There is a post here on the forum that has really taken off from legal matters to patients trying to figure out how screwed up the health care system is here and abroad (the UK). One of the topics throughout that post is whether or not a doctor would even tell you if there was a problem; I wanted to keep this going to see if any of you have found this to be the case.
I do want to address Kenkeith as he believes a doctor would never withhold information, even life threatening information, which happened in our case. (we were told our daughter had nothing wrong with her heart at 6 years other than WPW. She had a severe cardiomyopathy (HCM), ended up in heart failure by 13 and had to have a transplant at 22) Doctors do have issues with patients even going as far as to not treat them while they are hospitalized. Here's an example, Ken, I would like to know what you think about this:
My daughter was seen at a major medical center who had a pediatric cardiology department with 2 physicians; one being her doctor. She went into A-Fib (which could have killed her because of the Hypertrophic Cardiomyopathy; this is a very serious problem because of the HCM) The night she was admitted, her own cardiologist was there, but he left for a week the following day. The other cardiologist refused to take care of her for that week; we saw him several times because he had one of his patients on the same floor . He never once came to see our daughter or do anything to help her, not even when she had to be transferred to the CCU (Coronary Care Unit) when she got into trouble one night, The residents on the floor took care of her, even though they didn't really know what they were doing either. ( I can't blame them for that one) What do you think about a doctor like that? (Don't kid yourself, our doctor was absolutely LIVID when he returned the following week. So not only have doctors withheld information from us; they have gone as far as to not treating her! Remember that if a doctor does not tell you something, you don't know about it unless you really understand exactly what is going on to ask the right questions. I knew the questions to ask and all it got me was a doctor and his group of 10-12 Fellows who were obviously TORKED off at my audasity to even question them! We have been all over this country to the best medical facilities this country has to offer from Houston's Medical Centers ,to The National Insitutes of Health; we've seen good doctors and bad, believe me! There are A LOT of doctors out there who withold information from their patients; they judge you on how they think you will react to what they say and if they see any panic, they watch what they say, just the same as when medical records get rewritten saying tests were done on a certain day, even if you have had a blotched up surgery. (My major surgery actually disappeared from my hospital records and was replaced with a cath report that had actually been done 5 years earlier!!) So, as I asked earlier, what do you think about things like these happening? ( I do want to add a note that the doctors who first diagnosed my daughter as being perfectly fine were in the UK, not the US)
In Feb 07, I had my heart attacks and received emergency Angioplasty. A stent was put into my Obtuse Marginal and the attacks stopped. I thought it was all over. The cardiologist informed me that my left artery was 80% blocked near the top and it would be a simple matter of cleaning it out. For the next year, waiting for the procedure, I felt very comfortable, knowing I could be back to normal. When I arrived at the hospital, a different cardiologist had looked at my angio images and disagreed with the treatment. He said the blockage was 100%, not 80% and I would require a triple bypass. I got the other cardiologist on the phone and demanded he came to see me before anything was done. He basically said "well, 80% or 100% it looks like its too difficult to use angioplasty and you need a bypass". In a whole year I was looking forward to a simple procedure to put me right, now I was facing having my chest opened up.
The bypass failed after 3 months.
Ive been told by one cardiologist i need a transplant, another has said this is rubbish. Ive been told a redo-bypass is best, others have said it will never work. I was told by many cardiologists at three major heart hospitals it would not be possible to stent the blockage in my left artery. Yet, I now have an open left artery with 5 stents.
Cardiologists must all be taught different things because they all seem to have their own opinions and go with them, but they may not be the right one. I bet every single case would receive 5 different opinions from 5 different cardiologists.
In hospital last year, a junior cardiologist told me that the tiny vessels in my heart were blocked, there is no cure and if I didnt agree to transplantation I would die. Later the consultant apologised saying the junior had been reading someone elses notes, not mine.
I strongly believe we have to understand our own case, learn everything we can and keep asking them WHY. If I hadn't have done this, my LAD would still be blocked and I would be on a transplant list.
This is just from personal experience with me and family members. Doctors DO with hold information from patients. I think its part of what you hit on Grendslori and part because we as patients want someone to blame for what is causing our problems and sometimes doctors don't have the answers and or they do and don't want to admit it.
If I had seen my EKG from my dr in 2005-2007 there is no way I would have waited to see a cardiologist.He put down in his notes I was having no symptoms on those particular days [even with bigeminy & trigeminy each time; rbbb; some other things on the ekg's] 4 doctors I have seen now said there was no way he should have "missed" or overlooked those ekg's and signed off on them. I had complained of chest pain & sob previously in his office 3 separate times, and he had it in his files on the same page as the ekg results.
I want to blame someone - find the cause of the problem which we may never know. I want someone to tell me when this happened to me, why it happened and know if I could have saved myself some pain if this dr would have told me and not kept me in the dark.
"He put down in his notes I was having no symptoms on those particular days [even with bigeminy & trigeminy each time; rbbb; some other things on the ekg's] "
Just curious, what were the "others" mentioned on your EKG? The issues listed would not cause symptoms of chest pain or SOB which may be why the two were never connected, hard to say.
I know that my EKG shows an RBBB and I was never told as well, I only found out when I saw a different doctor in the office as mine was out. When I asked my original doctor why he never told me he responded that after reviewing the results of my echo and stress tests, there was no prognostic significance to the RBBB, which is backed up by what I have read since. My cardiologist also saw the RBBB on my EKG and did not tell me for the same reason. I think I can live with that, they know my heart better than I do.
My cardiologist probably thinking a non English background patient wouldn't have any knowledge of HEART. He hide my wpw for 20 years. He told me the wpw has fixed. I can feel my chest is not right since 2005. I tell him everytime when I see him. He told me it is nothing wrong. My heart is perfect. It is anxiety...... I went for a holter monitor without his permission. It came out "Pause" 3.2 second during the day time. Plus a lot of discovering. I showed him the holter report and he threw it away. He said "didn't make sense.
I finally got a chance to see a second opinion cardiologist. He looked at my ecg. He told me my wpw is clearly showed on the ecg. Of course, I told him it has been fixed a long time ago according to my EP said. He also questioning about the "pause" with the pacemaker which is not right. The echo also mentioned I have "severe hypokenises", MI etc. Because the second opinion cardio don't want to take me due to my case is complex. He sent me back to the EP. The EP told me it is anxiety, nothing wrong with my heart. He said, they (second opinion doctor group) don't know how to read my ecg. They read it wrong!
I haven't seen my EP for a year. I think anxiety should see the psychiatrist not an EP though.
Frequent persistent pvc's [bigeminy & trigeminy] can cause sob if frequent enough or that's how my EP explained it to me. They can lead to cardiomyopathy (which I developed) and the CP may have been due to the over 54,000 pvc's I kept having; Sinus bradycardia (51 was my average on ekg's); Short QT intervals <360 ms [330-350]; short RR's and wide QRS'. That pcp signed off on ekg's and never said a word to me about anything other than an occassional UTI for 2 years under his care.
Meanwhile, he put me on Phentermine [amphetimines] for 6 full months for weight loss, which my EP thinks did valve damage. I was dx after surgery with malignant pvc's and had to have a pacemaker/icd implanted due to long runs of polymorphic vt's and v'fib episodes.
QUOTE: "I do want to address Kenkeith as he believes a doctor would never withhold information, even life threatening information, which happened in our case. (we were told our daughter had nothing wrong with her heart at 6 years other than WPW. She had a severe cardiomyopathy (HCM), ended up in heart failure by 13 and had to have a transplant at 22) Doctors do have issues with patients even going as far as to not treat them while they are hospitalized. Here's an example, Ken, I would like to know what you think about this:
"Would never" knowingly withhold vital, life-threatening information is not exactly what I said. I try to never say everything or something is all inclusive as the word never implies. To put a good doctor's practice into proper perspective one would need to weed out incompetence, drug dependancy, greed, understaffed leading to negligence, etc.
As an example, there is rationing for heart transplants in the USA, and the information that one does not qualify when aged greater than 70 years is not withheld from patients. No need to lie and say one has a heart sufficient enough not to be a problem, and no transplant is needed!....there is no rioting in the streets as has been said. When there is a shortage there is rationing...not the doctor's fault.
I had that experience with my first doctor who staked out the emergency calls and ICU and caught me at a weak moment. He stated after reading reports, I needed heart transplant. At the time the doctor either lied to me or he is incompetent and greedy ....because I don't/didn't need a heart transplant, I can conclude either the cardiologist had lied, is incompetent and greedy. The doctor didn't speak English very well (that could be an issue...only understands when convenient, and didn't answer questions) , and he wanted to do a stent in my 72% circumflex after he had implanted an RCA stent about a 2 month's prior ...couldn't answer my question why it was not done at the the time of RCA implant...gaining knowledge of my condition from health forums, etc) and before I could smack him around he left the state a week after wanting to do the implant...sent me a bill for the consultation!:)
I now have a cardiologist that explains, shows an interest, etc. He would have no reason to lie or withhold information...he has informed me I need a mitral valve, but we agree to wait as I have no symptoms....its my call.
Change doctors if there is incompatibility. I have encouraged posters to learn as much as possible about the medical condition that is a problem so as to ask the correct questions when talking to a doctor. No one should expect a doctor to give answers that are not asked and what is considered medically insignificant. You did it right, but many do not know what to ask.
I've had a lifetime of experience, and I would not mislead anyone and tell them to put their entire trust in a professional evaluation, etc. for the reasons I have stated.
What do you believe is the underlying cause for your daughter"s mistreatment for good medical care? Shortage of qualified doctors and health care? Personal? Monetary?
Of course some doctors withhold information. As a law student I have come across cases in which doctors didn't tell their patients they had life-threatening problems because the doctors didn't think anything could be done to help them. Big mistake, doctors - PARTICULARLY when you're ignorant about the fact that something often can be done and you're just unaware.
A little over cynical I would say. I understand how some have experienced issues, but I would have to say it would be more a case of incompetence than withholding information. Do some doctors make mistakes? I'm sure they do just as lawyers do, pilots do, law enforcement officials do as well. I just don't think a doctor would take the time to test and diagnose a patient and then think, "I believe I'll just keep this information to myself". Why would a competent doctor find a life threatening condition and with hold that information? I know that I have always checked my doctor's record and background on line, pretty easy to get that information. I wouldn't see one that had a bad track record and I am capable of making that decision.
I am certainly more skeptical of lawyers than I am doctors, there is more of an opportunity to gain from some one's misery as a lawyer with far less consequences. I have had more bad dealings with lawyers in my career than I have with doctors so that is the experience I base my thinking on but I don't condemn all lawyers, I check their record out before I deal with one. Others have a different perspective I'm sure
I know there are others who disagree and for good reason, but I just think for the most part the medical profession can be trusted. We all have to do our parts, be informed, ask the hard questions and if something doesn't make sense, get another opinion.
I think its a mixture of things. Firstly as I stated in another post, Cardiologists are under a lot of pressure due to the number of patients they have to deal with. On average, each cardiologist in the UK has 60 patients to handle. If we say a third of these are severe cases, it is still too much to handle. However, the more they get through, the better their performance looks and the better the hospital targets look, making more money in the form of bonuses available to cardiologists. Now, like most humans, cardiologists want a good return for their hard work. I know many think they are all samaritans, but they are not, or else they wouldn't have big houses and the latest cars etc. Most have their children attending private schools so there is really no charity involved here.
A cardiologist is going to deal with the cases he feels will be successful first, putting the others on hold or really making it appear that something is being done, such as altering medication. I experienced this when seeing one particular consultant. He said he wanted to see me every week and each week he said a decision would soon be made. Six whole months later, I asked "whats the point in me coming here. Either you cant do anything and are stringing me along, or you are using me to look like progress on your statistics". He agreed instantly that nothing could be done and suggested I try a different hospital, but it took 6 months for him to say this and only because I got angry and questioned him. As patients we dont see the politics/economics of the hospitals but if you stay in hospital for a long period of time it soon becomes apparent there are immoral things going on.
I put incompetence of doctors under the unbrella of unsuitability. That not only includes improperly trained but not able/fit to practice effectively. It can include in house pressures to meet a quota, pressure to reduce costs, etc. As an example is HMO insurance. The policy includes their own doctors under contract as well as some hospitials. That is a perscription for abuse of patients' health care. A good, competent doctor does not work in that environment. A component doctor does not have a motive to lie.
I have read there is discussion for rewarding hospitals included in the Healthcare Reform
plan. Hospitals can be rewarded on successful treatment of a patient by acknowledging those hospitals that have fewer rehospitalization rate. That would be reasonable and no problem. But rewarding a doctor for successful treatment doesn't motivate good medical care as the doctor may only treat those patients where there a good possibility of a successful ooutcome.
Nick, I had 3 close relatives that are/were attorneys. My brother-in-law died of liver damage and he was an associate of a large firm in Miami. Florida. The profession engages in dishonest billing, hours misrepresented, hours aren't actually worked but charged to the client, the rate by associate is billed at partners fee, etc. and that is learned very early in the career of an attorney. It has already been said if a doctor fails to make a diagnosis or misdiagnose there are avenues of redress. Competent doctors are motivated to tell the truth, attorneys are motivated to lie...guess who I would believe.
Frankly, I can't believe that a doctor knew, then withheld information because (s)he didn't think there is any successful treatment available. To take that position just doesn't make sense! Obviously, that would be the plaintiff's position in a lawsuit and good material to review for class discussion.
The legal profession certainly has its share of crooks, but that is irrelevant. The issue is whether doctors might withhold information. I've run across cases in which the doctor admitted to withholding information. This is not a subjective issue - it's a fact. It happened. It has nothing to do with the plaintiff's argument, lawyers' trustworthiness, or any other such factor.
If one doctor has done it, it's not unreasonable to think that many have done it but have gone undetected.
If you want to talk about lawyers, which is an entirely separate issue, I'd say they are generally misrepresented. Many lawyers pad their bills, but that doesn't mean that all lawyers do so. One could point out that doctors walk in the door, give terrible advice with terrible bedside manner, walk out and charge $200 for a 5 minute visit that produced no results. Sounds like bill-padding to me. But that doesn't mean all doctors are crooks. Most lawyers and doctors I know abide by strict codes of professional responsibility, the violation of which can ruin their careers.
"Big mistake, doctors - PARTICULARLY when you're ignorant about the fact that something often can be done and you're just unaware."
This statement makes no sense and it implied that a doctor would withhold information because they're ignorant, that was a pretty damming statement. There are legitimate reasons for a doctor to withhold something if it has no prognostic value. The tone of your comment was overtly negative towards the medical profession as a whole. I also don't think you can compare the two professions. Lawyers work by a code in which they are bound to follow when interpreting law, it's all black and white in written form outlining the way they must conduct themselves. Medicine is a science and as such is subject to many variables, some that do not apply from patient to patient. What is medically relevant to one may not be to another. Much of what a doctor does is conjecture and the risk must be weighed against the benefit, not something that has to be done in the legal profession.
FYI, I have paid more than $200 for a short visit to an attorney that gave me terrible advice and they had no problem taking my money or thought to give it back when he was wrong.
"I just don't think a doctor would take the time to test and diagnose a patient and then think, "I believe I'll just keep this information to myself". Why would a competent doctor find a life threatening condition and with hold that information?"
"There are legitimate reasons for a doctor to withhold something if it has no prognostic value."
Guess you answered your own question.
The statement that you quoted above makes sense just fine. It is not the doctor's place to withhold medical information from his patient. The patient has legal rights, and knowing about his or her medical condition constitutes a big part of those rights.
It is PARTICULARLY egregious when the doctor withholds information thinking nothing can be done to help the patient when the doctor is ignorant about treatments that are available. The doctor has a legal duty to his patient to act in accordance with standards of care that are commonly accepted in the medical community. Unfortunately for the doctor of whom I speak, ignorance and failing to keep up with the medical literature is not an excuse. The law agrees.
Don't misunderstand me. I have great respect for many physicians, but they tend to be academics at large university hospitals who keep up with the literature and don't provide medical care in situations about which they are ignorant.
You are taking my statements out of context, but I expect that from a lawyer:)
"It is PARTICULARLY egregious when the doctor withholds information thinking nothing can be done to help the patient when the doctor is ignorant about treatments that are available. The doctor has a legal duty to his patient to act in accordance with standards of care that are commonly accepted in the medical community. Unfortunately for the doctor of whom I speak, ignorance and failing to keep up with the medical literature is not an excuse. The law agrees."
To say a competent doctor withholds life saving or pertinent information is ridiculous and you know it. It would be no different than a lawyer learning something that would set his client free but decides to keep it to himself just because he can, it makes no sense. You can argue the point all you want, but competent doctors that have spent a good portion of their lives not to mention acquiring a huge debt to their profession would risk everything by withholding necessary information just doesn't hunt, sorry. Can there be incompetence, yes. However this is the vast minority as incompetent doctors don't last too long and dishonesty just does not run rampant in the medical profession. There simply is nothing to gain but the loss of a career is a real consequence.
I am not impressed by some one taking my statements a twisting them so twist away, it will be good practice:)
The paragraph you quoted wasn't really in response to anything you'd said. It was an original assertion. I think we're talking past each other. I'm not suggesting that a doctor would withhold life-saving information. I'm talking about an ACTUAL CASE in which a doctor did not inform his patient of a diagnosis because he thought nothing could be done to help her. He was wrong - something could be done. And my point is that the doctor should never withhold a diagnosis because (1) the patient has a right to know, and (2) if he's withholding the diagnosis because he thinks nothing can be done, he damn well better be right that nothing can be done, or else the damages in a lawsuit will have him jumping out of a building.
Now, whether you can believe that a doctor would do this or not isn't really the point - it happened, it went to trial, the doctor admitted it, and it's recorded in a dusty legal reporter somewhere. Facts are not up for debate. Now I'm asserting that if this happened once, it probably has happened a lot - we just haven't heard about it. The latter statement certainly is up for debate, because I have nothing to back it up.
I understand your point, but one case should not be used as a reason to believe this is rampant among the medical profession. There will always be exceptions, doesn't mean there's an underlying environment of dishonesty and incompetence in the system, not a fair point of conjecture.
Jon, focused on the point that the original post didn't make sense and there isn't much to add. But it seems you were/are mostly conclusion oriented with your dialogue. Conclusions are not facts as has indirectly been pointed out....and now say it probably happens with some frequency is another conclusion...but it is a reasonable conclusion based on probabilities. Case closed.:)
I'm enjoying this - more than I should - so I'm not letting it go.
I'm not sure what you find conclusory other than my extrapolation of this seemingly isolated incident. I admitted that was conclusory.
When you read a legal case, you see findings of fact made by the court. In the particular case I'm talking about, the jury found that the physician had concealed a diagnosis. Yeah, maybe that's conclusory, but what else would you conclude when the physician himself admits that he did it? That he didn't do it?
What's conclusory is going off on a tangent about how crooked lawyers are when the point of this entire thread is whether doctors conceal information. Whether lawyers are crooked has no bearing on whether doctors conceal information.
"There are legitimate reasons for a doctor to withhold something if it has no prognostic value."
A doctor can write anything in the records and say anything to a patient if he needs to. How can we possibly know the information in a doctors head. If a doctor decides a patient will not be cost effective, he could simply say he/she is doing very well on medication. It is unlikely if there will be any come back because we can all die of heart attack at any time. I know that in the UK the body will only be examined if the doctor is unsure of the reasons for death. If someone is know to have heart problems, this is simply written on the death certificate and end of story. We talk of ethics in hospitals but even in the uk it was discovered certain hospitals were taking organs from the deceased when no donor card was issued and without next of kin consent. Mothers discovered their babies had been mutilated to remove vital organs for transplant without their knowledge. Believe me, if we dig deep enough, the discoveries will have us all too scared to ever go into a hospital again.
I believe my cardiologist wrote all over my file "anxiety". He won't admit any of his patient will die of heart related. If he admits his patient die of heart related then he is the one - cardiologist has to take responsiblity. MY CARDIOLOGIST WILL WRITE ON MY DEAD REPORT AS I DIE FROM "ANXIETY"!
I haven't been on the forum in a few days and really got a shock coming back on finding all of your posts! Heck this has been such interesting reading, I haven't even wanted to stop long enough to go grab a second cup of coffee! And Pika, your last comment really made me laugh!! :)
Ken, you asked me what I believed was the underlying cause of my daughter's mistreatment for good medical care. With everything that Ed34 has written about, I have to question if that was what was actually going on with us. It was obvious that the cardiologist that she was first sent to had predetermined that he was not going to diagnose her with HCM, which is terminal That was established BEFORE he ever saw her or examined her. There must have been a huge arguement between the cardiologist and the cardiologist who ran the echo on her; the doctor who ran the echo on her agreed the HCM was not only there, but was so obvious, that there was no way anyone could miss it; her wall thickness was that of a grown man. The diagnosing of children with terminal illnesses is different than diagnosing adults; children haven't lived a life yet. many young doctors look at the child and think about their own children at home who may be the same age and they consider what this sick child's life is like. They have, for the most part, a great deal of empathy for the parents. We've had many doctors over the years, who would not even look at us when they would talk to us. As odd as this may sound, knowing the right questions to ask can actually hurt you as a patient. I've had doctors who admitted being scared to death of me because of the knowledge I had with this disease; I've had doctors ask me HOW to treat my daughter when she was in the ER because they didn't know what to do with her. They didn't know how to treat her, because they had nevcer seen a patient like her before; if they tried to deal with the electrical problems, the muscle problems became worse and vise-versa. A few of the doctors resented the knowledge I had; including the doctor I mentioned at the beginning of this posting. The vast majority of care my daughter received was very good care; even when the doctors didn't have a clue, they certainly tried above and beyond. Monetarily, there was no real gain as far as I know, with the exception about what I am finding out about the bonuses Ed has been writing about on here.
Erijon, You made mention about checking out the doctors on line; not everyone has a computer or access to a computer and there are some of us who are just flat out computer dumb! LOLs! Asking the hard questions can be really difficult, that is why so many write on forums like this; they are too afraid to confront a doctor in a one on one basis. You also have to know WHAT questions to ask. It's the same old thing of "How do you look up the spelling of a word if you can't spell it in the first place?" The vast majority of patients don't have a clue what to ask; many want to know how long do they have to live, being faced with heart disease, but are just too afraid to ask. I would never agree that the cardiologist we saw was incompetent, not by a long shot; why he chose to keep a life threatening condition from us is really beyond me. I can't even say it was because there was no prognostic value; I could have allowed my 6 year old to run around and drop dead as a result of that. There was a life that had to be lived without free reign, but with major restrictions. Had it not been for the fact that she also had Juvenile Rhuematoid Arthritis and she was restricted by that disease, she could have dropped dead from the HCM and arrhythmia problems. For a period of eleven months, she had no treatment for a cardiac disease that was killing her.
So if many of you believe that doctors
I also have to question just how much input is made by drug companies with their very persuasive purses of money. Heart patients are like sheep, consulted, probed and then put onto statins. I know a few people who are on statins and yet had normal cholesterol levels. If you ask your cardiologist "if 75% of people with normal cholesterol get heart disease, why is it the number one blame" they simply say "because it is the cause". Since fat was seen lining arteries in an autopsy, a brilliant scientist decided "hmm, fat, so it must be caused by fat in the flood, end of story". For decades this idea has stuck and yet still not everything is understood about the chemical processes with cholesterol. It actually frightens me each time I take a statin/aspirin because I wonder if I am really doing the right thing. Am I doing something which is based on real fact, or am I simply another sheep doing what the drug companies claim is the right thing to line their pockets. I feel sure I'm not the only one who feels this way.
I can't dispute what happened to you, it is wrong on so many levels. However, I base my beliefs on my personal experiences, and what I can do to protect myself. At the same time, to discount my experiences along with all those that don't have a mistrust of the medical community is also just as unrealistic.
Here's the truth as I see it when it comes to forums. You will ALWAYS see more people post that have had adverse situations and outcomes, it is the nature of a forum. The vast majority of people have not had the issues you have confronted, they have had positive experiences like myself and they just don't post as they have no need.They have no experience to add and have moved on. When confronted with a situation as you have, that's not possibe, I know I couldn't move on. I also don't share the doom and gloom world that Ed describes, I don't think it's that bad. Someone show me evidence that doctors and hospitals intentionally compromise patient care for profit. I keep seeing this argument but no evidence, just conjecture.
This is a thread that will not bring anyone any closure, nor will it change anyone's personal experience or opinion. I trust my doctors and the advice I have received. I do my homework and if something they tell me doesn't make sense I call them out on it. Let's face it, there have been many plane crashes that are the result of pilot error and documented cases of airlines covering this up. I still fly 50 plus times a year and just got off a plane an hour or so ago. I don't condem the airline industry over isolated experiences of pilot error and airline coverup. Nor do I sit on a plane and wonder if the pilot is doing everything he is supposed to be doing, that's no way to live. I avoid airlines with a poor track record as well as discount ailines, that's what I control.
It has been interesting to see everyone's opinions however.
QUOTE: "A few of the doctors resented the knowledge I had; including the doctor I mentioned at the beginning of this posting. The vast majority of care my daughter received was very good care; even when the doctors didn't have a clue, they certainly tried above and beyond. Monetarily, there was no real gain as far as I know, with the exception about what I am finding out about the bonuses Ed has been writing about on here".
Grendslori, I touched on the subject Health Maintenence Organizations (HMO's) HMO's. Typically, this is an insurance option provided by an employer (HMO gives a very good deal for the employer to cut premium costs)...I wouldn't be surprised to see many lawsuits from this type coverage...I kinow some medical outcomes that should have been adjudicated.
The HMO is an organization for health insurance and has a network of providers, doctors, hospitals and labs with whom the HMO has negotiated a fee schedule, and where you must receive a referral from your physician before visiting a specialist outside the provider network. With rare exceptions, such as when you are away traveling, you are limited to seeking care completely within the network of providers, doctors, hospitals and labs . Since contracting discounts from a network of providers is one of the primary ways a HMO maintains cost effectiveness, the plan only works when you stay within the network....If a doctor does not meet the expectation of cutting costs there may not be a bonus, etc.
Competent doctors don't want their ethical standards of good quality care compomised by a severe restriction of costs vs. quality of care of their patients. I believe an HMO has a procedural policy that rewards hospitals based on a low rate of rehospitalization and that may be ethical and fair, but to reward doctors based on cutting costs is in my opinion is a breach of good healthy doctor/patient relationship. If nothing else there is a perception of unethical conduct. Don't buy HMO insurance, and the USA does not have nationalized health insurance so you should not worry about corrupt doctors from that aspect. I have had HMO insurance, and I know people that have not gotten good health care due to costs, and being told surgical intervention was not needed...no death iinvolved.
Before I can accept the proposition that doctors are inherently dishonest and withhold vital health care information requires knowledge of a reasonable basis. Competent doctors abiding by ethical principles of quality care to the best of their ability is the basis of the medical profession and almost always the motivation for an individual to get into the profession. For a medical doctor to risk losing their license to practice medicine or very high malpractice insurance premium (or risk of losing) after the time and expense of becoming qualified doesn't make sense, if it doesn't make sense it almost always is not true.
Jon and Ken, thank you both for your inputs; I have learned so much through reading all of these postings. I do want to clarify something; overall, we have received very good care for our daughter. We did not belong to an HMO during all of her care (however, we do now and I don't like it!) My husband was in the USAF at the time and all of her care were through civilian centers (along with some military centers in Texas) One of the reasons I started this post was to continue on from another post which I found very interesting; I really started wondering if patients on here had experienced some of the things we had with doctors witholding information or care. This has been interesting!
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