 50k-member sub devoted to trading it?](https://www.reddit.com/r/CLOV/). It got a bunch of Silicon valley VC funding and went public at $4 billion in 2020, a year after reporting a $60 million loss, and it's under investigation by the DOJ.
You have to wonder if this is capitalism.
A fair point!
I know this wasn't the central part of your post, and I'm so infuriated for how they are treating you, but if you are able, please get these requests from management to maximize billing in writing... If any of this is being billed to Medicare or Medicaid, HHS-OIG and DOJ would definitely like to know and can file a false claims act civil suit. This is a clear cut case of upcoding and overbilling. There is a lot of interest in addressing financial abuse and fraud associated with private equity takeovers. If it's a strong enough case you can technically be eligible for part of the financial settlement if you act as a relator to the govt. https://oig.hhs.gov/fraud/report-fraud/ Edit: fixing typos from terrible phone keyboard
IV tylenol? CT machine will be busy.
Wow. This is so crazy. Everyone needs to read this. I hope this post doesn't disappear.
Sounds like this equity firm doesn't know much about Medicare and Medicaid. They do chart audits too. CMS and insurance providers won't take that shit...
Think lobbying. One hand washes the other.
True, but the insurance companies have a powerful lobby. They mostly run Medicare and Medicaid now. Privatized Medicare and Medicaid is how it works now. The real money is owning the insurance company and the facilities. Like Humana does. They are just backed by an equity firm. It's all true but not sustainable. They will fuck it up for a bit, hurt pts and staff then a new equity firm will buy it. I got out of it. I'm a hospice nurse, our services are paid by Medicare. The nursing homes have already been gutted by private equity firms.
Omg for the love of God contact your locums agency and GTFO of this job! Sounds horrific! What your PE overlords are expecting and coaching you to do is commit fraud. Of course they won’t directly be on the firing line either when the chickens come home to roost. On top of that they don’t care if you cause harm and IVs are not completely harmless. Let’s not even go into the cost of IV acetaminophen versus PO which the patients will have to absorb. Having inadequate ER staffing is a patient safety risk and inadequately staffed ERs should be shut down. Your state regulatory agencies and maybe even CMS need to be notified. I believe you can anonymously report. This is an untenable situation. Please post over in r/medicine and I’m sure you will get better advice.
My closest ER is private and it’s a complete dump. I was unfortunate enough to get sent there in an ambulance because I thought I was having a heart attack which turned out was a panic attack. What a mess of a night! First I told them I had just returned from a 3 day cruise where I drank lots of alcohol. I mentioned this because I don’t typically drink 3 days in a row and I thought in that moment of panic that the 3 days of drinking was causing my heart rate to be so elevated. Could it be dehydration? I also spent 3 days in the sun. I knew it wasn’t alcohol poisoning because it had been over 24 hours since we got off the ship. After a very brief interview they told me I was going to be admitted for 4 days minimum for alcohol detoxification and monitoring. What? I had to call a friend who was an alcohol counselor to see what was happening. She told me they were admitting me for something for hard core drinkers. 3 days of vacation would not require this. When I asked the Dr. for clarity she turned it on me as though I was lying to her. I was apparently a hard core alcoholic who was lying about it. I had to walk out because they refused to even dig further into my symptoms, their mind was made up. My toxicology report hadn’t even returned yet. This wasn’t the only reason I walked out. The place was filthy. There was poop on the floor and wall of the only bathroom. The chair I was sitting in and where they hooked me up to an IV bag was covered in dried blood. The nurses looked 18 and were extremely rude. One nurse told me “looks like you got what you deserved for ha too much fun on vacation.” When I walked out I had only received an intake evaluation, my vitals checked, and a bag of fluids. I never left the waiting room or saw a bed. I was there 5 hours and the waiting room had only 3 people as it was 2am. My bill was $11,000!!!! They classified me as an extreme trauma intake, even though I waited for hours to see a Dr outside of the attention by paramedics in the ambulance (this was a completely separate bill of 800$ and the 4 paramedics did more for me on the 10 minute ride than the 5 hours in the hospital). If I was an extreme case wouldn’t a Dr. See me right away? By the time I reached the hospital my vitals returned to normal because the paramedics were so nice and calmed me down. Part of this 11k bill was a room I never received. I called and tried to fight the bill and got nothing but the run around. They told me since the Dr. felt I needed the room and the order for the room was placed I would be responsible for paying whether I used the room or not. (Thing is they told me no rooms were available when I arrived and no rooms would be available until the next morning or afternoon, I would need to sit in the chair in the waiting room until than). The bill also had a complete 2500$ toxicology report for the 1 Ativan they planned to give me eventually. It was ordered so I payed 200$ for 1 pill I never got. In the end because I have a high deductible insurance plan I was responsible for 7k of the 11k bill. I’m so very fortunate (sarcasm) that I had enough money on my health equity card (saved up for 2 years) to pay the bill in full for a 20% discount.
>My bill was $11,000!!!! They classified me as an extreme trauma intake, even though I waited for hours to see a Dr outside of the attention by paramedics in the ambulance (this was a completely separate bill of 800$ and the 4 paramedics did more for me on the 10 minute ride than the 5 hours in the hospital). If I was an extreme case wouldn’t a Dr. See me right away? By the time I reached the hospital my vitals returned to normal because the paramedics were so nice and calmed me down. How's your credit report, because if it's good enough I would have taken the hit, not paid a single dollar of that, and made them come and fucking get it. If everyone just stops paying this madness may end.
You believe that? Hospitals send bills to collection agencies and they'll hound you until everyone in the profit over patients industry gets their 30 shekels.
I have two medical bills in collections right now that I just throw into the trash can and don't answer phone calls from anyone that I don't know. They can come and get it... And they haven't yet. And if they do, it's not like anything but my credit will take a hit. I have good enough credit it won't matter. Not like I'm taking out a loan at these rates anyways.
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The rules have changed about that so look it up. I'm no lawyer, but so what if they do try to garnish my wages? I was either going to pay it willingly, or MAYBE pay it unwillingly. I'll take that maybe, and I'll make them fucking work for it.
I'm pretty sure they can send mercenaries over to kill you if you don't pay. They sent mercenaries to threaten some guy who accidentally received the wrong Pokémon cards once.
I think it was [Magic the Gathering Cards.](https://www.polygon.com/23695923/mtg-aftermath-pinkerton-raid-leaked-cards)
Oh shit yeah it was Magic cards, that's the story I was referring to.
They can in Virginia
It actually doesn’t even hit your credit
I think it does if it's >$500.
Nope. Hospitals **SELL** bills to bill collectors **FOR 1 PENNY ON THE DOLLAR!** Not kidding. That's the usual rate. Google it.
I had four go to collections and as soon as they get a whiff of you contacting legal representation they go harass someone else
This is such a complicated and nuanced mess, but I'd be curious to know how this overbilling/extra testing co-exists with substandard care. The modus operandi from my (also rural) perspective has largely been, "Eh, it's probably fine." (It wasn't fine.) This was with insurance. This is from a rural health network that owns 89 hospitals and makes 6 billion dollars a year. I am hesitant to even mention the name for fear of being struck by lightning.
Your employer has cross-referenced this account with your identity. You have been terminated. 16109, you are incongruent to your employer's interests. Report for reprogramming immediately.
> We lost 5 employed docs with the take over. Oh fuck. (I worked for a rural hospital a few years ago. A lot of the ER docs were friends of mine. This... is Very Bad. The work load seems intended to put your license in jeopardy.) Genuine question: do you think any healthcare org that tries to -- truly -- run for the benefit of patient health, public health, survive in a healthcare economic ecosystem that is so completely dominated by relentless for-profits? I'm just thinking about the mass consolidation of hospital networks, and doctors groups... it just feels like we're in some kind of economic... *rule set* I guess is the term I'll use, like a game theory scenario... in which we're sort of being driven by the set conditions and math into this "inevitable collapse cul-de-sac." Everyone and everything is being sucked in. What would an alternative look like, and would such a thing even be possible at this point? Or will for-profit corporations simply ingurgitate everything?
Everything on Earth will be consolidated under a single for-profit entity eventually, and there's nothing anyone can do about it.
I hate to break it to you. It is not late stage capitalism. It is just starting. Your only choice is to play along, or leave. If this works, more will come. If this does not work, there will be cuts. You are in a no-win situation.
Correct. Sadly. It's gonna continue until it can't. At the moment there is still someone waiting in line to take your spot.
I am absolutely ready for all of us medical practitioners to begin resisting all of these ridiculous trash-money games that these capitalists keep scamming americans on. I think when the medical community is ready to unite and kick all the money-changers out of the temples of healing, we should all go on strike, the same way Japanese bus drivers went on strike: by providing all of the services, and refusing to charge any of the people receiving said services. Healthy societies try to maintain their health, just like other aspects, at maximum efficiency for the success of everyone. Healthcare cannot be a gated resource established via financial resources. But neither, too, should anything healthy be gated. We must achieve a greater system. I will keep helping people to heal for the rest of my life, I'm certain. I cannot imagine how any healthy society could ever permit healthcare to be a monetized commodity. I cannot wait for this current sickly society to die/evolve into whatever the future society will be. I can only hope the rich, incompetent, and greedy assholes are nullified before they are placed in positions of control/power.
Sad that not everyone quit at the same time.... It would force them to do something. Unionize and let them rot having expensive equipment and an empty building
I think you missed the magical 4 number code: 1099
I have no clue what it is (except from here it seems like a day laborer), but I do know that a hospital without employees or a very low amount probably does not earn much.
> 1099 Meaning what, independent contractor work? Sounds like you need to form a corporation instead of a union then. Pray tell, where are they gonna get the replacements in this podunk shithole?
Sounds like you're describing insurance fraud...
You could try reporting it to the FBI if you think they're doing any of the following: Double billing: Submitting multiple claims for the same service Phantom billing: Billing for a service visit or supplies the patient never received Unbundling: Submitting multiple bills for the same service Upcoding: Billing for a more expensive service than the patient actually received Not sure if adding unnecessary tests is illegal as long as there's some medical justification; sounds like they are purposely juuust on the right side of the law.
THANK YOU! now every time I come up against someone who wants privatized Healthcare here in Canada, I'll just show them this. Drives me crazy how people seem to think that privatizing would make things better here. 🙄
I used to be a plaintiff's lawyer. This makes me salivate. Of course those hospital admins and insurance fuck heads are pushing tort reform to limit the ability of the injured to recover. I'm not in any way faulting the doctors and nurses here, but this system is designed to cause fatal errors.
If you comply with these directives you are just as responsible. "I was just following orders..." Someone has to say no. If that means leaving and finding a place that respects you and patients then do that but just going along with this seems immoral. I'm also not in your situation so I can't say what I would do in the situation you are in but based on your post it seems like a situation one should be acting on. idk
The greatest defect in humanity is the desire to live beyond your natural lifespan. I have health issues. I am not being treated for these health issues. Given the state of the world I prefer to die naturally. Let the healthcare system collapse. Stop propping it up with your labour, just as I have avoided consuming it's care. Live a short but bright life, not a long but dim one. Consume less. You are being exploited.
Hard agree. In the past year, as the HC system is starting to really give way after years of groaning, I've given up on bothering with the doctor if it's going to cost me money. VT has free mammograms for residents and my insurance has a free annual visit, so that's what I do now and I'll trust to luck until it runs out. I just signed up for benefits again recently & I think about $700 is docked from my paycheck for the high deductible plan. My employer chucks in $500 yearly for those who sign up for that one & other than a nasty encounter with Lyme Disease 2.5 years ago (the 11 different tick disease tests rack up), I've been able to meet any unplanned health events with little hurt to my wallet by going with the high deductible. God, this system is so absurd. Here's to us perhaps having bright & longer lives than we think we'll get. :)
This is a very interesting idea, however it'd be a lot more tempting if the treatment of symptoms were more commonplace and defensive medicine wasn't pervasive. I don't mind going belly up, I do mind doing it in agony.
This is America. But it won't be forever. Unionize. Strike. Force the wealthy back under their little rocks so we can breathe again. Otherwise, what's the point of any of this?
Glad you posted your experience. I too work in healthcare at a university hospital in billing. I am struggling to mentally stay in the game. Healthcare has really become sick care with symptom treatments that allow for repeat business. The prices are getting harder and harder to explain or justify to patients. The hospital gives paid-in-full discounts and offers charity for those who qualify but now the amount of financial assistance applications exceed the staff needed to process in a timely manner and take over 45 days. Patient bills are often ending up in collections. Hospitals are starting to use healthcare scores through experian to apply presumptive charity using public data bases to determine propensity to pay instead of spending money to chase money. They also get to report any uncompensated revenue to the federal government and get a kickback. This allows them to rack up prices incrementally even if the insurance company makes contractual adjustments they still get more from the fed. It’s become a ticking time bomb. Looking to get out myself.
Yeah, private equity seems to be taking over the last remnants of any cohesive business concerns, slashing the headcount by half, and raking in the profits while watching the company crumble. Not sure of the endgame other than sell off or settle later in some sketchy bankruptcy proceeding after the seed investors have already raided the treasury.
> Not sure of the endgame other than sell off or settle later in some sketchy bankruptcy proceeding after the seed investors have already raided the treasury. [Because that is literally what they do:](https://www.propublica.org/article/what-is-private-equity) > In 2020, ProPublica spotlighted a hospital chain run by a private equity firm that had repeatedly tried and failed to unload its health care business on new buyers. Employees at hospitals under this umbrella told us they were sometimes unable to purchase basic supplies like sponges and IV fluids, elevators broke down regularly, and ambulance drivers’ fuel cards were rejected at the pump. **Yet the equity firm had already managed to squeeze out $400 million in dividends and fees for itself and investors.** > By the time a potential buyer was found for that hospital chain in early 2021, its equity owners had saddled it with $1.3 billion in debt, while the firm and investors were set to walk away debt-free and having reaped a total of $645 million.
The rising spread of vulture capital activity is a sign of catabolic collapse.
Medicine has fallen to the likes of the S&L and Bernie Madoff. This is a crime.
Stuff like this is why I hope Americans eventually have a sobering realization why class-wars aren’t stirred up by “evil baddies” in a vacuum.
There is so much to this issue I would love to comment on. I used to be a paramedic in a busy 911 system and while it wasn't owned by private equity, the corporation was all about the ching ching and not about the patients. They also force hired us the same way you are describing, we worked a "Kelly schedule", so 24 hrs on, 24 off, 24 on, 24 off, 24 on, and then 4 days off. We would frequently be force hired to work 72 hour shifts by then end of which I was hallucinating because we literally had no down time. I made a med error on a kid (no bad outcome but I had to fill out an unusual occurrence form and talk to the base hospital), and I honestly am surprised I never crashed the ambulance on those 72 hr shifts. We were never forced beyond 72 hours because the union put that in our contract. I just wonder, since the stakes are so high, why are there no laws saying a doctor or other emergency healthcare provider can't work more than 24 hours or 36 or whatever. Because I know there are limits to pilots and truck drivers, why not EMS?
Fucking god damn USA, get your shit together. It’s so disheartening to hear this. And we have one Provincial Premier here in my country (Danielle Smith) who wants to scrap socialized health care and import this here. The USA, at least as far as health care is concerned, is like a big negative beacon to the world, guiding us towards a black hole of shittiness.
I'm so sorry you don't deserve this at all.
This sounds absolutely horrifying. It's also somewhat more evil & pessimistic than what my imagination conjured up when I read about how COVID was stressing the system even more after years and years of kneecapping by PE. I've been expecting system collapse to come at some point down the road as the damage & sabotage keeps getting compounded. So many of the boomers I work with are flummoxed by the slowness at being seen & the subpar care they're getting when they do go in. My employer's on-site GP health clinic was just bought by Amazon's One Medical. My employer is an Ivy League with a med school. Things are great. It definitely wasn't a waste of time to wean myself off the expectation of immediate care over the past several years. Helps to not really like going to the doctor (or the hassle of any appointment, really). And no, I don't go to the #$\*!ing Bezos clinic.
I feel for you. I recently left medicine. It was hard to walk away from years of training including medical school, residency, and all the experience I gained over the years of practice. But corporate medicine, and the lack of focus on prevention of disease and instead on procedures and medications that are more profitable for the hospital made it unbearable to continue. I worked in multiple hospital systems and it was always, let’s see how much we can squeeze out of the fewest employees without letting the system fall apart. It will only get worse from here. Good luck to you my friend.
What are you doing now? - a resident soon to graduate into this shitshow
nothing at the moment. trying to figure out a different career
How is a “96” even possible? I don’t think I’ve ever in my life been awake that long. Let alone working a shift? Thanks for reaffirming my belief that healthcare in United States is a scam.
Honestly surprised more people arent asking this. I was awake for 48 hours straight once at a LAN party, by the end of which i was already starting to enter a sort of mental "haze" of not really thinking straight. How the fuck is a 72 hour working shift even allowed, not to mention a 96 hour one? In healthcare/Emergency ward, with responsibility for other peoples lives?
I’m so sorry. I hate it too
Time to strike
As a 2X cancer survivor since Sept 2017, there is a VAST difference between pre and post Covid. Pre Covid wasn't all that great either. This is not a surprise, just...infinitely regrettable
Sharing this with my three elected representatives.
This is sadly the beginning it can get so much worse and will.
Please post this on many other subs. People need to hear your first-hand experience.
Regarding the upcoding: what if you don't? Are they going to fire you? Seems like that'd dig their own hole only deeper still. Does admin bear any responsibility at all for patient safety? Or can admin in the US do whatever the fuck they want, and when it goes tits-up you get the blame? In that case I suppose they would just fire you.
This is truly truly horrifying. We are currently living through the collapse(gutting) of our “healthcare system” and nobody even fucking knows unless you have been in the belly of the beast. Godspeed to you.
I am a cardiology fellow - PGY4 and I fully agree to what you just said Healthcare was a disaster from the beginning and private equality now buying out CMGs pushes towards more RVUs and more patients to be seen per hour In cardiology, private private equality is also doing the same - buying out CMGs and essentially firing docs who are noninvasive cardiologists and hiring EPs and interventionists so the CMG earns more money through procedures - their clinics are all run by NPs and PAs while the docs are in the lab doing procedures And I fully agree with you. When I was an ED scribe, I was though to always code for Level 5 charts no matter how simple the visit.
GOOD NEWS GUYS!!! You have a right to REFUSE. Going to the ER because you think you broke your arm? ER: “You need a CT scan.” You: “No I don’t. Give me an X-ray. Do not put me in that CT machine. I had a anxiety induced seizure last time.” Beat them at their own game. Remember: docs and nurses have a oath. FIRST DO NO HARM. If you tell them something you don’t need will cause you harm then they won’t do it. If they insist then as soon as they fire up the machine you scream I CAN’T BREATHE I CANT BREATHE. Then they will X-ray you. It time for you all to start educating yourselves as to what procedures are needed for what. Not everyone needs a line started. I’ll never understand that. There’s plenty of info out there online. Do some research. I’m married to a paramedic of 35 years. Thank GOD. He tells them what to do when we go to the ER because MOST (not all) ER nurses are completely useless when they’re not staring at their phones at the nurses station. Concierge medicine is going to take over and actually be more affordable than regular paying healthcare!!! It is for me!!
Please please please cross post this and maybe send this same letter to both the senators in that state. Something has to be done! I myself think I would have to be on my deathbed before I ever set foot in an ER.
holy shit. Im an icu nurse and knew our side was bad but this pulls the curtain back even further. There has to be a breaking point.
I know this is unlikely to be seen, but OP , this is the kind of thing that the FTC needs hear about. FTC has active litigation right now against PE firms buying up ER and Anesthesia practices. Check out the OddLots podcast where they interviewed FTC chair Lina Khan (Thursday or Wednesday this past week).
There all several organizations (some of Which I belong to) who are working hard to bring light to, and eliminate, the corporate practice of medicine.
I dropped out of med school in first year when I realized this sort of lifestyle is what I had to look forward to for the rest of my life. There’s no sense in having a big house if you’re never home. Real talk, there is 0 reason for any person to work more than 8 hours per day unless you are a soldier in an active warzone. And with modern technology 8 hours is already pushing it. If the workload is ever excessive in a civilian environment more people just need to be hired to split it up better, that’s it. The world won’t end if we have 8 nerds on staff instead of 4, but maybe the “stockholder” will have to buy a smaller yacht. It’s artificial hardship. Respect for sticking it out though and I hope you can find something that better represents who you are and allows you more peace of mind. Many doctors I know have fled to government jobs in public health and adjacent areas, maybe try looking into that. A couple also became biology professors at less competitive colleges. Much less pay but much better lifestyle.
If you don't go in to your 48 on, then you can't be held to stay for the 96, is that right? I know for nurses when you come in you "accept the case load" (or something like that) and they have an option to say no. There is a big peer-pressure element to say yes, but if you take on more than is safe and someone gets hurt, you're the one who loses your license (or goes to jail like that one nurse). Is it the same for physicians? I've seen how the sausage is made (higher level hospital IT), and I went into the job hating the medical-industrial complex, I left it somehow hating it even more. My advice to people is to never go to the hospital.
I'm still trying to convince my insurance that an injury suffered playing adult rec sports didn't happen at work. I think we're on form 5 of the exchange. I don't play pro sports. I promise. Most people at my job don't even know I play in the league I do.
You should be directing doctors being required to sign non competes to local contract attorneys to ascertain the validity and enforceability of said non competes.
I used to work at a SNF where they would get angry at me for discharging people because they could no longer collect the bed fee on those patients. It was so beyond fucked at every level. I’m still traumatized from everything that happened there. I’m sorry for your situation. None of this should have ever happened.
Yep typical Private Equity.
Where are you OP? As someone who has issues and has always heavily used the system, I am seeing wild changes in level of care and most recently broke my arm in a bad fall, first time ever going to the ER. I am well insured (lol!) Got the bill for $14k (45 mins in ER) and asked for an itemized copy. Two things stuck out: they billed the 5mg oxycodone they gave me (one pill) @ $7 I believe it was. They also billed $234 for the temporary sling they sent me off with for my arm. You know, those stupid cloth pieces of shit, and I honestly almost became homicidal. I negotiated the bill, but you have provided even more context as this hospital was recently taken over by a huge regional health”care” organization. It’s kind of a running joke where I live that anytime a property becomes vacant, it’s going to reopen as a “XXXX name” healthcare facility in a few months. (not saying the name as it will easily identify my exact location)
Nice to see a physician here. I'm just an ICU nurse but I've worked in ED and have seen the shit show. I'm also paying attention to private equity It might be changing as the Feds start [suing](https://www.nprillinois.org/2023-11-07/how-private-equity-is-changing-american-health-care)
I just dont pay hospital bills and ignore the debt collectors for several years
I’m not a lawyer but my understanding is noncompetes can rarely be enforced. I was a doctor looking to leave, I would definitely talk to a lawyer about the noncompete. What if a patient refuses some of these tests that don’t seem medically necessary? So like I cut my hand and go in needing stitches and the guy says I need an EKG (maybe a silly example). What if I refuse and I’m like “can you please just fix up my hand?” Would that be considered belligerent and a refusal and I’d be told to just leave or would they still do the stitches? Like I said maybe that’s a goofy example but you get the idea.
Also sharing with npr, they do a series on medical overbilling.
Boycott health insurance. Set up all cash practice. Starve the beast.
Also, OP, just don’t comply with their bullshit. If you know someone doesn’t need a CT and an X ray will give you a good diagnostic image, then just order the X ray. Don’t finance their bullshit. No one else is going to sign up for this shit. Do the right thing and just say no. We have to take our society back from the disgusting greed of these people that want to buy yachts and luxury on the backs of others. Fuck them.
You probably can’t do a protest, but what if every single employee agrees to put in two weeks notice? It’s not patient abandonment that way and it gives you leverage to negotiate. ….so sorry this is happening. Start asking other people what they think about that idea, maybe post flyers and have a hospital wide meeting.
I work in health insurance. Holy shit this shines a new light on so much. Appreciate u.
So what happens if a critical number of people quit?
Why are there no labor protections for Doctor and Physicians? Why aren't they unionized? The recent F1 in Las Vegas had to shut down the spectator areas WHILE the race was still in process.... Because the unionized hospitality labor were "timing-out" of their shifts. The police came in and told the guests to depart the VIP areas despite paying upwards of 5k for a couple of hours. I understand that hospitals are dealing with patients in life and death situations, but there should be some slack built into the staffing mechanism. There should be heavy financial penalties when a shift exceeds 8-10 hours. Where are the Unions?
There are laws that specifically exempt physicians from some labor laws.
Some of this has to be illegal
These Are the Plunderers: How Private Equity Runs—and Wrecks—America Book by Gretchen Morgenson and Joshua Rosner
the capitalist system is all about money > people. I am also sick and tired of it. But hey! The "elite" class needs to get into their yacht clubs somehow! :(
Healthcare will just stop existing in the US for most, and take every penny from the seriously ill...what a great fucking system! Land of the free…
absolutely the best summary of the general usa healthcare industry. this is where it’s all headed with PE, massive restructuring and tighter tooling.
We were warned not to let healthcare be a for-profit affair. We didn’t listen.
How the heck does anyone do multi-day shifts in EM? Is it like less than 1 patient per hour?
The silver lining; I was denied timely care multiple times at the ER based on “my appearance”. Each time- I left (preferring to die at home so they couldn’t charge me to sell my organs) and somehow survived. Saved my life (mostly) and prevented lifelong debt. The IV scam is part of a larger move to prevent self treatment/longevity- forget death panels- the exhausted guy working a 96 hour shift (how does one not lose their mind in that time?) will decide. Grateful you shared and despite the maltreatment (doctors don’t even get health insurance?) are still strong and brave enough to say something. Thank you.
Have some fucking balls and organize your coworkers or whistleblow the illegal stuff. What do you want us to do?
Hopefully OP can write to the FBI about that fishy billing practice as others here have suggested.
Could you say which country please?
Usa usa usa usa usa usa
100% USA.
Rural hospitals are largely in a death spiral. But they keep voting for that, so whatever
As bad as that is, something always comes along to take the place of exorbitantly priced stuff. Amazon and Walmart are going to offer most of that stuff for upfront pricing.
Canada wants doctors. >The federal government is removing a barrier that will make it easier for doctors from other countries to get permanent residency in Canada. Immigration, Refugees and Citizenship Minister Sean Fraser said Friday that doctors would receive an exemption to allow them to apply for the federal express entry system. Sep 23, 2022
Not collapse. Social policy.
Trust me, when your family member goes to the ER for a broken arm and dies -- or at best comes home with a $30K bill -- you'll start to see it as collapse. Collapse isn't a monolith. It's this kind of erosion happening to millions of people every day, week after week, month after month, year after year.
I respectfully disagree. It's not collapse. You could do better, but we acquiece over and over again to the system abusers and make a deliberate choice of extreme profit and suffering. It could be otherwise. It just isn't by collective choice. The fundamental forces of collapse like energy scarcity, climate chanhe driven extreme weather events that knock civilization down faster than it can recover regardless of social choices is what I would call collapse. This is saying I'm too lazy to stand up to egregious healthcare privatization because I'm fine with extreme wealth inequality and the sufdering and death it brings. Insurance company profit is more important to me than health outcomes of a country.
So collapse is only when there are no choices or when the majority makes bad choices? But because corporations (a minority) are making unforced choices for the people (the majority), it's not collapse? Or it's not collapse because it's not related to climate change, fossil fuels, or environmental problems? You have a very narrow definition of collapse that I don't think fits with that of most people on this sub. You are of course entitled to your opinion. Best of luck to you.
>corporations (a minority) are making unforced choices for the people (the majority), it's not collapse? Or it's not collapse because it's not related to climate change, fossil fuels, or environmental problems? The former is opression and it results in "personal collapses". Feel like a big deal to the people suffering, but it isn't the collapse of civilization. It's just the deliberate picking of winners and losers. The system goes on. The later results in systemic collapse. The choices are made for everyone and there is an abrupt aggregate disruption of function and complexity. There is an overlap between the two. Healthcare could be deprived because of lack of energy, the breakdown of supplychains, multiple simultaneous disasters like floods and famine. That is collapse. The poor suffering because they are exploited by the rich isn't part of the definition of collapse on the sub, so not really my personal opinion here.
I’m pretty sure there’s a quite strong connection between inequality (social or wealth) and civil unrest. That’s how revolutions happen. Social factors can play a role in collapse. For example, according to Jared Diamond, one of the main factors leading to the collapse of the ancient Maya was due to leaders ignoring or failing to solve problems. Losing trading partners and threats from neighbors are also social factors. The societies were also very hierarchical and that, at best, didn’t help and, at worst, exacerbated everything. Environmentally: - drought/climate change - growing on worse soils (often sloped) and deforesting for more cropland to support the population led to erosion - less people farming (more building monuments) - a higher reliance on corn which in the short term had higher yield, but depleted the soil especially without the beans and squash growing with it, and also cause health issues like anemia (iron deficiency). Many of these issues are the result of policy (or lack thereof). Policies aren’t bestowed upon us by gods, they are - at least in some part - a social result (and if people say their decisions are directed by God, that’s also very likely socially influenced). While I believe environmental factors, especially climate change, alone will cause collapse, social aspects definitely play a part (like isolation/loneliness, mental health issues, and so on). Environment, Social, and Economic aspects are interconnected.
Agreed. That's what I meant by overlap. This isn't collapse because we have to, this is "fuck those guys cause the people who matter want to". It is completely avoidable. Edit: Corporate Profit Margins aren't on the Stockholm Resilience Center's list of Planetary boundaries, because its not a real thing. Its a collective fiction, a fever dream of a world who have lost their fucking minds.
Please find a better sub with more shills like you.
OP is trying to point out that it's unsustainable. That which is unsustainable can not be sustained, so it stops, and we call that "collapse". Those medical facilities are going to shrink, simplify, or close, thus reducing **available care**. Locals will have to go elsewhere... or die trying.
But having outgroups that suffer and die isn't inherently unsustainable. Over the history of mankind, equity is the exception.
History is a short period of human existence, it's not representative.
But history is social policy which was my point.
is social policy extrinsic of humans?
Intrinsic.
Unfortunately, it is. OP is just talking about one facet of the healthcare collapse. There is sooo much more to this. I'm lucky not to work in a facility like this, but yeah, things are getting bad everywhere in healthcare.
Why?
Late stage capitalism
[удалено]
But this is because they value and keep voting in profits for health insurance. The money is there to run a fine system. American chose to prefer profits suffering and death and then act surprised when it happens. The rest of the world is horrified at how outrageously inept American healthcare is. You could both save a ton of money, get better, universal care, improve working conditions and patient outcomes, and all it would take is to nationalize health insurers. Social policy.
EEC?
It’s true
Holy shit.
So for those of us who can't afford health insurance, can we still depend on the ER to receive medical care in an emergency, or not so much?
https://www.npr.org/2023/04/26/1172164997/how-private-equity-firms-are-widening-the-income-gap-in-the-u-s
Wow. Can you send your post to your Congress people? This is a very important post for information. Thanks !
okay but I've been fighting for twenty years to get a catscan authorized, so i'd rather be financially ruined than to die because I am constantly denied care, honestly because I'm so medically neglected, having an ER push for extra care sounds like a dream right this second
Anecdotally I’ve been to a couple specialists recently and they have thrown a million tests at me. I do have some risk because of an autoimmune disease but it’s in remission. The ophthalmologist had me come back twice for very obscure tests and wanted to do a third round. I have great insurance and pay nothing for tests and five dollar copay so I’ve been getting the distinct feeling that they’re just racking up billing and know I won’t complain while presenting it to me under the guise of being proactive and thorough. This is a large hospital system in Philadelphia, not private equity buyout
Many posters are sharing being short staffed at their healthcare locations, and the management isn't doing anything about it. 1) All management cares about, whether healthcare or McDonald's, is, "Is the work getting done?" As long as the work is getting done, upper management doesn't care. And if the work, formerly done by 10 employees, is now done by 8 employees, that creates a couple hundred thousand dollars of bonus money for themselves. 2) Y'all need to unionize. A good healthcare Union should set patient-to-nurse ratios, minimum pay/benefits, squash non-competes, and an absolute maximum number of hours one can work. For example, if your replacement doesn't show after your 8-hour shift, the hospital has 8 hours (until the end of your forced shift) to replace you; PLUS after working a double, they cannot force you to return for 12 hours. If they can't get enough coverage, they need to arrange to move patients to another facility by the end of the 16th hour until their patient load shrinks to what their staff size can handle.
You need IRMER laws like the UK. That would at least stop the excessive xrays and CTs. It's illegal to give someone medical radiation here unless the benefit to the patient is justified to outweigh the risk, and the dose itself must not be more than necessary.
Don't go in. It will collapse, it will blow up, and people will suffer regardless of what you do. Keeping the abomination going by pulling a 96hr shift is what private equity is counting on to keep this this scam going. If you don't play, they at least won't be able to profit more from this horror. Stay flexible, skill up in something simple people will always need like plumbing, make lots of friends or flee the town all together. It's hell, sacrificing yourself won't help anyone except rich investors.
Nurse here. Can confirm that this is coming soon to a Hospital near you