Getting old is no fun

Page 2 of 6  
snipped-for-privacy@snyder.on.ca wrote:

At least my daughter will never go South for what? To be pushed around by $$$ sign? She always says "I did not become a doctor to get rich" Nowadays keeping busy during her off shift at refugee clinic here.
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wrote:

Thankfully MANY Canadian doctors have the same outlook. Many who have gone south for the dollar come back appreciating the fact there is more to doctoring than money, and here in Canada they don't have to chase patients for payment and fight with HMOs tooth and nail.
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On 2/26/2016 11:16 PM, snipped-for-privacy@snyder.on.ca wrote:

My PCP is a "doctor" -- in much the same way that I'm an "engineer". Neither of us wants to deal with the messy "business side" of our professions.
I think this is something you can pick up on if you are observant.
E.g., I have friends who recount how their doctor made them come back for a second appointment (instead of addressing TWO problems in a single visit). I bring a laundry list of questions, issues, etc. and my MD is very happy to address all of them in a single visit.
At the same time, he's aware of how the billing system works and you wouldn't be surprised to hear him say: "You're better off going to XYZ to have that addressed because *we* would bill you $$$"
This is unfortunate as it just adds to the delivery cost (i.e., the fact that he has to KNOW those things; or, that there are two different prices for the same service provided in two different ways/providers)
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Per snipped-for-privacy@snyder.on.ca:

Some years back I saw a documentary on health care in France - where doctors are on salary and make house calls.
The doctor and wife they featured were not getting rich by any means, but they lived at a very high standard (nice car, nice house, restaurant meals when they felt the urge...and so-forth....)..... The bottom line per that couple was that they thought they had a really good life and medical school was 100% worthwhile to the guy.
--
Pete Cresswell

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On 2/26/2016 10:28 PM, snipped-for-privacy@snyder.on.ca wrote:

Here, the "demand" would be (artificially) increased to fit the supply. Then, the supply again increased to ensure wages stay lower :-/
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On 02/26/2016 11:00 PM, Don Y wrote: ...

Over the long-haul I have no way of knowing. I know of only one who went directly back to Canada since we've returned to the family farm (15 yr now) and that was a specific family hardship case. The others leave for "greener pastures" within the States at least initially; East and West coasts are primary target areas of course; anywhere but "flyover country".
W/ the changes in US medical practices, many are becoming more frustrated but that's not restricted to the Canadian imports; it's pretty universal throughout.
The reductions in Medicare/Medicaid pay schedules has forced several of the rural hospitals into closure so we have several multi-county areas now with no emergency response facilities at all...the local is hanging on but it's "iffy" even though while still small by city standards at least are one of the higher-populated counties with a regional retail hub from the surrounding area as far as into SE CO, far NE NM, and the OK and TX panhandles.
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On 2/27/2016 7:11 AM, dpb wrote:

So, they've voted with their wallets to stay?

From discussions with my MD and other medical professionals (connections at one of the local hospitals), this seems to be the case.
On the one hand, you can say its sour grapes as now pressures are being brought to bear (that hadn't previously) on how they practice medicine. The semi-god-like reverence for doctors has faded significantly over the course of a single career; I'm not sure that's easy to accept.
OTOH, there may now be too much of a move to "bean counting". E.g., the new coding system breaks things down into such fine detail that i wouldn't be surprised if some of the codes are only "applied" ONCE, in a year, NATIONWIDE: "eye injury; left; fall; trip; child's roller skate; while texting"
OToOH, my peeks inside medical practices suggest they are long overdue for rethinking. Do you REALLY need all those bodies to deliver healthcare? How do places with fewer staff "manage to cope"?

I think we have ~10 hospitals. But, only one "trauma center". The area covered is pretty large -- most hospitals have (and use on a regular basis) helipads to airlift patients in.
There's also a bit of "book cooking" that happens, esp with INS involvement. E.g., a truck full of "illegals" that crashes will have them all treated at a local facility; but, INS won't assume CUSTODY of them until afterwards (leaving the hospital trying to get payment from the "patients" -- which will soon be deported).
Of course, hospitals can play that game, as well: advertising to more affluent Mexicans that they should come up, have their baby delivered here (US citizen!) and get in a few days of shopping before going back across the border...
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On 2/25/2016 10:48 AM, snipped-for-privacy@snyder.on.ca wrote:

And they don't want to run a deficit. So, that suggests they just omit expenses when they approach their budgetary limits.
I.e., how do you budget for an unknown "consumption" pattern? Unless they only "sell" so much "product" and then close up shop...

In theory, that is true in our "nonprofit" AND "for profit" institutions. Waste cuts into profit. Or, cause your costs to be higher than another facility -- that can end up driving YOUR reimbursement rate ("Hospital A is willing to accept $X for this procedure. Take it or BEAT it!")

That, of course, would depend on the local market. If there are a surplus of "health care professionals", then there is downward pressure on at least *some* wages.
Are patients going to complain that Dr. Bob's phlebotomist is "a bad shot" while Dr. Tim's is "always spot on"? Are they going to just pick up and move to a different/new practice? Do they even have that choice? (why would a practitioner want MORE patients than he can already handle -- "quotas"?)

OK, that's a difference. Here, the anti-big-government folks fight any attempt to create registries and INFORM consumers (ANY type of consumer!)

I assume a doctor can't up and move to a different province and hang his shingle anew? Here, that's entirely possible! Walk away from your past performance/problems... (unless you're jailed!)

We've supposedly got LOTS of checks and balances -- ambulance chasing attorneys being the biggest "check". But, they don't seem to work. Too many ways to game the system.
My PCP has a stake in the other organizations to which he refers me: for XRays, Lab work, etc. Should he be prohibited from making those investments? Should he be prevented from directing me to one of those providers -- perhaps to an inferior provider?
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On Fri, 26 Feb 2016 21:58:32 -0700, Don Y

And there is one of the BIG differences between Canada and the USA
We are what yiu folks call a "socialist" country. We demand our government do things Americans won't let their government even think about.

It does happen occaisionally -but each province has it's own medical association - and to practice you need to be a member.
If you have been disciplined by one, generally all the others will find that out. Some get away with it for a little while - - -

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On 2/26/2016 10:24 PM, snipped-for-privacy@snyder.on.ca wrote:

If, IN PRACTICE, that's what ACTUALLY happens, you've obviously got more oversight/involvement than we do, here.
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Per Ed Pawlowski:

I was looking at electric stair climbers for awhile - but concluded that their slowness would make me crazy.
--
Pete Cresswell

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On 02/23/2016 8:00 AM, (PeteCresswell) wrote:

Have installed a couple for friends...they have been a veritable godsend for both. It has opened their houses back up for them.
--


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On 2/23/2016 7:00 AM, (PeteCresswell) wrote:

That;s probably true.
OTOH, I always thought that the little "scooter" (power chairs) would be dog slow, etc. Had to repair one for a non-profit. Took it for a test drive and nearly ran folks over with it! Damn fast!
Apparently, they come in different "speed grades". The chair I had repaired would do 6MPH! Makes me wonder how folks can navigate INDOORS without punching holes through walls...
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On 2/22/2016 5:43 PM, (PeteCresswell) wrote:

A good bit of thinking re: those sorts of "issues" went into choosing this place. House layout, weather, size of yard, bathroom layouts, etc.
And, I've been subtly scheduling the larger "maintenance" issues (new roof, paint job, felling trees, etc.) with an eye towards "how long can I postpone these things yet still be able to tackle them myself -- so the *next* iteration will be well past the point where I *must* hire it out".
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email.me:

I almost did that a few months ago. In the dark I hit the corner of a kitchen cabinet door right above my eye. Down an inch...
I try to keep the doors closed but I still forget sometimes.
--
You know it's time to clean the refrigerator
when something closes the door from the inside.
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On 2/23/2016 10:42 AM, KenK wrote:

My achilles heel is the upper cabinet door on the linen closet in my bathroom. Go to stand up (from the Throne) and it always wacks me in the top of my head! I keep forgetting to keep it CLOSED... :<
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Uncle Monster posted for all of us...

+1 The brim is the problem. When I was a FF we used the newer style helmet which didn't have much of a front brim but the face shield would pivot up and one could still see. The problem was with the SCBA. couldn't see much peripherally. Now thermal imaging cameras work wonders.
--
Tekkie

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On 2/22/2016 4:45 PM, (PeteCresswell) wrote:

As a HVAC guy, I'm in and out of peoples cellars. I find that facing the stairs gives my feet more grip. And less likely to hit my head.
--
.
Christopher A. Young
learn more about Jesus
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wrote:

I was 68 and one day walking down the stairs, my left leg kept bending, collapsing, and I had to hold on to the railing with my right hand to avoid falling to the left. I made my way down the whole flight of stairs like this, and then I rested at the bottom for a minute.
Then I was fine, and 8 months later, it hasn't shown up again.
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Per Micky:

Husband of a couple we socialize with had that happen - but he fell down the flight of stairs and blew out his knee.
--
Pete Cresswell

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