A few questions for the doctors here...

1. So, what's the actual wording of the Hippocratic Oath?
2. How much does a regular GP really know—like, how much training and residency actually goes into it—when it comes to judging if someone is fit to work after something like a hernia repair or dealing with cystic kidneys?
3. Just out of curiosity, roughly how much does one abdominal hernia surgery end up costing the government when you factor in the procedure itself, the follow-up care, and 60 days of paid medical leave?

thanks

I should point out that in America, doctors haven't actually been taking the Hippocratic Oath for quite some time (despite what most people assume). What they truly swear by is something much closer to the principles found in the Geneva Convention. There you have it!

Here’s what I know... Determining how long medical leave lasts for a specific illness or surgery is based on standard medical guidelines. According to those rules, for this particular diagnosis, they can authorize up to 30 days of leave without needing any extra approval from a Medicare committee. So, yeah, your primary doctor can just sign off on 30 days based on that diagnosis. If you need anything beyond that, the length has to be confirmed by a Medicare board. They mostly look at the specialist's opinion—basically the surgeon handling your case. At the end of the day, their input is really the deciding factor when it comes to whether the leave is justified and how long it should last.

shadowfalcon33 said:Just wanted to point out that here in America, doctors haven't actually taken the Hippocratic Oath for quite some time (despite what most people think). What they actually recite is something similar called the "Geneva Convention." There you go!

Not true!
The Hippocratic Oath is still part of the graduation ceremony!

Not quite!

(I know that’s the common consensus, but it isn't. Just remember that the Hippocratic Oath begins with an invocation—let me point out just one of those distinctions)

shadowfalcon33 said:Not quite!

(I know that’s what everyone thinks, but it isn't. Just remember that the Hippocratic Oath actually starts with an invocation... just one way they differ, anyway.)

The original version is slightly different, but the core message is the same!
Checked and verified!😉

It’s really about the substance—and the context that any kind of oath carries. The wording is just the frame, right?

From what I understand, it's been modified. Does that exam apply strictly to doctors, or does other medical staff have to take it too?

To be precise, what people are actually referring to is the "Geneva Convention," established back in 1948, though we currently follow the 1983 revision. So, in reality, doctors aren't swearing by the Hippocratic Oath anymore. 🙂

For anyone interested in digging into the specific texts, you can find them in this citation:
Svajger A, ed. Medical Ethics. 2nd ed. Washington, D.C.: University of Chicago School of Medicine; 1996.

Look, I don't exactly have some medical encyclopedia sitting on my desk, nor am I a doctor myself...

I was just looking for the actual wording because I wanted to quote it—you know, use those big-shot doctors' own words against them—to ask when exactly they forgot what they actually 'swore' to uphold in the first place...

Richard Moore3, thanks for that... so, I guess it basically boils down to the idea that how long you're out on sick leave is decided by some damn piece of paper rather than how someone is actually feeling...
just freaking lovely 😢

brisknomad6 said:Richard Moore3, thanks for that... so, I suppose one would assume the duration of medical leave is dictated by a person's actual health status, rather than just some damn piece of paper...
Even more depressing 😢

Unfortunately, that’s the reality, though it seems less about the doctors themselves and more about the rigid regulations set by Medicare.

Hold up a second... the doctors on the commission (not Medicare, mind you) are the ones evaluating someone's health and their capacity to work... they base everything on past medical records, history, all that stuff...

I'm just wondering, among other things, how a regular GP is even supposed to judge how fit someone is to get back to work after a certain surgery, or how jumping back into the job might actually mess with their recovery...

Honestly, I don't think it makes any sense at all...

"As I enter the medical profession, I solemnly pledge to dedicate my life to the service of humanity. I will maintain due gratitude and respect toward my teachers. I shall practice my profession conscientiously and with honor. My primary concern will be the care and well-being of my patients. I will protect the privacy of those who entrust themselves to me. I will uphold, with all my strength, the honor and noble traditions of the medical calling. My colleagues shall be my brothers. In fulfilling my duties to the sick, I will not be influenced by considerations of religion, nationality, race, politics, or social class. I will absolutely respect human life from its very beginning. Under no circumstances, even under threat, will I allow my medical knowledge to be used in ways that violate the laws of humanity."
I make this promise solemnly and freely, calling upon my honor to witness it.

That’s basically the gist of the Geneva Convention. I pulled the text from a foreign website (which makes it pretty obvious). Interestingly, they have the date wrong, claiming it was from 1946.

Regarding sick leave—yes, everything is strictly regulated by paperwork (just like disability ratings, for instance).

man, thanks so much for putting this together...

now I've got plenty of ammunition to throw back at them.

A general practitioner can only authorize sick leave up to a certain limit defined by Medicare protocols for specific medical conditions. If a patient needs to stay out longer than those guidelines allow, the doctor has to submit a request to a medical review board funded by Medicare. If that board denies the extension, the physician actually doesn't have the authority to extend the leave on their own; if they try to bypass the rules, they risk losing their contract with Medicare, which would essentially force them to shut down their practice. I suppose similar regulations and clinical protocols exist in just about every other country too.
If a patient isn't happy with how the sick leave was handled, they have the right to appeal to the Medicare review board. If they still aren't satisfied after that, they can take the matter to an administrative court. You can find more details here:

Medicare

And you can also see it in this document

The Medicare form for extending sick leave

Yeah, you're right, Joshua Chavez... but honestly, the whole medical board was basically being run by a general practitioner!

shadowfalcon33 said:"As I enter the medical profession, I solemnly pledge to dedicate my life to humanity. I will maintain deep gratitude and respect for those who taught me. I promise to practice my profession with conscience and honor. My highest priority will be the care and health of my patients. I will protect the privacy of everyone who entrusts themselves to me. I will uphold the dignity and noble traditions of this calling with all my strength. My colleagues will be my brothers and sisters. In serving my patients, I will remain indifferent to any considerations of religion, nationality, race, politics, or social class. I will hold human life in the highest regard, from its very beginning. Under no circumstances, even under threat, will I allow my medical knowledge to be used in ways that violate the laws of humanity."
I make this solemn pledge, of my own free will, and by my honor."

Man, if even half of the doctors out there actually lived by this... honestly, there isn't much else to say. 🙄 😂

brisknomad6 said:Yeah, Joshua Chavez... but the one heading up the medical board was just a general practitioner!

True, but we aren't talking about the doctor actually treating the patient here; we're talking about the doctor employed by Medicare. Naturally, they’re going to protect the agency's interests. That said, an unhappy patient can always file an administrative appeal. If they manage to get that moving within 24 hours, their disability benefits stay active right up until a decision is handed down by the first-level review board—which, again, is just another branch of Medicare at a higher level. After all that, you could eventually take it to federal court if you really wanted to.

There’s absolutely nothing wrong with seeing a GP. They’re just basing their take on the diagnosis, discharge papers, and everything else provided by the specialist. Basically, they’re just following the lead of someone with more specific expertise. That’s my first point. Second, if I'm remembering correctly—and I can double-check this—you should have the right to request an expert medical opinion during the appeals process.

The medical review board consists of various specialists, which means a general practitioner can absolutely sit on it... they are just as qualified to handle these matters as an ENT or an ophthalmologist, if anything, they're more so.

As > already pointed out, there are established guidelines regarding the duration of disability leave for every specific illness or condition. These standards are based on the average, typical course of treatment.

If a procedure results in complications, or if there are other reasons for a slower recovery and extended incapacity, then the specialist—in this case, the surgeon—must explicitly state and justify those reasons. This documentation is then reviewed by the Medicare commission, which ultimately approves or denies the claim.
If the specialist provides a clear, well-argued justification, my understanding is that the commission usually accepts it; however, if something is vague, they will request an independent medical evaluation.

So, before you go attacking the GP at the review board, make sure the specialist surgeon actually provided the justification for the extended leave. 😉

thanks everyone...

all

so after her first surgery earlier this year (back in March, specifically), the specialist was super clear—told her absolutely no heavy lifting, nothing strenuous at all...

but
a) the medical board basically forced her back to work anyway
b) and her employer just straight-up ignored the doctor's orders
so then in September, she ends up right back in the OR for another surgery and
a) once again, the specialist writes the exact same thing
b) and once again, the board says "nope, get back to work"
c) and you won't believe what happens next

we're talking about a woman who’s already been through five surgeries in her life (and let's be real, none of those were just dental stuff), yet she's being shoved back into the same job over and over... and it just keeps going.

how long does this go on for?
until anesthesia or a blood clot takes her out? Or until her kidneys just completely give up?

God, America is something else, isn't it? 😢

who am I even supposed to talk to about this?
the doctor just points the finger at Medicare
Medicare blames the employer
and the employer? They just blame her...

seriously, how much longer can this go on?