Brandon Newman95 said:Look, here’s how I handle it: first off, I make sure I’m setting aside enough for my retirement and health insurance. For the first part of my retirement savings, I put away 15%, and then there's the second part where I'm required to contribute, so that's another 5%. On top of all that, I have basic health coverage, but I also pay extra for supplemental insurance, which runs me about $43 every single month. Honestly, thank God I actually signed up for it—if I hadn't, I would've gone totally broke. I really needed it last year, and I definitely need it again this year. Plus, I’ve had to shell out for private tests too—some things were covered by a referral, some I paid for myself, some EEG tests, you name it. If you counted every single ailment I've dealt with and what it cost just to see my primary care doctor for prescriptions I absolutely cannot stop taking, I’d be penniless. So, on top of all those deductions, I’m still paying out of pocket for private visits and even some medications. To top it all off, I urgently need a gynecological exam. Let me tell you, if I call one of our local hospitals: the wait time is like a month and a half! What am I supposed to do? I need this done within a week. Should I head to the emergency gynecological clinic, go to a private doctor, or is there something else?
Look, I run into this issue constantly (it’s not gynecology, but the principle is identical). With EMERGENCY exams, you don't just "wait" in the traditional sense; you show up at the ER clinics and then you either wait your turn based on when you arrived, or—depending on how critical things are—you get bumped up the line. That's how it works that day. But here’s the kicker: if you personally feel like your situation is an absolute emergency, but the doctor decides it isn't... well, that's where the friction starts. Every single time. Now, "urgency" is usually pretty clearly defined by medical standards, but let's be real—patient pressure, the fear of making a mistake, the terror of being sued, and all sorts of other paramedic-level anxieties mean that the ER is always absolutely slammed.
It is pure absurdity that the ER of a single hospital serving a population of maybe 50,000 to 70,000 people sees up to 20,000 patients a year—plus all the people who bypass the main ER because they come straight from a city urgent care or their primary care physician. If those numbers were actually accurate, we'd be looking at thousands of deaths every year just from "emergency" cases alone.
Brandon Newman95 said:Look, here’s how I handle it: first off, I make sure I’m setting aside enough for my retirement and health insurance. For the first part of my retirement savings, I put away 15%, and then there's the second part where I'm required to contribute, so that's another 5%. On top of all that, I have basic health coverage, but I also pay extra for supplemental insurance, which runs me about $43 every single month. Honestly, thank God I actually signed up for it—if I hadn't, I would've gone totally broke. I really needed it last year, and I definitely need it again this year. Plus, I’ve had to shell out for private tests too—some things were covered by a referral, some I paid for myself, some EEG tests, you name it. If you counted every single ailment I've dealt with and what it cost just to see my primary care doctor for prescriptions I absolutely cannot stop taking, I’d be penniless. So, on top of all those deductions, I’m still paying out of pocket for private visits and even some medications. To top it all off, I urgently need a gynecological exam. Let me tell you, if I call one of our local hospitals: the wait time is like a month and a half! What am I supposed to do? I need this done within a week. Should I head to the emergency gynecological clinic, go to a private doctor, or is there something else?
Well, I went ahead and ran the numbers for you—roughly, at least. Do the math: figure out your age and how much longer you expect to be around. Now, imagine if tomorrow you suddenly ended up needing dialysis—could you actually afford that if you had never contributed a single cent to the healthcare system? If you hadn't, you'd be stuck paying the full, brutal price for treatment right now. Believe me, you aren't that wealthy—and honestly, neither are you nor the vast majority of people in this country.
And listen, you're assuming you're the one paying into the basic health insurance, but I'm pretty sure your employer handles that part, not you—meaning it isn't being deducted directly from your take-home pay. Correct me if I'm wrong on that. What actually comes out of your own pocket is that supplemental insurance you mentioned, plus whatever medications you end up buying yourself.
ruggedscout91 said:The issue is she didn't go to a private clinic. She went to the very institution we all fund with our taxes, yet we still find ourselves waiting behind everyone else in line. Furthermore, why is it that during major surgeries—say, an imminent pelvic organ collapse involving the small intestine due to a massive myoma that they failed to diagnose early—a patient is forced to endure ten days of testing? They could simply admit the patient to that same facility to run those tests. Is it really necessary to travel to a major General Hospital from a small town just for that? Not everyone lives in Los Angeles, Miami, or Chicago. We end up traveling for 932 miles at least ten days. It’s absurd. And what if a small intestine ruptures during those long journeys? One less American. A convenient solution for the masses.
Similarly, the role of public healthcare needs some clarification. I once worked in a public health institution in another country. In America, I fail to recognize any meaningful role for public health beyond promoting subpar vaccines for Hepatitis B or certain flu viruses. Preventive care is practically non-existent.
Private gynecological practices have essentially hollowed out primary care, and quality has plummeted as a result. How does that happen? Even the most trivial ailments become massive systemic problems in a setup where the goal is to bill for services rather than actually cure patients. How can a standard color Doppler ultrasound fail to detect a 20 cm myoma?
Look, I personally have about ten different pre-op exams to run through every single day. Now, just imagine if I tried to admit all ten of those people to the hospital every day—it's impossible! Usually, I only have a maximum of eight beds available for all internal medicine cases, and sometimes I'm down to just three. You simply cannot meet everyone's demands.
If they think it's just a myoma, then there is absolutely no reason to be hospitalized just for pre-operative testing. If someone didn't catch an appendicitis, that has nothing to do with a myoma.
I get it, there’s a social component here, and there are real social issues at play, but a hospital isn't the place to go solving those kinds of problems. Don't come asking me where else they should go to solve them, because you might as well ask me where an unemployed person is supposed to find a job. I don't know.
ruggedscout91 said:The issue is she didn't go to a private clinic. She went to the very institution we all fund with our taxes, yet we still find ourselves waiting behind everyone else in line. Furthermore, why is it that during major surgeries—say, an imminent pelvic organ collapse involving the small intestine due to a massive myoma that they failed to diagnose early—a patient is forced to endure ten days of testing? They could simply admit the patient to that same facility to run those tests. Is it really necessary to travel to a major General Hospital from a small town just for that? Not everyone lives in Los Angeles, Miami, or Chicago. We end up traveling for 932 miles at least ten days. It’s absurd. And what if a small intestine ruptures during those long journeys? One less American. A convenient solution for the masses.
Similarly, the role of public healthcare needs some clarification. I once worked in a public health institution in another country. In America, I fail to recognize any meaningful role for public health beyond promoting subpar vaccines for Hepatitis B or certain flu viruses. Preventive care is practically non-existent.
Private gynecological practices have essentially hollowed out primary care, and quality has plummeted as a result. How does that happen? Even the most trivial ailments become massive systemic problems in a setup where the goal is to bill for services rather than actually cure patients. How can a standard color Doppler ultrasound fail to detect a 20 cm myoma?
Let’s get one thing straight: not everyone is actually paying. It's the people working who pay, and even then, it’s not even them—it’s the employers paying on their behalf. The average American barely contributes anything to the healthcare system, yet they expect the world from it. Just look at the math: if you take an average US salary of maybe $3,000—$2000 let's say about $500—$333 goes toward health insurance premiums every single month.
Even if I grab the highest possible number, say $1,000—though most people are definitely contributing way less—that means in one year, you're looking at $4000 over ten years, that's $120,000... $0.00 so over a 40-year career, we're talking roughly $480,000.$0.00
I was just reading that one year of dialysis can cost around $150,000. $0.00 So, if that patient worked their entire life, they might cover about three years of dialysis themselves, and someone else is stuck footing the bill for the rest... Most people have absolutely no clue what the actual price tag is for any kind of medical treatment—and don't even get me started on the cost of quality care.
@ ruggedscout91 Look, let's be real here—everyone knows that famous faces get treated faster and better everywhere else. So why on earth would we expect anything different when it comes to the US healthcare system? 🤷
Angela Wright said:We should be striving to meet people halfway when it comes to rights that are fundamentally guaranteed to any human being. The right to life, to health, to medical care, and to die with dignity—those aren't optional extras. No one has the authority to start playing favorites or deciding who gets full rights and who gets the short end of the stick.
Look, it’s easy enough to agree with that in theory, but translating it into reality? That's a different story entirely. What we're talking about here are philosophical musings that just don't hold much weight once you face practical application. In times of war, for instance, the lives of children, women, and the elderly are suddenly treated as more precious, while young men are basically relegated to cannon fodder... There is always someone, somewhere, making calls on matters they have absolutely no business deciding.
2. I haven't had a bowel movement since yesterday morning.
😁
3. They get a referral from their doctor for chest pains that look like pre-heart attack symptoms, but then they tell me they have a burning sensation when they pee. I call the doctor who sent them over, and he tells me he actually told them they needed to come in because of severe chest pain starting an hour ago... I could go on forever with this nonsense.
See, that last issue would be perfectly solved if we actually had a unified system where primary care doctors and specialists were all networked together. Person xy would have a single digital file containing every single note from every medical visit. Not only would coordination and communication become seamless, but other initiatives—like follow-up studies on recovery rates for things like cancer—could actually happen. Some altruists I know would probably build a system like that pro bono, but the problem is the government thinks such a thing would violate privacy rights. 🙄🙄🙄Think what you want.
People are working on it, sure, but when you're dealing with a system this massive—and let's be honest, dealing with IT-illiterate Americans—it’s an incredibly slow process. But hey, movement is happening. Right now, most hospitals are mostly digitized, but only within their own walls. A GP's office connects to its own central hub, whatever that might be. I guess the next logical step is connecting those hospitals to the central hub, and eventually, getting everything fully networked.
But let's look at the reality here: hospital digitization started back in 2006, and even today, it's still nowhere near finished.
There’s a hell of a lot that gets under my skin... But the truth is, the longer you stay in this line of work, the more you have to start putting death, the patient, and the disease itself into perspective—otherwise, you're going to lose your damn mind.
I get the distinction, I really do, but this is just the reality of the US healthcare system. Even if they tried to accommodate everyone, it’s simply impossible.
Alexander Lewis said:Kudos to you for having the guts to post that. I don't live in the States myself, but I find myself visiting quite often. I actually have family over there who work within the US healthcare system, and they’ve also dealt with it from the patient side of things, so I figured I’d weigh in.
It’s true that the process drags on way too long, especially once you factor in the residency requirements. But if you ask me, the quality is essentially on par with the University of California—not exactly breaking any records. At the end of the day, money makes the world go round, and in those institutions, people have managed to secure cushy positions despite having scientific careers buried under layers of dust. Nepotism is rampant there. How many of your colleagues in med school had parents who were already doctors? I’d bet it’s a staggering number. It’s honestly sad, but if you don't have those family connections in the States, you're looking at two options: either grab a job outside of a major hub like New York or Chicago, or face an uphill battle finding steady employment. It’s probably why medical school is becoming such an unpopular choice for students.
It’s a sad reality, honestly. We are looking at a direct consequence of a massive physician shortage. Fewer people are entering med school, and even those who do are being squeezed out because hospitals are mismanaging their funds. Instead of allocating enough budget to ensure doctors can cover shifts without working themselves into an early grave, they blow through cash on questionable expenditures. There’s zero oversight on equipment procurement, which is where the real money moves—controlled by directors who, more often than not, were appointed for political reasons rather than merit. Hospital doctors are caught in this impossible vice between Medicare, which refuses to provide decent pay or workable conditions, and patients who rightfully expect humane treatment. It’s tragic, but you see it all the time: frustrated doctors start moonlighting or running side gigs just to stay afloat. When that happens, they either fail at communicating with patients or the quality of care takes a hit, which is something I find hard to forgive. On top of that, there is this blatant "closed-door policy" in our hospitals. You sit there in a crowded waiting room like a ghost, staring at the wall, with no idea if you'll be seen in five hours or eight. It’s pure apathy—a "don't bother me" attitude that is fundamentally inhumane. Is it really that difficult to just share some numbers and say, "Hey, expect a four-hour wait"? How much common sense does it take to actually plan a workday?
If you’re interested, I know this from firsthand experience: it is absolutely infuriating how much mindless administrative busywork primary care doctors are forced to deal with just to satisfy Medicare. You have people who spend years studying to become physicians, only to end up wasting an hour or two every single day buried under a mountain of paperwork. On top of that, they’re being terrorized by constant billing audits and shifting thresholds for contract renewals. A portion of the costs gets pushed directly onto the primary care physician, creating a broken system that essentially exists only to feed the bureaucracy at the Medicare local offices.
Kate Collins67 Asks: Across the field emergency services throughout the US, with a few rare exceptions, you’ll find people who are woefully underqualified for the job. Most of them are just kids fresh out of med school without a single day of actual hands-on experience. Of course, if you want to point fingers, don't blame the paramedics and EMTs just trying to pay the bills; look toward the Department of Health and Human Services instead. If we follow that logic, things might actually see some improvement in five or ten years—once the first wave of true emergency medicine specialists finally emerges. It’s almost laughable, considering how much more advanced neighboring countries are in establishing dedicated emergency specialists while we're still stuck in this loop.
Some people argue that Emergency Medicine is actually the highest quality sector of the entire US healthcare system. I get why they say that, but let's be real. It’s definitely not the most glamorous place to build a career. You’re dealing with relentless stress, working out in the field, and pulling shifts at hours that defy logic. That explains exactly why you see so many rookies flooding the ER. It becomes the default landing spot for medical school graduates who don't have some well-connected uncle or family ties ready to pull strings and land them a cushy, prestigious position at a top-tier private clinic or a specialized hospital wing. When you lack those connections, you end up on the front lines.
meritas As stated by: If you look at most ER departments around the country, you’ll notice a recurring pattern: the front lines are usually manned by residents or doctors who just finished their training. It isn't exactly their fault, of course, but there is a glaring irony in the fact that the places where you need seasoned experience the most are often staffed by those still finding their footing. In some hospitals, there’s at least a decent level of oversight from a senior attending, but in others, these junior doctors are essentially left to fly solo because the necessary supervision simply isn't available. Don't get me wrong—this is just my personal take—but I firmly believe that strict supervision is absolutely essential. These residents are technically still in training; they shouldn't be expected to operate without a safety net. In my view, we should probably have laws mandating that kind of oversight to ensure patient safety isn't left to chance.
In the US, patients are generally left wide open. If a doctor makes a significant blunder, the odds of actually proving it—without a bunch of colleagues stepping in to downplay the error or "adjust" the medical records to cover their tracks—are incredibly slim. And even if you have an older physician overseeing things, what are the chances they’ll actually step up and do their job instead of just nodding along while the junior staff sleeps through a crisis because they know there won't be any accountability?
Are you suggesting that someone experiencing a dramatic medical crisis needs to be a medical expert or pass some objectivity test before they're allowed to show up at the ER? That completely undermines the fundamental principle that an insured citizen has a right to care. If I decide right now that I have a headache and it’s worrying me, I have the right to use my insurance to head to a hospital with an emergency department and ask for an evaluation. The sad reality in America is that many people flock to the ER because when they try to go through regular channels, they're told they won't see a specialist for months. That is a direct consequence of how the system treats patients. If regular appointments were processed within reasonable timeframes, the surge at the ER would naturally drop.
Honestly, I think the odds of the American healthcare system being better tomorrow than it is today are pretty much zero. Financial deficits will grow as abuses increase, Medicare administration costs will climb, we'll see fewer doctors, patient dissatisfaction will skyrocket, and new therapies will just get more expensive... On top of that, even now, doctors often suffer from a reputation of being corrupt, indifferent, or just plain incompetent. That image is only going to get worse thanks to media outlets obsessively focusing on medical catastrophes—you know, the stories about losing a limb after surgery, a pregnant woman dying because the OBGYNs were watching a game, or surgical tools being left inside a patient. It's fueled by a population frustrated by endless waiting lists, closed doors, and surly faces in hospitals. But most importantly, it's driven by the fact that politicians won't dare touch a rotting system that is financially doomed to fail, because they know it's a political minefield. Look, if a corporation refuses to pay its payroll taxes, how can its employees expect full health coverage when the funds aren't there? But what can you do? Denying them healthcare is political suicide. Punishing the company is impossible because the CEO or owner is usually a major donor to the party in power; you don't touch them. So, we just keep pretending everyone is entitled to everything, when in reality, there isn't enough money to go around. Doctors work until they collapse, basic supplies and reagents run out, and total chaos ensues. Nominally, everyone has rights to everything, but in practice, nobody can actually access them in this century—yet we all play dumb about that little detail.
Well, this one is a little harder to tackle. Let me throw out a few examples of how things get abused. 1. A patient rolls into the ER during regular business hours because they’ve had a temperature of 99°F since this morning, but they don't have any other symptoms. When asked if they've seen their primary doctor, they say, "Yeah," and what did the doctor say? "Nothing, it was too crowded, so I sent them here." 2. "I haven't had a bowel movement since yesterday morning." 3. Someone gets a referral from their doctor for chest pains—something looking like a pre-heart attack state—but then tells the ER nurse that it actually burns when they pee. I call the doctor who wrote the referral, and he tells me, "No, he told me his chest had been killing him for the last hour..." I could go on forever with this nonsense.
Emily Moore14 said:I still haven't found any explanation for this, so if anyone knows, could you please give me a layman's "translation" of what this actually means?
I’ll feel free to interpret this—even if I might be off base here—but essentially, it looks like you have fatty liver, or hepatic steatosis, which is part of some hyperlipoproteinemia caused by hypothyroidism... assuming, of course, that you actually have an underactive thyroid.
In plain English (assuming I'm reading between the lines of what they meant): you've got actual fatty liver. Usually, it's a reversible condition—it's often referred to as NASH—and why is it fatty? Well, maybe because your thyroid isn't cranking out enough hormones, which drags your metabolism down to a crawl, so your body is slow to break down fats, and—boom—they just start piling up in your liver. I don't know how much simpler I can make that.
Angela Wright said:Of course we're pushing for a hospice to open! Should we just stay silent about it?! The newspapers are being way too soft anyway; what would they even write? You've got people waiting three months for radiation, patients being denied meds because of some "cost-effectiveness" nonsense, and then they're just left to die like dogs. The government isn't doing its job—even though they explicitly promised to—and they aren't being held accountable. This isn't about whether a building has been constructed yet; this is about human lives and dying with dignity. We've been around since 2007, and considering how few of us are actually active, we've pulled off miracles in these two years within the society we live in. We hunt down media coverage like hyenas whenever we can, and we launched a website that gets massive traffic specifically to educate, inform, and provide support. We are all very aware that a crowd doesn't gather overnight, but someone has to kick things off, stir the pot, and get everyone else riled up. That's where the initiative is lacking.
And regarding that show link I posted—in this case, a doctor stood up and spoke out, but his own colleagues turned their backs on him in public. The only public support he received came from a patient. Once the pressure mounted, the problem was fixed. The hospital received emergency funding and the limits were raised.
I honestly have just one question here. So, they raised the limit for this particular hospital? That means from our pool of imaginary $33 hospitals, instead of having $6.75, we now have $10. All the other hospitals, the clinics, the community health centers—they've all been stuck with $27 until now, and suddenly this one gets bumped up to 70? Look, for someone to gain, someone else has to lose. It's just that harsh reality of life again, isn't it? One-off fixes don't solve anything in the long run, but hey, I suppose everyone has the right to fight for their own life and their own dignity.
Look, when it comes to the issues facing the country right now... they're all over the place. We have a healthcare budget—it is what it is. We have to work within the actual constraints we've been handed. If we tried to guarantee absolutely everything for everyone, we’d be chasing a pipe dream. So, let's get back to reality.
I hope we can all agree that it’s impossible for everyone to get access to every single thing—at least not under a socialized healthcare model. It just isn't practically feasible. I could easily quote the patient advocacy group from that link above, "Open Access," who basically said: "We simply need more money."
Prevention, without question, equals savings. But for prevention to actually work, we have to go back to step one: university education is subpar, and that's where the change needs to start. Step two: in a socialized healthcare system, a patient shouldn't be able to just decide whenever they feel like it which tests they want to undergo. Tests should only be performed based on a doctor's indication—and those doctors need to be held to strict criteria based on medical algorithms that, frankly, don't even exist yet. If we implemented that, we'd see massive savings and a genuine boost in the quality of care. Step three: if you want to do whatever you want, whenever you want? Go private.
Angela Wright said:Well, you've got it backwards, at least regarding the association I represent. We have never, ever, ever gone against the medical profession. On the contrary, we build and maintain excellent relationships with doctors. Everywhere we go, we emphasize how vital good working conditions are and highlight the high level of expertise we have here in the US; we collaborate heavily, especially on prevention campaigns and second opinion initiatives. Like I told you before, we actually experience the exact opposite: whenever we speak out publicly to advocate for medical workers' rights, the profession stays silent. Then, the government turns around and claims we're lying because, since the doctors aren't reacting, everything must be fine. Look, sorry, but we've practically swallowed our pride just to fight for you, and then when it's time to point out what's actually happening, you all just scurry back into your mouse holes... so where's the progress in that? How are patients supposed to get on your side and use the media effectively if this is how it works?
EDIT: here is a =63230&tx_ttnews[backPid]=23&cHash=f1ad1cca92%3E[tt_news]=63230&tx_ttnews[backPid]=23&cHash=f1ad1cca92']link to the show "Openly," which does a great job showing the difference between how doctors defend the profession versus how patients do. When you watch it, please try to view it through the eyes of someone who is sick, or maybe someone in your own family, rather than looking at it through a doctor's lens. It completely changes your perspective.
Look, if you follow the news, it’s always the same old story—every other headline is some exposé attacking a mistake here or a failure there, someone being blamed, someone being accused of negligence... but you almost never see a front-page story about an oncology patient advocacy group begging for more hospice care. I get it, you don't call the shots on what gets published, but I'm just calling it like I see it in the American press.
Sure, people can be weirdly indifferent, but that isn't just on the medical staff. Just look at how little anyone cared when the unions organized those strikes over pay cuts a year ago—or whenever that was. They didn't exactly break any attendance records, did they?
The truth is, both you and I are going to have a hell of a time fighting for anything just by "gathering people together"—because real change doesn't just happen overnight. My take? We need to spread awareness about the actual, underlying issues through every channel possible. Eventually, that critical mass will build up, and maybe then we'll start seeing a shift in the collective mindset.
Angela Wright said:Believe me, looking at it from the perspective of an oncology patient, you don't have to be stumbling drunk to get a tiny dose of actual "humanity." But hey, it is what it is; you get what you pay for. That logic applies everywhere, including medical services. Empathy is something they only bother writing about in palliative care textbooks—which, by the way, remains a total mystery in the US, even though we've been living in the 21st century for ages and its foundations were laid back in the Renaissance.
Let’s be real: palliative medicine practically doesn't exist in this country in any meaningful sense. We’re talking about actual hospices here. But look, there are a couple of cold, hard facts we have to face: 1. Most oncology drugs just don't have a logical cost-to-benefit ratio. (That’s the brutal reality right there) 2. There is only so much money in the pot, and within the system, it has to be allocated where it can actually do the most good. There’s more to it than that, but I don't want people getting the wrong idea.
To be perfectly honest, I have a massive issue with how this whole setup works—but if or when an individual like me actually has the power to change things, I’ll certainly give it a shot. For now, though? My hands are tied. Just a heads-up: this is strictly my own take, and I can almost guarantee most doctors aren't going to agree with me on this one.
But if you look at it from the patient's perspective, the problem is way more deep-seated, which means the burden still falls on the patients to force a change in the system. The thing is, "patients" usually go about using the media and other platforms all wrong. Instead of pointing out the specific, systemic failures, they just end up attacking the staff... I've listed a few examples below.
Just to clear the air—I’m actually a guy. My wife opened this account, but I didn't really feel like dealing with it myself, so here I am using hers.
Look, I’m in no position to be making any big moves or changing things right now, and there are two very specific reasons for that. 1. In the grand scheme of the corporate ladder, I’m pretty much at the bottom. 2. Until I finish paying back that 1,000 $0.00 debt to the system that supposedly "trained" me, I can't exactly afford to start throwing punches—if I lose my job, those collectors are going to be knocking on my door immediately.
Side note: we can't just band together and act as one because, let's face it, we don't all see eye to eye, and these changes aren't going to sit well with everyone.
Browsing through various threads on different forums, I’m noticing a pattern: there is a massive amount of general dissatisfaction with the US healthcare system among the general population (the ones actually online—and honestly, it terrifies me to think what the people who *don't* know how to use the internet are thinking). Usually, this frustration gets boiled down to just bashing the medical staff—which, let’s be real, is sometimes justified and sometimes isn't.
Here are a few points that people really ought to understand, assuming anyone here is actually interested in a deeper discussion...
1. Medical school in the States, much like the rest of our education system, doesn't provide an adequate foundation in my opinion (I've experienced this firsthand—it takes way too long and provides far too little).
2. Physician working hours—though not necessarily the hours for other medical staff, based on what I see around me—violate numerous labor laws (if I’m interpreting them correctly). For example: we're looking at roughly 60 to 80 hours of paid overtime every single month due to those 24-hour shifts that stretch into 25 hours minimum, every month of the year. Last year, I spent about 100 days pulling 25-hour stretches at the hospital; last month alone, I had 88 overtime hours, plus another 8 that nobody even bothers to record anywhere. Let me be clear: we don't have a choice whether we pull these shifts or not. Anyone who hasn't spent 24 straight hours on the job should probably hold their tongue before commenting. When you're in a state of exhaustion like this, it’s absolutely insane to expect a smile, warmth, or a good mood—even though I still try my best to provide that, I'm finding myself giving in more and more and becoming just like the people who make you so angry in the first place.
3. Primary care has completely failed (I don't know the exact reasons, but I see the results): it's likely a mix of administrative headaches and a total lack of oversight regarding "home visits" during those final hour and a half of the workday (have you noticed your primary doctor finishes up around 1:00 or 1:30 PM, even if their shift goes until 3:00 or 4:00 depending on whether they start at 7:00 or 8:00?). Then there's all this maneuvering regarding leasing offices versus running actual private practices. The bottom line? Very little actual MEDICINE is being practiced in general practitioner clinics.
4. In field EMS services across the country, with a few exceptions, the jobs are being filled by people who aren't quite up to the task—mostly young grads fresh out of med school with zero days of actual work experience. Of course, you shouldn't blame the individuals who are just trying to earn a living; you have to look at the Ministry for that. We might see some change in 5 to 10 years when the first true emergency medicine specialists finally emerge (from what I understand, specialists in urgent medicine already exist in places like Mexico—so much for our progress compared to our neighbors).
5. At hospital ERs, it’s usually residents or brand-new specialists on duty—again, not through any fault of their own (you notice the pattern: in the places where experience is most critical, you get people without it). In some hospitals, they have decent supervision from senior colleagues, but in others, they're basically flying solo because proper supervision isn't provided. Don't get me wrong, I personally believe supervision is ESSENTIAL; ultimately, it should be legally mandated, because residents are still in training and shouldn't be working without oversight. (That’s just my personal take.)
6. Here comes a crucial point that most people either don't grasp or simply choose to ignore, and it concerns the patients themselves. Anyone using the ER for every little thing (and there are a huge number of such patients) is directly endangering patients who are in real, life-threatening situations. We urgently need to implement a system of sanctions—whether financial or otherwise—that can be applied to patients who abuse emergency services and hospital ERs.
7. We can go further if there's interest... in the hope that "tomorrow" we might actually have a functional healthcare system.
It’s not that nothing happens when your Alkaline Phosphatase levels are high—it’s that something specific *causes* those levels to spike in the first place. When we're talking about a mild elevation in ALP, we might be looking at something like increased bone remodeling, or perhaps even a parathyroid adenoma—assuming all your other lab results line up and you're actually showing symptoms that point in that direction. Now, if you're seeing truly high ALP numbers? That’s usually a red flag for biliary issues—think things like a bile duct obstruction or biliary cirrhosis stemming from various types of hepatitis. But look, let's be real: a slightly elevated ALP doesn't always mean anything at all... it might just be noise.
And look, don't go thinking I'm just here to talk trash—I’m actually trying to open your eyes to the other side of this, which honestly feels a lot more intuitive to me. I wanted to give you an answer regarding ALP (alkaline phosphatase), since, for what it's worth, that's basically a marker for bone formation. Maybe it doesn't mean much, or maybe it means you've already got—or are headed straight for—osteoporosis or osteopenia... or who knows? Maybe it points to some third thing entirely that I haven't even wrapped my head around yet.
This goes out to everyone who decides to play doctor by running their own searches online—only to come back and insist that their self-diagnosis is gospel, or worse, demanding that their physician validate some random connection that doesn't even exist. It leads to those incredibly frustrating, nonsensical answers like: "It’s just because of your diet," or "it’s all down to your thyroid..."—just endless, baseless correlations that make zero sense.
Look, there is such a thing as medical screening and routine physicals. These are organized, structured exams where the provider actually knows what they are looking for and how to interpret the results. But instead, patients fixate on these tiny, clinically irrelevant details. They obsess over them so much that when they show up at an ER ten years later and you try to ask for their actual medical history, they bypass everything important just to drone on about some "liver cysts" or "kidney nodules" they supposedly had back in 1981. In real medical terms, it was likely just a minor cyst with absolutely no clinical significance, yet they cling to it like it's the most vital piece of information ever recorded.
I could give you a million examples, but there’s no point in listing them all. Just a little heads-up: when you ask a doctor something they genuinely don't know, you’re probably going to get a stupid answer. Every once in a while, someone will actually be honest and say, "I have no idea"—which, let's face it, is usually the truth.