State of the healthcare system in America: Let's discuss why it's failing

mistyjackal842 said:So, it seems like the only issues being brought up are those three specific instances you mentioned. And everything else is just... well, it's being framed exactly like those three very real-life examples you're citing. I guess maybe there's a bit of overgeneralizing going on here? Why not mention the other cases where patients weren't just making things up, and they actually weren't at fault? Or is it your view that everyone is just lying? I also noticed some rather inappropriate language being used here—not necessarily directed at the forum members themselves, but still.

Oh, please. If we’re going to start nitpicking over semantics, then as far as I know, there aren't any rules against using colorful language when you're just venting about your own damn self...

And regarding your little examples—I have hundreds of them, but I'm not going to list them because a) it's pointless, b) it's actually illegal to discuss a patient's condition with anyone who isn't immediate family, and c) even if I did, it wouldn't change a single thing.

Just so we're clear, nobody has died on my watch because I failed to run diagnostics, and my hospital admission rate—for the people I send in—is sitting right around 70%. The percentage takes a hit during weekends or holidays because, believe it or not, I don't have an X-ray machine or a lab sitting right next to me, so sending someone to a general hospital for diagnostics during those times messes with my stats. It's like some kind of cosmic joke, but people always seem to have a tendency to trip and sprain their ankles playing sports or getting into various "personal projects" over the weekend...

Alright. I suppose we've finally wrapped up this discussion.

Kevin Garcia12 said:Oh, please. If we’re going to start nitpicking over semantics, then as far as I know, there aren't any rules against using colorful language when you're just venting about your own damn self...

And regarding your little examples—I have hundreds of them, but I'm not going to list them because a) it's pointless, b) it's actually illegal to discuss a patient's condition with anyone who isn't immediate family, and c) even if I did, it wouldn't change a single thing.

Just so we're clear, nobody has died on my watch because I failed to run diagnostics, and my hospital admission rate—for the people I send in—is sitting right around 70%. The percentage takes a hit during weekends or holidays because, believe it or not, I don't have an X-ray machine or a lab sitting right next to me, so sending someone to a general hospital for diagnostics during those times messes with my stats. It's like some kind of cosmic joke, but people always seem to have a tendency to trip and sprain their ankles playing sports or getting into various "personal projects" over the weekend...

You can share examples, just don't use names.🙂
Regarding the referral percentage, I know one person working in the ER who brings in about 95% of their patients, only about 5% end up getting hospitalized, and they all arrive with the exact same diagnosis. 🙂
If you ask me? They'll be out of a job soon enough.

Kevin Garcia12 said:Oh, please. If we’re going to start nitpicking over semantics, then as far as I know, there aren't any rules against using colorful language when you're just venting about your own damn self...

And regarding your little examples—I have hundreds of them, but I'm not going to list them because a) it's pointless, b) it's actually illegal to discuss a patient's condition with anyone who isn't immediate family, and c) even if I did, it wouldn't change a single thing.

Just so we're clear, nobody has died on my watch because I failed to run diagnostics, and my hospital admission rate—for the people I send in—is sitting right around 70%. The percentage takes a hit during weekends or holidays because, believe it or not, I don't have an X-ray machine or a lab sitting right next to me, so sending someone to a general hospital for diagnostics during those times messes with my stats. It's like some kind of cosmic joke, but people always seem to have a tendency to trip and sprain their ankles playing sports or getting into various "personal projects" over the weekend...

That is just one more absurdity within the system: "cover the patients," they say, but then they won't let you run basic tests, so instead you're forced to just make an educated guess.

mistyjackal842 said:Alright. I suppose we've finally wrapped up this discussion.

We haven't, because a discussion like this can never—and should never—actually end; talking through a problem is both the essence of it and the very first step toward fixing it. But you patients really need to understand that those of us working inside the system are dealing with just as many headaches and frustrations as you are, so please don't take your anger at the system out on us... because being nervous or aggressive on one side just triggers that exact same response from the other...

Just so you know, here are a few "gems" of systemic stupidity, just for the sake of it...
I’m still sitting here waiting for pediatric defibrillator electrodes I ordered two months ago; thank God there wasn't a single kid who actually needed them, because I wouldn't have had anything to treat them with...
When I asked about certain medications, the answer was basically—we don't have them, you aren't getting them, so stop bothering the ER... and for others, the administration actually had the nerve to ask, "What do you even need that for?" Well, excuse me, but I think I know what I'm doing if I'm asking for them... But nooooo, that's not how it works—if nobody else at your workplace uses it, then you shouldn't need it either. It doesn't matter if it might save someone's life; it's better to just blindly shove things in a bag and drive to the hospital and hope whoever makes it arrives alive...

The bottom line is that our system is sick, and there isn't a doctor in sight to fix it, which is why everyone having issues with the SYSTEM complains about the SYSTEM rather than the doctors—because we aren't the ones who make up the system. Besides, the amount of influence most of us actually have over it (believe it or not) is practically zero. If you have an issue with a specific EMPLOYEE (doesn't matter if they're a doctor, a dentist, a nurse, or a hospital administrator), call them out by name and demand a second opinion—you have every right to do that...

On the flip side, you also have OBLIGATIONS to the system, and that isn't just paying your basic or supplemental insurance—and I mean INSURANCE, not a SUBSCRIPTION. When you buy car insurance, you don't go driving recklessly all over the road, right? So why should such a cash-based approach be accepted when it comes to health? Look out for yourselves, and when you're given advice—listen to it...

And there you have it...

Kate Collins67 said:That is just one more absurdity within the system: "cover the patients," they say, but then they won't let you run basic tests, so instead you're forced to just make an educated guess.

Tell me about it...

I would be absolutely thrilled if I had access to a good lab and X-ray 24/7; honestly, you wouldn't even need a radiologist present if the only thing that expensive is the staff and the equipment...

Here’s an idea: Why don't we set up a few dedicated clinics within the Medical Center specifically for GP doctors during weekends and holidays? They could have full access to the hospital lab and all the diagnostic tools they need—that way, they can wrap up care for patients who don't actually need to be hospitalized.

Kate Collins67 said:Here’s an idea: Why don't we set up a few dedicated clinics within the Medical Center specifically for GP doctors during weekends and holidays? They could have full access to the hospital lab and all the diagnostic tools they need—that way, they can wrap up care for patients who don't actually need to be hospitalized.

We’re actually looking into something pretty similar here, though in my neck of the woods, emergency medicine is already integrated into the general hospital setting, so patients aren't just being dumped straight onto specialists without any filter. Most of the colleagues working there are essentially doing "general practice" anyway—though once the healthcare reforms finally kick in, they should technically be classified as urgent care specialists—so it takes some of the pressure off the specialists since they only get called in when it’s absolutely necessary. Beyond that, whenever I send someone off for diagnostics, I make sure to specify on the referral that we only need the tests themselves, which helps the colleague at intake avoid wasting time starting the entire review and processing from scratch... they can just enter an internal hospital order for the X-ray or the lab work and simply wait for the results to come back...

Look, if people actually did things this way, everything would be fine—and clearly, it *is* possible... it’s just that certain people lately have been taking advantage of that "full review" option on their referrals to go big.

Kate Collins67 said:Look, if people actually did things this way, everything would be fine—and clearly, it *is* possible... it’s just that certain people lately have been taking advantage of that "full review" option on their referrals to go big.

I know a former colleague who used to operate exactly how you described, though thankfully she recently moved over to general practice, so that whole headache has died down...

Technically, you can do it. Even if the referral specifically says "review and processing" or something similar just to make the billing work, we still have all our supporting letters, findings, and histories for any scheduled appointments, not to mention those note sections on the paperwork. If the people on both sides of the line are actually reasonable professionals, then this works perfectly with minimal effort. Honestly, the job is already miserable enough without us making life even harder for one another by overcomplicating things...

Kate Collins67 said:Here is my inevitable take on this whole mess.

Look, there are countless grandmothers out there facing the exact same situation you are. We are pouring massive amounts of money into keeping people afloat for just a few months, and then—get this—that same money isn't there when someone younger (and I’m talking about folks in their late 60s or even younger) suddenly needs medical care after a lifetime of staying healthy. It’s a cycle, isn't it?

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.

Kate Collins67 said:The "solution" they're pushing? It'd be much simpler if they just handed everyone their invested cash in cold, hard cash and told us to switch over to a totally private system. Then you'll see exactly where the money goes—you'll blow through it in a heartbeat and then just drop dead because you can't afford the next round of treatment.

I think you mixed things up because I was actually comparing how pension funds get paid out abroad versus how our healthcare system works...

Healthcare doesn't pay you out, but at least they aren't constantly ripping you off to begin with...

I'm totally on board with that...
Honestly, nobody here ever mentions taking actual responsibility for your own health... In so many developed countries across Europe and the US, people are actually encouraged to look after themselves and save money on their insurance through various private providers, so you end up with the idea that those struggling with alcoholism or drug addiction are basically making the whole healthcare system way more expensive for everyone else...

Americans are basically just scraping by on pure survival mode most days... so you really can't come walking in here telling us to go out and "recreate" or whatever... It just doesn't work like that when the countries you mentioned have a totally different standard of living than what we deal with here... making that kind of comparison is just impossible...

I mean, who could honestly be held responsible for someone else's liver issues from drinking too much, or smoker's lungs, or any other addiction-related stuff like diabetes or cirrhosis, especially when that person is actually trying to watch what they eat and stay healthy... Why on earth are we standing in solidarity with immorality and drug addiction... They basically bank on the fact that someone will eventually step in and bail them out just because they’re human beings, but since they're acting so reckless, nobody's actually going to lift a finger to help...

Look, there are countless examples out there of people only finally deciding to get their act together and change their entire lifestyle once they hit rock bottom with their health... honestly, you're just being intolerant and totally heartless, and there's really no arguing that anymore...

It’s actually wild how things work here in the States, where they go to such extremes that people who struggle with heavy drinking can end up having massive fundraising campaigns just to fly overseas to places like Italy to get liver transplants...
It’s just wild how even the basic stuff that hits young people can go untreated, because let's be real, nobody in this world wants to bother organizing a charity drive for the everyday person...
People are just throwing everything under the sun into these humanitarian funds to line their own pockets, and it’s honestly wild how they exploit those hardworking, decent folks who actually believe in earning a living through honest work instead of just peddling immorality and profiting from it...

I'm just gonna pass on this one...

I'm looking through the comments on this new law and I don't see anything about individual health accountability—you know, that part where your own choices could actually shift how much you pay for Medicare... which basically means some people will start watching their habits while others just keep acting reckless and leaving everyone else to foot the bill since we're all in this together...

What would you even do? Try to force people to go out for a run every single day, weigh every gram of food, and obsess over every single calorie... honestly, it's just nonsense. And what does "taking care of your health" even actually mean anymore? Everyone acts like they have these perfect, pre-packaged answers ready to go, while completely ignoring the biggest risk factor out there, which is stress—you can watch everything you eat and drink all you want, but if you're stressed out...
People are just wired differently—some folks are always on the move while others prefer to just chill, and honestly, everyone is just doing their best to live within their own limits, their personality, their DNA, and all that stuff...
Looking at the big picture, what you’re saying is actually a really positive way to look at things, but honestly, that kind of mindset comes from how an entire society is raised and shaped... I just don't see that happening here in the States anytime soon, especially since people are out here grinding themselves to death for peanuts, just constantly frustrated and feeling the squeeze under all this pressure... You'll probably tell me that change is always possible, but I'm telling you, it just isn't... In theory, sure, anything can happen, but if you want real-world change, there are so many other pieces of the puzzle that have to fall into place first...

Like, look at the medication madness here in the States. Honestly, I don't think there's any other place in the world where you see so many seniors—and I mean they aren't just taking meds, they're practically chugging them—acting like little walking pill organizers in everyday life. Whether it’s a bit of depression hitting, a full moon, or just some digestive issues, they swarm the clinics like ants, and you can't even get an appointment without waiting five hours in line...
Where did all the family medicine or the local doctors go? They're all acting like they're doing us a massive favor just by showing up.

That's exactly what I was getting at, the entire healthcare system in America is basically screaming for a total overhaul... but I still can't get behind how you keep pointing out certain age groups like they have some kind of special claim over everyone else. Let's be real, the older you get, the more things start breaking down because our bodies just wear out, so making a huge drama about it like you are feels pretty unnecessary. Of course most seniors need a ton of pills because if you've got Type II diabetes—which is super common—it starts a domino effect with blood pressure, heart issues, and maybe even your liver or kidneys... you have to realize that when one thing fails in old age, it triggers a chain reaction, and people are just trying to help them manage it, which naturally means a lot of prescriptions. Personally, I find it way harder to wrap my head around those healthy young people or middle-aged folks who are constantly popping every vitamin and mineral they can find at a drugstore... I'd call that "supplement mania" rather than the "medication mania" you keep obsessing over...

Or look at psychiatry.
The whole psychiatric service is totally broken and never seems to be where it actually needs to be, yet the big shots at the top are still getting their massive paychecks. For what, exactly?

I'm with you on that, but honestly, psychiatry is its own messy beast for a million different reasons. Sure, it makes sense for something like schizophrenia, but trying to fix certain types of depression with 99 different pills is just plain incompetence, especially since if you actually understand how affective disorders work, the real answer is a combination of medication and psychotherapy, which hardly anyone does well around here...

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...

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...

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"...

Jacob Fox6 said: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"...

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.

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.

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.

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...

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...

Jacob Fox6 said: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...

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.