Posts by Jacob Fox6

Kate Collins67 said:But how exactly am I supposed to "inform" them? Should I use dense medical jargon? Or switch to layman's terms—which, let’s face it, usually strips the actual medical meaning right out of the conversation? Honestly, there are times when I just don't know how to explain something to a patient because even after I've tried five different ways to say it, they still look at me like I'm speaking Greek.
When you try to simplify complex medical issues just so a layperson can grasp them, you almost always end up distorting the reality of the disease. Then, what happens? Later, the patient repeats that simplified version to another doctor, which gets translated back into technical terms, and suddenly we're dealing with a totally skewed picture. This is exactly why we rely on medical records—they exist so we can interpret things based on hard facts, not filtered conversations.
Is it really our fault if patients aren't educated enough to understand the complexities of their own health? I mean, what can you do? It’s like when some imaginary friend from NASA tries to walk me through quantum physics; I just sit there nodding blankly, knowing full well I haven't understood a single word, no matter how much they try to "dumb it down."

I am signing onto this word for word... 🙏
There really isn't anything else to say...🙏

Jamie Rivera78 said:Clearly, you didn't actually read what I wrote. I’m not out here saying people should work for free—even though let's be real, there are plenty of folks in this country grinding away for nothing. What I actually said was that in the medical field, thank God, the paychecks actually show up on time. Is that really so hard to grasp? Most private doctors who aren't tied to government bureaucracy make a pretty damn good living.
Honestly, it feels totally ridiculous to act like certain jobs belong to some untouchable "elite." Since when did we start measuring status based on how many years you spent in school? Yeah, okay, med school is a grind and it takes forever, but everyone knows that before they even sign the papers. If someone can't hack it, they should’ve picked something else. Lawyers have to study constantly, professors are always hitting the books, and civil engineers aren't exactly sitting idle either.
The real issue here—the thing that actually matters—is how medical staff treats their patients. It drives me absolutely insane when I see that "looking down your nose" attitude, or when you get that vibe of, "Why should I explain this to you? You clearly don't get it." Look, sorry, but I actually care about what meds I'm taking and the specific chemicals they're planning to pump into my bloodstream. In my book, explaining a medical procedure isn't just an option; it's a fundamental job requirement, maybe even basic human decency. People using the healthcare system are paying a fortune for it, so they have every right to get a clear breakdown of their condition and what's coming next. My experience with private doctors has been mostly solid, but when it comes to doctors covered by Medicare, the quality is all over the place.
Bottom line: patients are BUYING healthcare services, and a customer has every right to demand service that matches what they're paying for. At the very least, if the equipment is outdated and crappy, they should make up for it with better communication. That's the only way the whole thing actually works.

Ugh, I totally got misunderstood again... I wasn't talking about those snobby elites driving around in Mercedeses with their fancy attitudes, but more like the intellectual elite... What I was laying out is just how the world works everywhere you look, so if someone’s got an issue with that, they can take it up with the rest of the world instead of coming at me, because I'm really just stating the plain facts about how things stand in the US, Canada, and all over Europe...

I totally agree that you have every right to know, just like any other patient out there... You can always just ask, and honestly, I doubt they won't give you an answer...🤷
Look, it’s kind of like when a client walks up to a contractor and demands they explain the entire load-bearing structure of the house... I mean... honestly... pharmacology is such a massive, complex beast that if you weren't in med school, you wouldn't even touch it until your third year just to get a handle on the basics after years of prep work... I don't see how you can boil all that down into a couple of quick sentences without losing the plot, and besides, where would doctors even find the time to give full-blown lectures on medical science to every single patient? It’s like walking into a Chase branch and asking them to walk you through the exact backend processing of every wire transfer... There's a huge difference between saying "this is for your blood pressure" and what you're asking for—the deep dive into the specific chemicals being injected—but what else would you actually need to know other than the fact that it lowers your pressure? If you really want to geek out on chemistry, maybe go study it in college... I just don't get what you're expecting here. We're already facing a massive doctor shortage in the US, and they simply don't have the luxury of sitting around for long chats to satisfy every technical question a patient has... seriously, if you're frustrated, take it up with our favorite politicians and tell them that instead of whining about the physician shortage, they should actually hire more people, but of course they won't because they don't have the budget for the salaries...

I feel like some patients just love to push their doctors to the limit... demanding an explanation for every little thing while everyone else is stuck waiting forever just to get seen. Honestly, if you want that kind of attention, just pay for premium private insurance like they do in the States, where the doctor gets a massive salary and might actually take the time to "educate" you, though I'm pretty sure even over there, doctors don't explain every single detail, believe me... what you see on TV is nothing like reality...

Jamie Rivera78 said:I have to generalize sometimes, even if it bugs you. It's simple: salaries across the board are low because the economy is a mess. For tons of professions, you spend forever in college, only to struggle finding a job and getting paid peanuts. Healthcare workers rarely get fired—honestly, I think they get paid better than other jobs with similar education levels. And it's not just doctors busting their backs; plenty of others do too. A lot of them work for basically nothing. Luckily, in medicine, the paychecks actually show up on time, right?

At this rate, they’ll probably end up losing their paychecks too, and then where would we be... might as well just head out to some remote cabin in the woods to get treated...

And honestly, it just doesn't sit right with me because most specialists—you know, those guys who haven't even finished their sub-specialties yet and have maybe only spent about ten years in med school... they end up making less than some lawyers who have way less stress on their shoulders, fewer responsibilities, and much shorter workdays. I look at these lawyers, whether they’re family friends working at big-name firms or just local attorneys, and the whole picture just feels wrong. It really doesn't feel right at all... Plus, it totally bugs me when someone with just three years of an economics degree suddenly becomes some pseudo-manager pulling in a massive salary while being practically illiterate...

Look, I honestly can't see eye to eye with you on this at all... maybe if you actually shadowed a doctor at a place like the Mayo Clinic for just one single shift—from that first morning round all the way until they clock out—then you could try telling me I'm wrong. No one is saying there aren't other tough jobs out there, but even a construction worker, and I totally respect the grind, isn't spending ten years mastering a single skill set like a physician does. It’s really just about finding that sweet spot between the level of training, the actual workload, and the paycheck... because by the time a doctor finally finishes their residency, someone else has already wrapped up a master's degree and is halfway through a PhD at another university, and that's just the reality of it. Medicine is such an outlier because of how long it takes and how deep the knowledge goes, which is true in any civilized society... doctors, lawyers, and those elite executives (not the ones we usually see around here in the States) are basically the intellectual cream of the crop everywhere in the world. It’s only in certain parts of the world where people sit around arguing about why someone with just a high school diploma should be making the same money as a licensed physician...

Being a doctor in America is honestly such a curse because, given how much knowledge, sacrifice, and sheer time you pour into it, you still end up getting dragged through the mud for no reason at all... There are all kinds of doctors everywhere in the world, and just think about it—every year we graduate around 250 medical students, and not one of them is struggling to find work since there's always a massive shortage of doctors here, so if you take those 250 students and assume maybe 20 of them turn out to be bad doctors, that’s actually a pretty decent ratio. A doctor isn't there to hold your hand, they're there to apply their expertise to whatever is wrong with your body and try to help... Once you finish med school, and even just a few years after graduating, the way you see the world changes completely. Medicine is a calling, which is why people enroll in that school in the first place, but a job is a job. A doctor has to be objective, not subjective. Sure, being subtle helps, but they see death and conditions that most patients can't even fathom, so how could those same patients or anyone outside the field truly understand when they aren't used to seeing death and severe relapses and constant vomiting every hour like we are...? It's just impossible. A patient might sit there looking pale while the doctor lays out a grim health situation and then heads to lunch to process it all, but for someone who doesn't live that life, trying to understand is just futile... It's practically and theoretically impossible.

Sarah Johnson11 said:Look, we all know this reality. It isn't some distant threat for tomorrow; it's already knocking at the door. We’re looking at a growing number of people struggling just to survive, and it's not just about healthcare—it's every single broken segment of this economy and its entire infrastructure.
The math is simple and brutal: if you have money, you can afford an education for your kids, quality medical care, and whatever else your heart desires. But if you don't? Well... you're just left to fend for yourself.

I'm right there with you on this one. What happened "yesterday" is staring us right in the face, and honestly, I can't even imagine what "tomorrow" is going to throw at us...

Angela Wright said:Look, I have to disagree. There are countless systemic failures that could be fixed right now regardless of the budget. To me, this sounds like a convenient excuse for inertia—a way for people in power to justify doing absolutely nothing while they coast along.

Did you know that when someone receives a drug donation from abroad under a "compassionate use" program, they still get hit with sales tax and customs duties? We're talking about medications that aren't even registered in the US, usually life-saving treatments for rare diseases with astronomical price tags. Does that sound remotely sane to you?

People are the ones who drive change.

I sort of see where she's coming from, but I feel like those tiny little tweaks people want to make—and hey, I'm all for improvements—just aren't going to actually fix working conditions for medical staff or give patients better care, which is the whole point, and without that, nothing truly changes... I'm all for any initiative to make things better, but I can't stand seeing some folks breaking their backs to fix things while everyone else just sits there doing zero work... What I mean is, we need a huge chunk of healthcare workers to actually step up so we can finally reach a critical mass where they can't just say "no" anymore...

I know about those kinds of medications, though I'm definitely not an expert on the subject... Even though I'm aware that the US isn't some special case here, since tons of other countries with much higher standards deal with this exact same headache... From what I gather, Medicare mainly focuses its budget on covering the most common illnesses and treatments since that affects so many people, but I totally agree that we should always aim for more progress... I'm all for it...🙂

nan said:Honestly, I just hope things stay exactly as they are right now... because the coffers are looking pretty empty, and it’s pretty obvious we’re headed toward a situation where they start deciding who actually gets care and who doesn't, and it won't just be about age anymore...

Finally, someone is actually speaking some sense here... We keep talking about fixing the healthcare system when we totally ignore the fact that our government is basically teetering on the edge of bankruptcy, which means we could be facing real shortages soon... if we don't fix the national economy first, any attempt at healthcare reform is just going to result in absolutely nothing, or honestly, making everything even worse...

Treating patients like they're just some frustration to be vented on isn't okay, and it honestly makes the whole profession look terrible...

I totally agree, but you really can't just generalize everything like that.

I've heard people blame dissatisfaction on low salaries and crappy working conditions way too often. Honestly? I'd say the conditions aren't even better or worse than what most other jobs in the US deal with...

You really can't compare those two things at all because healthcare has to be held to a different standard. And look, when it comes to pay, every single doctor who complains about it is actually 100% justified. You've got six years of med school, then residency which can take forever, plus specialty training for at least three more years... not even counting masters or PhD work. First off, just look at the sheer amount of time poured into becoming an expert. Secondly, just look at how those same doctors who started out so passionate are being treated now... if a doctor can't give you a specific treatment, you're gonna blame them, not the system that's breathing down their neck preventing them from even prescribing it...

Besides, this kind of situation isn't anything new, and every aspiring doctor knows the score before they even enroll. Yet interest in medicine has never been higher. Isn't that a little weird? The hospitals are in absolute shambles, yet everyone wants to be a doctor. Is the motivation pure humanitarianism, or is it something else entirely?

Actually, interest in medicine is totally tanking, so you've got it wrong there... Nobody wants to kill themselves over medical school just to fight for scraps against someone who finished a quick three-year program under the Bologna system. The comparison is just impossible. Plus, doctors are actually grinding away while others just sit there with their hands in their pockets. Don't try to generalize and draw parallels between things that have absolutely nothing to do with each other...

Kevin Garcia12 said:ROFLMAO we don't even have anything to talk about "ladies," let me know when you've got like... maybe 5 or 6 years under your belt, then we can actually chat...

I think you totally missed the mark there, but honestly, I’m not looking for a fight, so just believe whatever you want to believe...😁

Besides, aren't you basically the rookie here given what you do for a living? 😉
I've put in my time both in the clinic and the ER, and even though I haven't officially graduated yet, I feel like I've earned the right to speak my mind, regardless of how little tolerance you have for anyone seeing things differently...

You haven't actually shared an opinion or pointed out the core of the issue, or even tried to—nothing at all. You just complain about how everything sucks, trash the whole system, and then play defender for the doctors—as if they're all perfect, which they definitely aren't!!! So overall, your posts feel super egotistical, one-sided, and frankly kind of dictatorial, because this thread is supposed to be a discussion to understand the issues in our healthcare system, not just someone throwing examples from the absolute bottom of the "pyramid" instead of trying to grasp what's happening at the top...

I agree, we really don't have anything left to say...😉 Our conversation has hit a plateau and now it's just spiraling downhill fast...😁

Kate Collins67 said:I mean, it really depends on how you look at it—the way laws actually get passed around here basically boils down to one single person at the top pulling all the strings on the important stuff.
Sure, technically it isn't just one person sitting in the executive branch making every move, but let's be real: it's still just one person hiding behind that fancy title of "legislator."

Oh my God, where did you go with that one... 😵 😁

I wasn't talking about politics, I was actually referring to the entire medical profession across the globe agreeing on certain standards that some people might question, all while using the Hippocratic Oath as their guiding light...

Kate Collins67 said:Fair enough if that's how you see it—really, I respect the perspective—but don't take it personally when I say that even that "ideal" could vanish completely at some point in your life. Maybe you aren't the type to feel the need to protect yourself so fiercely, but honestly? The real question is what you’re going to have to say when it’s your own kids on the line.

Thanks so much... And honestly, it's the exact same thing when it comes to my kids, and even my parents whom I love dearly...

The whole "protect yourself" thing is pretty subjective, isn't it? In most areas of life, I'm actually super self-protective, but everything changes when we're talking about the difference between one life existing versus another in medicine... That's where that instinct to save yourself just disappears, because then we're talking about a literal fight for survival... If I were stranded on a desert island, I'd do whatever it takes to make it through, but when there are two lives involved—even if one of them is mine—I'm sticking to those rules no matter how crazy they might sound...🤷

Kate Collins67 said:I hear exactly what she’s saying, I hear what I’m saying, and I get your point—but let’s stop pretending for a second. Let’s forget that I’m a doctor, you’re a medical student, and she’s a patient. Let’s pretend we’re all just "patients" stripped of any identity other than raw medical data.

Personally? It would absolutely kill me if my son, my daughter, or my grandchild died, while someone in their 80s gets to cling to life for a few more months simply because the system is rigged to prioritize "excessive care for the elderly," causing a massive bottleneck for everyone else.

On the flip side, if it were my grandfather or grandmother in that bed, maybe I wouldn't be able to say that—though, honestly, life has already shattered most of my ideals anyway. But even then, I wouldn't want to be the one forced to make that call when it comes to my own flesh and blood (even though my grandparents have all passed away).

ruggedscout91 writes what he writes because he understands the fundamental truth: in a system where it is impossible for everyone to get everything, it makes more sense to prioritize those for whom the intervention will actually provide long-term value (or at least, that's how it looks from where I'm standing).

That’s exactly why it shouldn't be left up to any single person to decide. Like, is the life of some kid—who, let's be real, might end up being a criminal one day—actually worth more than the life of your mother, who's in that older age bracket? Age isn't an absolute metric for anything, really, and it shouldn't be a criterion for anything else either. Personally, I think the rules are fair because I dealt with those exact dilemmas a long time ago... At the end of the day, every life is just a life and nothing more, and there's no such thing as a life being more or less valuable once you're talking about survival...

I think I already covered the rest of my thoughts in my last post...🙂

Kate Collins67 said:Sure, the protocols for transplants might be black and white, but that doesn't mean they're actually moral.
In my book, if there's only one liver available and two patients—one who's an alcoholic and another dealing with a liver disease they had zero control over—that second person is the one who deserves it.
Since nobody is asking me to make the call, I'm not going to play God, and if the law dictates a certain way, I'll follow it—but don't think for a second that I agree with it.

If you ever found yourself in a position where you desperately needed a liver, only to watch it go to an alcoholic while you're left with maybe six months to live, I bet your perspective would look a whole lot different.

That’s exactly the point—I wouldn't have looked at it any other way... I'm not putting myself above an alcoholic, even if that's clearly a hard pill for you to swallow... We're both stuck in the exact same boat here, regardless of the fact that he's struggling with addiction and I am not...

Look, I'm not gonna get all deep into your personal moral compass or anything... I only really brought up ethics because that’s when it starts messing with how you actually do the job. If you're following the law and playing by the rules like you say you are, then whatever... what you think about it in your own head is totally your business. Work is supposed to be objective, so bringing your own feelings into it just isn't the move...

Kate Collins67 said:Well, money has always been the issue. Always. But we can't sit around daydreaming about "what if" scenarios; we have to deal with the reality of surviving within the system as it exists right now.

But look, that reagent example you gave is a bit too simple because, usually, nobody gets fired over something like that. You have much more serious examples out there—far more serious potential diagnoses—where you're still prevented from acting, and suddenly you're stuck in this impossible dilemma: you know exactly what resources you have available, and you realize you can only help, say, one more person before the end of the month or the year. You're forced to choose between two people. And medically speaking? The only thing distinguishing them might be age—one is 40 and the other is 70—or maybe one struggles with alcoholism and the other doesn't. In certain situations, you might manage to game the system and help both, but in many others, you won't. And as time goes on, you'll probably start to falter because fighting against the system is exhausting and, most of the time, completely futile.

Since the law, with its restrictive budgeting, basically gives you a way to shift the blame onto the government, you’d think it would be easier to stomach—but it doesn't change the fact that you are constantly being forced to choose one person at the expense of another.
In a system set up this way, avoidance is impossible. And when you are finally making that choice, it becomes incredibly significant whether you're looking at a person with cancer or not, an alcoholic or a teetotaler, the young or the old. Because at the end of the day, you are the one making the decision that helps one person while depriving another... it's tragic, but that's just how it works. I'll say it again: sometimes there's a way to screw the system, but sometimes your hands are tied.

I'm with you on that. But I think you misunderstood part of what I meant... I've been consistently against the views expressed by ruggedscout91, who starts off by suggesting we should give this or that based purely on personal opinion. I'm not sure if you see the difference between what you're saying and what she was arguing. She was pointing out typical cases of discrimination, which isn't really what you're talking about here, because her point was about discrimination on a personal level fueled by individual prejudices (I could pull excerpts to prove it if needed), whereas you're talking about systemic discrimination, which isn't what I was getting at at all. It's an exaggeration to say the rules generally can't be followed. Of course, it's not always possible, and doctors definitely try to squeeze out every bit of good they can, but overall, there are guidelines that are easier to follow in some specialties than others, though I truly believe a doctor can act in a way that stays within the bounds of humanity... And again, that's not the same as what ruggedscout91 writes, where it seems like people are just tossed aside because they're elderly, or judged as doomed because they're alcoholics, using those excuses to justify treating or not treating them... what she represents is prejudice, while what you represent is something else entirely, and even though the line is thin, it exists. You're doing it because of a limited budget and you can't just change who you are to do things the way they "should" be done, but she does it because of bias. That's the whole point...

Kate Collins67 said:Let’s look at a hypothetical scenario here: imagine you have, say, 100 units of thyroid hormone reagents left for the month of May 2010. After those are gone, the hospital is physically incapable of running any more tests—it's literally impossible because you lack the supplies. So now, you find yourself in this position where you have to reach out to everyone who might need them, or you try to hand-pick a specific group based on your own judgment—your experience, your knowledge, whatever—to decide who will actually benefit the most from what little you have left.

You’re staring down exactly two choices: either you message everyone in order, regardless of how slim their chances are, which means by the 15th you've burned through everything, leaving nobody else able to get tested for the rest of the month and creating a massive waiting list.
The other option is to be selective—to make the hard calls and play judge, knowing full well that in the process, you are inevitably going to screw someone over. But at least then, you're aiming to minimize the overall damage.

That is exactly how the system works in the real world. You are forced into a position where you have to choose, and you can't pretend you aren't making a choice just by acting like it doesn't concern you—because no matter what you do, you've already picked a side.

I am totally on board with what you're saying here...

But I can't get behind the way ruggedscout91 is looking at things, because honestly, she’d probably try to hand off someone’s organ for transplant to whoever she thinks "deserves" it more, even though the rules are super clear on that... And those comments about third-party coverage are just totally out of line, and complaining about the number of prescriptions seems pretty silly to me. Sure, there are a lot of them, but most of those people genuinely need them just to live a normal life...

What you pointed out is exactly what I was thinking about when I brought up the budget... To me, what ruggedscout91 is advocating for isn't quite the same thing as your example, because yours is pure reality while her take is pretty questionable from a moral standpoint. Of course someone is going to miss out, I never said otherwise, which is why I emphasized that absolute truth, but as long as you aren't denying someone care based on prejudices like age or lifestyle, then I'm right there with you... because it stays within the realm of reality and isn't about discriminating based on some personal worldview, but rather just judging how urgent a specific test is. Even at my local clinic where I always go for bloodwork, they handle thyroid tests right there, so I don't see why every single patient needs to be sent to a major Medical Center unless they're actually hospitalized, since local clinics usually have decent labs... But hey, that was just a simple example for thyroid stuff, and there are a million other tests that can only be done at a big hospital. I know that's why waiting lists exist and all that... But we end up back at what I said—it all comes down to the money... Even with an organized system like ours in the States, it would be so much better if hospitals just had a proper budget...

ruggedscout91 said:If we don't implement proper triage and prioritize emergencies correctly, the inefficiency of the medical system will result in even the most easily treatable diseases deciding who lives and who dies.
Regarding psychiatric illnesses, what is the actual ratio between existing alcoholics and those receiving treatment, or between those seeking help and those left out? Doesn't an alcoholic who actually seeks treatment demonstrate a desire to improve, deserving a higher degree of care? Of course they do. That is what Jacob Fox6 is talking about.
Organs and health aren't items in a grocery store; you can't just go buy new ones when you run through your supply too quickly. That is a utopia.
Personally, I am glad you still have enthusiasm. I appreciate it, though that enthusiasm needs to be tempered with the reality that awaits you after medical school. Neither you nor I are to blame for this.
I am simply trying, in the absence of other options, to debunk certain misconceptions on this forum regarding the use of the system. People are unreasonably disappointed, yet when it comes to the ACTUAL SYSTEMIC FAILURES, no one wants to point a finger.
It is an expensive, inefficient system, paralyzed by the inertia of a political establishment that most doctors have integrated themselves into. The results are catastrophic. Because of politics, no one dares to wake the sleeping lion. Issues aren't resolved even at the primary care level, creating a domino effect that hits secondary and tertiary care, effectively turning specialized care into basic services and blurring the lines between all levels of medicine.
Courting a woman with flowers and chocolates while telling her she's beautiful, yet choosing to sleep with the neighbor instead—that is the essence of our healthcare system today. It is pure hypocrisy, and frankly, it suits certain people just fine. They enjoy the weekly hygiene maintenance, the ability to ease the guilty consciences of the patient's relatives, and the luxury of feeding the terminally ill false hope instead of offering honest hospice care and a dignified death. They prefer sending children from wealthy families to the front of transplant lists while leaving the kids of average citizens stuck on waiting lists twenty people deep. It’s a rigged game, and some people thrive in it.
The detergent label exists to show the difference between being responsible with your household groceries and being negligent with your health—like when there aren't enough spare parts for a defibrillator. Regarding the former, people claim, "We can influence this" (just tell the boss). Regarding the latter, they say, "There's nothing we can do."
WE COULD, if that doctor mentioned the chaos he caused, called the news, and announced that he's missing a defibrillator and someone might die tonight. Only then would something actually happen.
BUT IT WOULD ALSO MEAN he gets fired on the spot and blacklisted from ever working in the medical field in the USA again.
We have stumbled into the territory of a physician's constitutional rights versus their Hippocratic Oath, and whether they should face termination for simply following their conscience and their oath.
I hope you never find yourself in such a position.

I basically agree with that, though I feel like when it comes to the two of us, things might play out a little differently...

We’re out here talking about taking care of our health, but let's be real—more and more people are losing their jobs every single day and that trend isn't slowing down anytime soon... We talk all about how the American insurance system is supposed to work, only to face the reality where you're stuck waiting an entire year just for a basic scan or some routine testing. Everyone loves to chime in with "it should be this way" or "they don't have the right equipment in the hospitals," but honestly, nobody seems to grasp that all of this is just the byproduct of money, corporate greed, and political maneuvering... To me, listening to the endless complaining about what a hospital lacks is pretty pointless when everyone from the patients to the doctors and the medical center directors already knows the deal. That same director who turns down a specific medication isn't being difficult for fun; they're just working within a tight budget at a hospital that's already drowning in debt. And look, I’m just a regular guy doing my job, so there's no point in overanalyzing it... If you can handle the grind, then handle it, but if you can't, go find some help to make things a little easier on yourself...

What you’re calling some kind of utopia is honestly just a total misunderstanding on your part... expecting the healthcare system to actually work properly anytime soon isn't a dream, it's just reality, and whining about it is pretty much just exhausting and unnecessary... but it definitely isn't a utopia to say that even within the current system, no matter how flawed, a person shouldn't throw their morals out the window and try to play judge and jury themselves... like, here's a simple example—if someone is at the top of the list for a kidney transplant, they get that kidney, period, regardless of age, medical history, or what anyone personally thinks about them being "worthy"... a doctor is in the hospital to focus on the illness and the patient, not to let their own personal moral compass dictate how they act... my own moral leanings happen to align perfectly with the Hippocratic Oath, thank God, and I don't recognize any other way of doing things...

There's really no such thing as absolute correctness because humans aren't perfect beings, and since everything involving people is subjective, I honestly have zero interest in arguing over who "deserves" what or anything like that... I'm not there to pass judgment, I'm there to follow the laws as they stand... if someone has an issue with the law itself, they should take it up with the right authorities... it’s like being a lawyer who has to defend a guilty client; even if it clashes with your personal code, you don't just turn around and blame them in court instead of doing your job, because that would just be hypocritical... the institution makes the calls, not the individual, and there's a reason it works that way... everything I've heard so far feels like nothing more than isolated, deviant takes on what morality actually means...

I still firmly believe that being a doctor isn't for everyone, because it requires this massive amount of humanity that, unfortunately, not everyone possesses... I didn't go into medicine just to pick and choose who gets help, I went into it to help everyone I possibly can... and when you hit those situations where helping everyone is impossible, the rules are crystal clear... anything else is just chaos... if someone can't handle following professional standards, then they probably shouldn't be practicing this profession in the first place...

Sarah Johnson11 said:A patient is a patient, whether they consume alcohol or drugs. They must be treated, they must be helped, and they deserve another chance to get back to a normal life.
In medicine, there shouldn't be divisions based on age groups or the specific nature of the illness—even when dealing with alcoholics. However, in practice here in the States, everything is quite different from what’s written on paper, but...
What does "maintaining health" even mean? I don't smoke, I don't drink, and I haven't lived a reckless lifestyle regarding my diet, yet stress and genetic predisposition still take their toll. You don't choose sickness; it finds you. In the end, even small children get sick despite having zero bad habits. I think there is a lot to be discussed regarding the true roots of certain illnesses and the patients themselves.
The flawed logic used by doctors insults us as patients. Being sick is hard enough without feeling tethered to a broken healthcare system.

I couldn't agree more with everything said here.

It’s pretty obvious that our healthcare system is struggling partly because some people decide to play judge and jury instead of just doing their jobs...

An alcoholic is essentially someone suffering from a mental health condition who ended up destroying their liver as a result. To deny them help just because they damaged their own health through an untreated primary illness is just wrong. Any doctor who views an alcoholic as anything other than a mental health patient isn't really practicing medicine properly. You can excuse a random person on the street for not knowing the first thing about medicine, but you can't excuse a physician for labeling and stereotyping. The second they start doing that, they stop being a healer. Why should we accept physical ailments but marginalize, belittle, and label mental ones, effectively deciding someone doesn't have the right to live? That's why not everyone is cut out for this; medicine isn't just a career, it's a calling, and clearly, for some people, it's become just another paycheck...

The state of modern medicine is pretty grim, and nobody is disputing that... from the decent paychecks to the endless bureaucratic red tape, the constant arguing over everything, and the fact that some people work themselves to death while others just coast through their shifts... I get the frustration, I really do. But that’s no excuse to let your moral compass slide, because that's just a weakness of character, and that’s the last thing you want in a doctor...

A lot of doctors will tell you, "Man, I just take the path of least resistance to survive," but I don't buy that for a second... because there are plenty of doctors who stayed true to themselves despite impossible working conditions. I know a doctor who spends an hour and a half on the treadmill after her shift just to process all the stress... It's not some wild fantasy, either; doctors should be the first to know that physical exercise is one of the best ways to handle mental burnout, which science has been proving for years now...

ruggedscout91 said:I am not a doctor, nor would I choose to be if someone were paying me a massive salary to work here.
Regarding comments about that liver, I am not bound by any oath that serves as nothing more than a hypocritical barrier to honest relationships in healthcare.

That is why someone who continues to drink—even if there is a slight suspicion they will—shouldn't be given someone else's liver for a transplant.
Wouldn't that liver be better utilized for a child or a teenager who is sick but isn't an alcoholic? How long will this hypocritical approach to humanity last? Humanity isn't rewarded by how many units you clock in; it's measured by its utility and depth.

Or worse, a patient presents with cancer, and in the end, the real issue is whether they can die with dignity.
Where are the hospice centers in America? There aren't any. Does anyone have the right to choose to forgo chemotherapy and radiation—to die on their own terms? No. That is the conversation we should be having.

Until people learn to point to the actual source of failure in the healthcare system, they will continue to generalize. The goal should be to point at what MUST change to prevent systemic gridlock, to ensure we get the most out of our investments, and to focus on reality rather than hypocrisy.

No profession is granted divine status, including healthcare. People shouldn't view health as a right to be exploited while treating the obligation to maintain health as something to be ignored. Imagine if rules were implemented where those who take care of their health paid lower Medicare premiums; many would become far more careful.
In reality, it is much more important to criticize a manager at Walmart for failing to order the right detergent than to attack someone for not having spare parts for a defibrillator.

I honestly don't know how many times I’m going to have to say this, but I totally agree that our healthcare system needs a massive overhaul, especially when it comes to getting palliative care actually on the right track... though I really can't wrap my head around why anyone would claim a patient can't opt out of radiation or chemo, because that honestly makes zero sense at all... and besides, most people actually fight tooth and nail to try every possible option even when the odds are slim, so saying otherwise is just completely wrong...

I’m just gonna stop commenting on this because you’ve totally gone off the rails... we're talking about healthcare here, but you keep pivoting to medical reform based on your own personal views, and honestly, medicine and the healthcare system aren't even the same thing, so you've really lost the plot on the topic itself. The professionals who actually make a living in medicine—people who actually understand morality and basic humanity—are the ones who established the standards we live by today, and thank God for them, because what you're saying is just shameful... If I'm reading you right and you actually are a doctor, I honestly can't wrap my head around how you have the nerve to look any patient in the eye. I really don't know how. Just try looking a 50-year-old man in the face and tell him you think his life is basically over, and that you're going to take the kidney meant for him on the waiting list and give it to someone younger instead because... Hey there... just checking in on you... I mean, you gotta wonder if the younger generation deserves a fair shot at life more than anyone else...

The rules aren't actually hypocritical, they just aren't what you're out there preaching about... It would be real hypocrisy to say, "Hey, you're younger, so you deserve the kidney," or "You lived a clean life, so you get the treatment while everyone else can just kick the bucket because it's their own fault." That's what true hypocrisy looks like, and honestly, I think people who act like that are just primitive souls who haven't really grown up morally...

Kate Collins67 said:Just a few months back, if I recall correctly, over in England, a younger patient was denied a liver transplant simply because they couldn't convince the doctors they were going to stop drinking.

So, even in highly developed countries, your utopian little theory doesn't hold water; there are protocols, and resources aren't just handed out equally to everyone without reason.
If I’m reading you right, you’re still stuck in med school? Well, get ready for a massive reality check once you actually start working and having to make real-world decisions on your own. If you keep thinking like this, after just one year grinding in an ER seeing all the absolute madness that goes down, you’re going to need professional mental health support just to keep from losing your mind... our system will break you.

But hey, I don't want to act like I have all the answers. Why don't you come back and post here in a few years? It'll be interesting to see how much you've changed.

I don't have a utopian view, I have one that actually works in the real world...
You clearly aren't getting what I'm saying. You aren't reading my actual words, you're just reading whatever version of them you want to see in your head...

A patient like that would be turned away here too, and I know exactly where and when that's happened... A transplant is only given to someone who signs off saying they'll stop drinking (that's just a basic example). Most people do stop for a while, and then they slip back into it. An alcoholic is a sick person, not just in hepatology, but mentally too. Unless, of course, you want to start labeling all mental health patients. That applies to everyone. Everyone has a right to live. If a patient signs that agreement to get the transplant on the condition they stop drinking, then they get the transplant, period. Some people stay sober, some don't, and you have no way of knowing which is which. Doing anything else is basically murder, and in the West, you'd answer for that by losing your license, facing massive fines, or potentially going to prison. There's no dreaming here; the law is clear and fair because it respects the principle that everyone has an equal right to life, which is the truth in every sense. Anything else is just narrow-mindedness, inhumanity, and "animalistic behavior," and if I recall correctly, I think people these days are more like "homo sapiens sapines"...

dustymarlin10 said:The thing is, their money was used for healthcare for whoever needed it at the time. Just like how my own money is being used right now for someone else's needs—like, say, kidney dialysis.
Btw, do you even realize how much a single year of dialysis costs?
We can't just paint everything with the same brush—sure, there's wasteful spending and probably some theft involved (especially back in the nineties), but it's not like the whole system is a total disaster...

Dialysis, including all the meds they have to use alongside it, runs about 250k total $0.00.

I really doubt there's any "shuffling" of funds between people who need help and those who don't... I seriously doubt it...

Sarah Johnson11 said:I’ve been following your posts from the very beginning, and look, I get it—doctors have their limits, they aren't exactly making huge salaries, and let's face it, they’re working under some pretty brutal conditions. I understand that, really, because I'm a patient myself with multiple diagnoses. Serious ones, too. I’m constantly in and out of hospitals for tests and follow-ups, so I know the inner workings of this system quite well.
But reading this? I honestly couldn't believe someone could actually write this, especially not a doctor.
Listen, doctor: every single person, regardless of age—whether they are 5, 10, 50, or 90 years old—has a right to live. And by extension, they have a right to healthcare, especially when the diagnosis is as severe as this one is. It shouldn't matter how much time they have left; at the end of the day, you are the ones who can help them, even if that "help" just means finding the most painless way for them to pass.
Sure, it costs money. But since when did we start weighing the value of a human life against a dollar sign? Has money truly stripped us of our morality and made us indifferent toward these elderly folks who spent their entire lives working, earning, and contributing to a healthcare system that is currently in total shambles, whether anyone wants to admit it or not?
The Secretary and the rest of the big shots won't be choosing to be treated in our hospitals, which currently don't even have the basic reagents needed for standard blood work to test for autoimmune diseases, let alone anything else. It's the same story across the board.
You wait months for an MRI, even when it's an urgent case that should be done in days, not months. And that’s not even mentioning all the other more critical tests. There is zero chance of getting a specialist appointment sorted within a reasonable timeframe, and don't even get me started on the nurses—and I'm trying to be polite by not using a much harsher word for them.
Now, there are very good doctors out there, compassionate people who deserve praise, but then there are those who see us as nothing more than a number sitting in a hallway, something to be "dealt with" so they can move on. To them, whether we get proper care or not simply doesn't matter.
Medical errors and lapses in care are everywhere, but we always seem to justify them with the excuse that "everyone makes mistakes." What's truly catastrophic is the behavior of certain staff members when they *know* they've messed up. They act like they're untouchable because they know they'll be protected, and who are you going to complain to? It’s pointless. It feels like the system is rigged so that patients are always blamed, while doctors rarely are.
That's why I feel like arguing is useless. It seems like those of us fighting illnesses prefixed with "CA" are viewed merely as a drain on the system. In their eyes, we probably shouldn't even be in a hospital; we should just be sent home to die because it's cheaper. It’s tragic, but it feels like the reality of the situation.
The Secretary stands on TV smiling and lying through his teeth. He isn't even ashamed to say things that fly in the face of what we experience every single day in these hospitals. On top of that, you never know which nurse or doctor is going to show up, or what kind of attitude you're going to have to swallow from them.
So much is broken in our healthcare system. So much needs to change, and it needs to happen yesterday. Money is tight, yet they keep pouring funds into healthcare and supplemental insurance—so where is all that money actually going? Where is it being hidden? Only someone in power could answer that... and well, that's why we are where we are.

I'm with you on this one.

It is absolutely shameful that a physician would think that way... Because of people like this, I’ll make sure my own parents only ever see me or my colleagues, rather than leaving them in the hands of these "moral butchers"...

Any medical professor would be mortified to be associated with a doctor like this... For some, the Hippocratic Oath is nothing more than a joke instead of a way of life... It's just plain disgraceful...