Leaning forward at my desk causes my back to get stiff and then it hurts when I get up. A few weeks ago, my left hip joint was acting up and now it's doing it again. Not sure what's causing that. I'll mention it to the dr. next week.
Oh. Are you allowed to have two things potentially wrong with you at the same time then? My GP's surgery doesn't permit that anymore. Or rather, you're allowed to have loads of things wrong with you, but you're only allowed to mention one per visit and outright forbidden from suggesting two or more symptoms might be linked. Probably something to do with broadband limits. One search per 2.48 minutes (about as long as a consultation takes) and if you don't resemble a picture - out you go without even a prescription to finish you off. It's so bad, I'm beginning to think the doctors there aren't doctors at all, but receptionists.
Anyway... hope you're not suffering too much with it today, David :)
I sit at a different desk in the afternoon. It has a smaller chair that isn't as bad. That said, the hip problem isn't restricted to just my desk chair. It also happens at other times.
And at the frequency with which I've been running off to the euphemism today, my back hasn't had time to get stiff.
David
Miserable old git
Patiently waiting for the asteroid with my name on it.
Oh. Are you allowed to have two things potentially wrong with you at the same time then? My GP's surgery doesn't permit that anymore. Or rather, you're allowed to have loads of things wrong with you, but you're only allowed to mention one per visit and outright forbidden from suggesting two or more symptoms might be linked. Probably something to do with broadband limits. One search per 2.48 minutes (about as long as a consultation takes) and if you don't resemble a picture - out you go without even a prescription to finish you off. It's so bad, I'm beginning to think the doctors there aren't doctors at all, but receptionists.
Aha ! That's what is known in "The Trade" as Salami Slicing ! :-) :-)
Oooh .... your child has another ear in addition to the one on the left side that I just looked at ? Well well. A right side ear. Shall we look at that next time, hmmmm ?
You have correctly detected that such is not actually medicine and thus the practitioners are mis-titled. There are indeed some who do sweat heavily if the Internet goes down. DownUnda I can only think of some benefits to this style :
- it makes the rest of us look good. Nice competitive edge there.
- keeps the dear lawyers in business. Can't have them wasting their avarice.
- something for the medical board to do { shocking trembles as he opens letter from the Australian Health Practitioner Regulation Agency ...... aaah .... just a Christmas card, phew }.
- likewise for the health bureaucracies that give out the awards for Good Stats eg. patient attendances, re-attendances, re-re-attendances, admissions, re-admissions, re-re-admissions and then The Final Discharge.
- boosting shares of Undertakers-R-Us ...
As for healing the ill, salving the woes, timely intervention to optimise current and future health ..... bah ! So passe. So 1956 .... how dare you hold such hopes in this modern age ?! Cheer up. There is a silver lining : your dog/cat is probably doing much better down at the vets .....
Cheers, Mike.
I have made this letter longer than usual because I lack the time to make it shorter ...
... and my other CPU is a Ryzen 5950X :-) Blaise Pascal
Re joints: While you still have some it would be a good idea to insist on a referral to an orthopedist. He will do a exam, take x-rays and send you off for an MRI. When that comes back they will give you the bad news (if you are feeling anything it is bad news) or the terrible news. They can do amazing things with a scope today and tell you how to make sure you don't further injure yourself. Of course it should all be worker's comp!
David, if you are hurting, don't wait. Get thee to a Doctor and get the referral PDQ. The more you wait the worse it gets.
I had held my tongue on this until Mike made his comments so now I feel I need to throw in my 2 cents as well
Quote:
Quote:
Oh. Are you allowed to have two things potentially wrong with you at the same time then?
Quote:
Aha ! That's what is known in "The Trade" as Salami Slicing ! :-) :-)
Here in the USA it's called HMO. (Having worked in Colorado {often referred to as East California})
Under their rules you are only allowed to bill for that complain on your appointment (only 1 complaint per visit). If you treat anything else they will refuse to pay the entire bill. If you continue to do so, they will drop you from the plan.
Quote:
- keeps the dear lawyers in business. Can't have them wasting their avarice.
Current stats show there is 1 lawyer per every person in the continental USA with more in school and more Law schools being built. (All those individual that were going to go to medical schools decide it was losing proposition)
Quote:
- something for the medical board to do { shocking trembles as he opens letter from the Australian Health Practitioner Regulation Agency ...... aaah .... just a Christmas card, phew }.
Here it's a couple of agencies. The first is the official letter from the Department of Justice. Usually it is just the renewal but it still stops your heart for a second.
Next is the State Medical Board Letter and Newsletter. Either of these showing up in your mailbox causes shivers down the back. If you dare to read the newsletter, you can see all the physicians they have punished in the last 3 month, their names, where they live and practice, the crime they are charged with, the boards decision and punishments.
Quote:
- likewise for the health bureaucracies that give out the awards for Good Stats eg. patient attendances, re-attendances, re-re-attendances, admissions, re-admissions, re-re-admissions and then The Final Discharge.
Ah yes, our favorite now here in the states.
Hello sir, how can I help you today?
You say your left hip is red and infected? you had it replaced 3 weeks ago in Maine? You went swimming in the Caribbean 2 weeks after surgery against your surgeons advice? But your now down here in Texas?
Couple of problems here. Mainly, No one is going to get paid for services on this gentleman. See, the government and thereby insurance companies no longer pay for readmission of any patient for a period of 2 months after the initial surgery. Not the new surgeon, not the old surgeon, not the new hospital, not the old hospital. Everyone associated with seeing this person will now not get paid. In fact, it doesn't even have to be related to the initial encounter. Lets say he develops a bladder infection 2 months after his shoulder surgery. If he returns to any hospital and needs to be admitted, everyone gets denied payment and payment already made will be withheld from all future payments to everyone involved.
So, readmission are going to soon become literally a matter of life or death.
And on that note, a new twist with Obamacare. If you come to the ER with a non life threatening conditions, you will been seen by a physician then a person will come in and say, you don't have an emergency, if you wish to be treated you need to pay us 250 USD up front in order to get treated. Otherwise you can leave.
It's already happening in many hospitals here.
(sort of reminds me of Ukraine, where the ambulance shows up and you have to pay the ambulance and doctor first before they take you to the hospital to be treated, Oh and family member take care of you in the hospital there, change your beds, clean you and the room and bring you food) Better hope none of the hospital CEO get wind of that.
Quote:
- boosting shares of Undertakers-R-Us ...
Maybe but hopefully not...
On a serious note, I hope you get to feeling better with your back and hip. Might need a Rheumatologist as well if the Ortho can't find anything.
See, the government and thereby insurance companies no longer pay for readmission of any patient for a period of 2 months after the initial surgery. Not the new surgeon, not the old surgeon, not the new hospital, not the old hospital. Everyone associated with seeing this person will now not get paid.
This is a brilliant insurance tactic, otherwise known by the phrases 'core deduction', 'core offset' or somesuch I believe. That is, the insurer takes the bet ( premium by whatever means ) and then by fiat gets to define away the core/bulk of the risk. As post operative complications can well exceed in cost the original procedure this can reduce payouts by an order of magnitude, and retain profit even while leaving else alone. Two months is ample time to rebut most troubles. I think the health mobs got this trick from the Act-Of-God/It-Was-A-Flood-Not-A-Storm/It-Was-A-BushFire-Not-A-HouseFire/It-Was-Mere-Trespass-Not-A-Burglary crew.
A good friend of mine who used to raise milk-fed beef was told by his worker's insurer that no claims would be accepted for injuries in & around the cattle yards ie. the only significant material risk to his workers on the property. These un-insurers were basically allowed to write the legislation and micromanage the incredible detail. Surprisingly this seems to be the accepted norm for many industries. But it is the equivalent of Lotto providers being allowed to repaint the numbers on the balls after they come out of the barrel. Or the bookies getting to re-order the horses over the line after the race is run. Legally ! And they whalloped the mafia for running numbers and rigging horse races !
But all this is nought but infant paddling compared to the following near-future scenario, down at your local WeLoveYouToDeath Health Fund :
"I'm sorry sir but we don't offer insurance for those who haven't provided their DNA for profiling. Otherwise the paperwork you have filled out is fine."
"Oh. Err ... "
"Just to the left sir, they will accommodate you. The door is marked Rejection Assessors."
......
......
"Well Madam. Ahem. We missed that one didn't we ? Chortle. We are happy to take you on under our Full Insurance Package. Just sign off on that 17 page list of exclusions and then we're done!"
"Oh. Err ... "
"Now even though you do have a 78% risk of inherited accidental tendencies ( we call it the Clumsy Chromosome ) we will give you this bonus offer for no extra cost ... "
"Oh. Err ... "
"Yup! Firstly free complimentary copies of The Hunger Games and Gattaca. Secondly free trauma coverage if you are run over by the Pope when she's driving a pink Prius on a Tuesday when it is raining. If it is sunny we will cover only half the costs."
"But the Pope is a man!"
"Come now Sir .... Maam ! Keep your voice down. You can't express such prejudicial behaviour based on mere genes. That would be illegal ..."
"Oh. Err ... "
"What?"
"I was only here to deliver the Pizza. Do you have a toilet I can use ?"
"Nope. We've p***ed on you enough already ... now get out !!" :-))))
Cheers, Mike.
( edit ) Gosh I'm lucky. Seriously. I get to sit with the dear patients and listen while they tell me what's been happening to them. I get to do the whole person thing like I was taught in the early 80's. The system thinking - which is what I love the most - and none of this partition crap. I have painstakingly built this mental model in my head over 35 years of how people work. And how they don't. I add little twigs of variations every day, the low percentage routes and the fine print modes. I'd hate to be a doctor starting up now as a generalist, to be penalised for rejecting the normative pressures. I've got about another ten years of full time in me I reckon. Perhaps when I 'retire' I'll start a second career : Full Time Pain In The A*** To Politicians & Health Bureaucracies !! Hey what ? Are you with me people ? :-) :-)
( edit ) There is this amazing book that I read back then : The Missing Medical Text: Humane Patient Care by Anthony R. Moore, Melbourne University Press, 1978. It said it all really. I still have my copy. The author was the Medical Director ( the resident doctor's boss ) of the hospital across the road from the University that I went to. He did an unprecedented ( nor repeated ) thing : debriefs and group discussions with the young doctors and medical students that were about in the 1970's. About all manner of things right through to the biggies of Life & Death, and the even bigger I Am Sorry That I Stuffed It Up For You. The book is an aggregation of that experience. Sadly that narrative is still well and truly MIA with modern teaching too. Maybe 'someone' could write an update ....... ;-)))
( edit )
Quote:
Current stats show there is 1 lawyer per every person in the continental USA
.... sounds 'bout right .... of course that depends upon how our dear legal friends are classified .... Homo Sapiens Litigans .... :-)
I have made this letter longer than usual because I lack the time to make it shorter ...
... and my other CPU is a Ryzen 5950X :-) Blaise Pascal
I never ceases to amaze me the tales from abroad about medical attention. In the UK we have had a free at source National Health Service since 1948. If you have an accident or become ill you get whatever treatment you need, no matter who you are. Of course you can opt to go private if you wish to pay for extra care. Anyone collapsing in the street will get an ambulance called and taken to hospital without any question of cost.
If it is a visitor to the country, short term on holiday or study visa, their country's embassy gets billed from the NHS for the cost. At least that is what is supposed to happen. All EU countries have reciprocal heath arrangements through the EHIC, and some other countries also have reciprocal arrangements non EAA.
I note that Russia is there on the list of but not the USA. So much for our special relationship then!
But of course everyone moans about the NHS but they just don't realise how lucky they are, even if some hospitals don't pass muster. What really annoys us is the foreign women, mainly from eastern Europe, who turn up in the UK a fortnight before the birth, knowing full well that they and their baby are more likely to survive than back home. All free for them and I doubt some countries will cough up if billed. I read a report somewhere that said the birth rate in UK hospitals was higher than the UK population increase.
Waiting for Godot & salvation :-)
Why do doctors have to practice?
You'd think they'd have got it right by now
Talking about the "final discharge" it is amazing how much it costs when someone dies. My dad died in April and we have only just this week finalised it all. We had a private cremation, then a service of remembrance at the parish church, with buffet & drinks afterwards. Then we went through probate, marketed and sold the house, and we used house clearer's for what we couldn't shift ourselves.
What really surprised me was that the vicar made a charge for each service around a couple of hundred pounds. I always thought that they did that for free as part of the parish duties. Good money for a 45 minute service, but I suppose you are renting the church premises as well. On top of that there is the cost of flowers, the wake, undertakers fees, solicitors bill for the probate, solicitors bill for the conveyancing, then the estate agents bill of 1.25% for the sale. You add all that up and it comes to quite a tidy sum, if you die owning property.
But of course being a civilised western country we still have this.
Quote:
In England, a Pauper's funeral was a funeral for a pauper paid for under the Poor Law. The phrase is still sometimes used to describe a funeral paid for by the state when the estate of the deceased person or the relatives of the deceased person do not have sufficient funds to cover the cost. Pauper's funerals which are very basic burials at public expense, still exist today for people with insufficient assets.
I wonder if they exist elsewhere as well?
Waiting for Godot & salvation :-)
Why do doctors have to practice?
You'd think they'd have got it right by now
They do DownUnda, in Victoria at least. It's one of those things that is only occasionally used. I think the money comes from a fund which skims some profit from interest on other temporary monies type of thing. Some of which would normally go to the Feds - essentially a tax on transfers over a certain threshold - and so winds up being a Fed to State grant in effect. Decades ago it ( and other pro bono's ) used to come from the Poor Box run by the local magistrates courts. Now we don't have such courts, more regional now, and these days you can't overtly buy your way out of an offense anyway ( covertly it is business as usual ).
Cheers, Mike.
I have made this letter longer than usual because I lack the time to make it shorter ...
... and my other CPU is a Ryzen 5950X :-) Blaise Pascal
What really annoys us is the foreign women, mainly from eastern Europe, who turn up in the UK a fortnight before the birth, knowing full well that they and their baby are more likely to survive than back home.
You are annoyed because they survive? You say 'us'. Do you speak for your entire country?
Wealthy Chinese fly in a couple of days before they are due and stay in a hotels across from hospital to give birth here. Then fly back with their dual citizen baby. Not so bad as they leave.
On the low end of the scale, people from south of the border migrate up to Mexico then cross the rio and walk into the hospitals along the border to give birth so they can have "anchor babies" and stay here.
RE: RE: By the time I get
)
I sit at a different desk in the afternoon. It has a smaller chair that isn't as bad. That said, the hip problem isn't restricted to just my desk chair. It also happens at other times.
And at the frequency with which I've been running off to the euphemism today, my back hasn't had time to get stiff.
David
Miserable old git
Patiently waiting for the asteroid with my name on it.
RE: Oh. Are you allowed to
)
Aha ! That's what is known in "The Trade" as Salami Slicing ! :-) :-)
Oooh .... your child has another ear in addition to the one on the left side that I just looked at ? Well well. A right side ear. Shall we look at that next time, hmmmm ?
You have correctly detected that such is not actually medicine and thus the practitioners are mis-titled. There are indeed some who do sweat heavily if the Internet goes down. DownUnda I can only think of some benefits to this style :
- it makes the rest of us look good. Nice competitive edge there.
- keeps the dear lawyers in business. Can't have them wasting their avarice.
- something for the medical board to do { shocking trembles as he opens letter from the Australian Health Practitioner Regulation Agency ...... aaah .... just a Christmas card, phew }.
- likewise for the health bureaucracies that give out the awards for Good Stats eg. patient attendances, re-attendances, re-re-attendances, admissions, re-admissions, re-re-admissions and then The Final Discharge.
- boosting shares of Undertakers-R-Us ...
As for healing the ill, salving the woes, timely intervention to optimise current and future health ..... bah ! So passe. So 1956 .... how dare you hold such hopes in this modern age ?! Cheer up. There is a silver lining : your dog/cat is probably doing much better down at the vets .....
Cheers, Mike.
I have made this letter longer than usual because I lack the time to make it shorter ...
... and my other CPU is a Ryzen 5950X :-) Blaise Pascal
Re joints: While you still
)
Re joints: While you still have some it would be a good idea to insist on a referral to an orthopedist. He will do a exam, take x-rays and send you off for an MRI. When that comes back they will give you the bad news (if you are feeling anything it is bad news) or the terrible news. They can do amazing things with a scope today and tell you how to make sure you don't further injure yourself. Of course it should all be worker's comp!
David, if you are hurting, don't wait. Get thee to a Doctor and get the referral PDQ. The more you wait the worse it gets.
I had held my tongue on this
)
I had held my tongue on this until Mike made his comments so now I feel I need to throw in my 2 cents as well
RE: See, the government
)
This is a brilliant insurance tactic, otherwise known by the phrases 'core deduction', 'core offset' or somesuch I believe. That is, the insurer takes the bet ( premium by whatever means ) and then by fiat gets to define away the core/bulk of the risk. As post operative complications can well exceed in cost the original procedure this can reduce payouts by an order of magnitude, and retain profit even while leaving else alone. Two months is ample time to rebut most troubles. I think the health mobs got this trick from the Act-Of-God/It-Was-A-Flood-Not-A-Storm/It-Was-A-BushFire-Not-A-HouseFire/It-Was-Mere-Trespass-Not-A-Burglary crew.
A good friend of mine who used to raise milk-fed beef was told by his worker's insurer that no claims would be accepted for injuries in & around the cattle yards ie. the only significant material risk to his workers on the property. These un-insurers were basically allowed to write the legislation and micromanage the incredible detail. Surprisingly this seems to be the accepted norm for many industries. But it is the equivalent of Lotto providers being allowed to repaint the numbers on the balls after they come out of the barrel. Or the bookies getting to re-order the horses over the line after the race is run. Legally ! And they whalloped the mafia for running numbers and rigging horse races !
But all this is nought but infant paddling compared to the following near-future scenario, down at your local WeLoveYouToDeath Health Fund :
"I'm sorry sir but we don't offer insurance for those who haven't provided their DNA for profiling. Otherwise the paperwork you have filled out is fine."
"Oh. Err ... "
"Just to the left sir, they will accommodate you. The door is marked Rejection Assessors."
......
......
"Well Madam. Ahem. We missed that one didn't we ? Chortle. We are happy to take you on under our Full Insurance Package. Just sign off on that 17 page list of exclusions and then we're done!"
"Oh. Err ... "
"Now even though you do have a 78% risk of inherited accidental tendencies ( we call it the Clumsy Chromosome ) we will give you this bonus offer for no extra cost ... "
"Oh. Err ... "
"Yup! Firstly free complimentary copies of The Hunger Games and Gattaca. Secondly free trauma coverage if you are run over by the Pope when she's driving a pink Prius on a Tuesday when it is raining. If it is sunny we will cover only half the costs."
"But the Pope is a man!"
"Come now Sir .... Maam ! Keep your voice down. You can't express such prejudicial behaviour based on mere genes. That would be illegal ..."
"Oh. Err ... "
"What?"
"I was only here to deliver the Pizza. Do you have a toilet I can use ?"
"Nope. We've p***ed on you enough already ... now get out !!" :-))))
Cheers, Mike.
( edit ) Gosh I'm lucky. Seriously. I get to sit with the dear patients and listen while they tell me what's been happening to them. I get to do the whole person thing like I was taught in the early 80's. The system thinking - which is what I love the most - and none of this partition crap. I have painstakingly built this mental model in my head over 35 years of how people work. And how they don't. I add little twigs of variations every day, the low percentage routes and the fine print modes. I'd hate to be a doctor starting up now as a generalist, to be penalised for rejecting the normative pressures. I've got about another ten years of full time in me I reckon. Perhaps when I 'retire' I'll start a second career : Full Time Pain In The A*** To Politicians & Health Bureaucracies !! Hey what ? Are you with me people ? :-) :-)
( edit ) There is this amazing book that I read back then : The Missing Medical Text: Humane Patient Care by Anthony R. Moore, Melbourne University Press, 1978. It said it all really. I still have my copy. The author was the Medical Director ( the resident doctor's boss ) of the hospital across the road from the University that I went to. He did an unprecedented ( nor repeated ) thing : debriefs and group discussions with the young doctors and medical students that were about in the 1970's. About all manner of things right through to the biggies of Life & Death, and the even bigger I Am Sorry That I Stuffed It Up For You. The book is an aggregation of that experience. Sadly that narrative is still well and truly MIA with modern teaching too. Maybe 'someone' could write an update ....... ;-)))
( edit )
.... sounds 'bout right .... of course that depends upon how our dear legal friends are classified .... Homo Sapiens Litigans .... :-)
I have made this letter longer than usual because I lack the time to make it shorter ...
... and my other CPU is a Ryzen 5950X :-) Blaise Pascal
I never ceases to amaze me
)
I never ceases to amaze me the tales from abroad about medical attention. In the UK we have had a free at source National Health Service since 1948. If you have an accident or become ill you get whatever treatment you need, no matter who you are. Of course you can opt to go private if you wish to pay for extra care. Anyone collapsing in the street will get an ambulance called and taken to hospital without any question of cost.
If it is a visitor to the country, short term on holiday or study visa, their country's embassy gets billed from the NHS for the cost. At least that is what is supposed to happen. All EU countries have reciprocal heath arrangements through the EHIC, and some other countries also have reciprocal arrangements non EAA.
I note that Russia is there on the list of but not the USA. So much for our special relationship then!
But of course everyone moans about the NHS but they just don't realise how lucky they are, even if some hospitals don't pass muster. What really annoys us is the foreign women, mainly from eastern Europe, who turn up in the UK a fortnight before the birth, knowing full well that they and their baby are more likely to survive than back home. All free for them and I doubt some countries will cough up if billed. I read a report somewhere that said the birth rate in UK hospitals was higher than the UK population increase.
Waiting for Godot & salvation :-)
Why do doctors have to practice?
You'd think they'd have got it right by now
Talking about the "final
)
Talking about the "final discharge" it is amazing how much it costs when someone dies. My dad died in April and we have only just this week finalised it all. We had a private cremation, then a service of remembrance at the parish church, with buffet & drinks afterwards. Then we went through probate, marketed and sold the house, and we used house clearer's for what we couldn't shift ourselves.
What really surprised me was that the vicar made a charge for each service around a couple of hundred pounds. I always thought that they did that for free as part of the parish duties. Good money for a 45 minute service, but I suppose you are renting the church premises as well. On top of that there is the cost of flowers, the wake, undertakers fees, solicitors bill for the probate, solicitors bill for the conveyancing, then the estate agents bill of 1.25% for the sale. You add all that up and it comes to quite a tidy sum, if you die owning property.
But of course being a civilised western country we still have this.
I wonder if they exist elsewhere as well?
Waiting for Godot & salvation :-)
Why do doctors have to practice?
You'd think they'd have got it right by now
RE: I wonder if they exist
)
They do DownUnda, in Victoria at least. It's one of those things that is only occasionally used. I think the money comes from a fund which skims some profit from interest on other temporary monies type of thing. Some of which would normally go to the Feds - essentially a tax on transfers over a certain threshold - and so winds up being a Fed to State grant in effect. Decades ago it ( and other pro bono's ) used to come from the Poor Box run by the local magistrates courts. Now we don't have such courts, more regional now, and these days you can't overtly buy your way out of an offense anyway ( covertly it is business as usual ).
Cheers, Mike.
I have made this letter longer than usual because I lack the time to make it shorter ...
... and my other CPU is a Ryzen 5950X :-) Blaise Pascal
RE: What really annoys us
)
You are annoyed because they survive? You say 'us'. Do you speak for your entire country?
We have the same issue here,
)
We have the same issue here,
Wealthy Chinese fly in a couple of days before they are due and stay in a hotels across from hospital to give birth here. Then fly back with their dual citizen baby. Not so bad as they leave.
On the low end of the scale, people from south of the border migrate up to Mexico then cross the rio and walk into the hospitals along the border to give birth so they can have "anchor babies" and stay here.