Gun Sales Surge After Obama Re-election!

[Plane]

Horrible idea.....and the quality of care just keeps nosediving

Although, I must defer somewhat to your beng a professional in this field, and give proper weight to your opinion thereby....

   What is wrong with using something like this to expidite triage?

[sirs]

The importance of a hands on assessment can't be minimized.  It's why Dr's, way back when, actually went to pt's homes.  Physicians & therapists are largely only as good as their assessment abilities.  You can't get any kind of thorough assessment without seeing and putting your hands on the patient.  Sure, its cuts out time, but it guts quality of care, all the more

[BT]

Horrible idea.....and the quality of care just keeps nosediving

Why is it a horrible idea? Seems a lot of Doctors appointments are all about renewing prescriptions. I don't see a need for hands on consultations for that. Lab work and conversation would do the same as a hands on examination.

[sirs]

Horrible idea.....and the quality of care just keeps nosediving

Why is it a horrible idea?

I thought I had just answered that...but ok, I can paste ... The importance of a hands on assessment can't be minimized.  It's why Dr's, way back when, actually went to pt's homes.  Physicians & therapists are largely only as good as their assessment abilities.  You can't get any kind of thorough assessment without seeing and putting your hands on the patient.  Sure, its cuts out time, but it guts quality of care, all the more

[BT]

4 out of my last 5 drs appointments did not involve hands on assessment. The one that did involved a stethoscope. I don't see why , in my case, 80% of the visits couldn't be done remotely.

I can see where in physical therapy you need to assessment range of movement etc that would require measurements etc, but in my case, when new symptoms are not presenting, both patient and doctor would benefit from the time savings without a loss in quality of the care.

So no, i don't think it a horrible idea and i don't accept your argument as convincing, i find it self centered and closed minded.

[Plane]

I have been expecting more work for RN and technition level medical personell, as our population ages and grows, can't an Idea like this help cover the need?

What is the better alternative?

More Doctors?

[BT]

There is quite a bit of remote diagnostics going on. I know in GA of doctors accessing stroke victims to see if they would benefit from an injection of alteplase, which if injected within 4.5 hours not only saves lives but has left many a patient with no visible after effects of the stroke.

[sirs]

4 out of my last 5 drs appointments did not involve hands on assessment. The one that did involved a stethoscope. I don't see why , in my case, 80% of the visits couldn't be done remotely.

Your status as a patient may be the exception to the rule, if your Dr never really has to actually examine you.  A medical professional is only as good as their assessment.  You physically can't assess someone, if they're not physcially in your presence.  You can't move things or look under things, or appreciate depth or tone, or tolerance.   

So perhaps in your case its plausible, though if I had a cardiac history, by God, I'd want the presence of my cadiologist for any and all visits.  This is just another layer of depersonalizing, as Physicians are being required to see more and more patients, within the same 8+hour day.  It's just not possible to provide the same quality of care, especially if you don't even see them
 
Sorry of my support for quality of care is so "close minded".  I should say damn the patients, full speed ahead

[BT]

Your status as a patient may be the exception to the rule, if your Dr never really has to actually examine you.

I doubt it. But to be clear i didn't say my doctors never had to examine me, i said of the last 5 visits, 4 could have been handled remotely.

Let me give you another example.

One of my numbers is trending upwards. During my last visit, it was decided that we would see what the next labs showed. The results were showing that that particular number was still trending upwards.

2 days after i had the labs i had a call from my cardiology nurse stating that the doctor wanted to double the dose on one of my meds and that she would be piggy backing some tests when i go for a cat scan in December. I emailed her back acknowledging the change in medication.

No visit necessary, no 25 mile trip. No hands on assessment needed.

How many medical disciplines have to physically assess a patient. And if the need does arise then a physical appointment is set. Even the British system allows for that.

[sirs]

Your status as a patient may be the exception to the rule, if your Dr never really has to actually examine you.

I doubt it. But to be clear i didn't say my doctors never had to examine me, i said of the last 5 visits, 4 could have been handled remotely. ...How many medical disciplines have to physically assess a patient.

Most every Doctor, and pretty much every Therapist

And if the need does arise then a physical appointment is set. Even the British system allows for that.

Yea, at what level of wait time?  How many months just for a routine exam?  And not if what I saw being proposed is being set to be implimented.  As I said, screw the patient, there are dollars to be saved

[BT]

Most every Doctor, and pretty much every Therapist

Is this an assertion that i should take as Gospel?

My guess is you have no real experience with video conferencing and your reaction is based on speculation.

Yea, at what level of wait time?  How many months just for a routine exam?  And not if what I saw being proposed is being set to be implimented.  As I said, screw the patient, there are dollars to be saved

Since the initial consultation has already taken place, triage been done, my guess is the routing to the appropriate specialist would be fast tracked, depending on the nature of the ailment.

[BSB]

Will wonders never cease? I actually agree with Sirs on this one.

BTW, Plane, I see my doctors licenced practitioner for some things. She is more available and checks with my doc before making a change. So really it's like seeing my doctor but easier.

BSB

[sirs]

Most every Doctor, and pretty much every Therapist

Is this an assertion that i should take as Gospel?

You asked a question, I gave you an educated guess, as a Health Care Professional, intimate with the dealings in providing healthcare

My guess is you have no real experience with video conferencing and your reaction is based on speculation.

My "reaction" is nothing more that patient advocacy, with an emphasis on quality of care.  You can not provide quality of care over a TV screen.  Under UHC, It gets screwed in order to save more dollars, and under the current tangent being discussed, the patient gets screwed even more so, with a lessening of time between patients & physicians, even more

Yea, at what level of wait time?  How many months just for a routine exam?  And not if what I saw being proposed is being set to be implimented.  As I said, screw the patient, there are dollars to be saved

Since the initial consultation has already taken place, triage been done, my guess is the routing to the appropriate specialist would be fast tracked, depending on the nature of the ailment.

Good guess, but likely still taking months, given what we read coming across the Atlantic.

[BT]

You can not provide quality of care over a TV screen. 

Define quality care.

And i doubt a video consult would be on a TV screen. It would be on a computer monitor and preferably recorded.

I grant that some medical disciplines can not work without in person contact. Dentistry comes to mind. xrays and ultrasounds currently could not be performed remotely. Psychiatry and Psychology could. Cardiology and pulmonary as well as primary follow ups definitely could.

I don't see any reason why remote medicine could not be as personal, efficient and accurate as in person medicine should be. And your claiming it wouldn't without any backups or examples is not convincing me otherwise.

[sirs]

You can not provide quality of care over a TV screen. 

Define quality care.

The ability to provide quality care, specific to that patient's needs.  You can't look under certain folds in skin, you can't palpate irregular nodes, you can't pat someone on the back on telling them how well they're doing....you can't do any of those things threw some disconnected artificial interface

And i doubt a video consult would be on a TV screen. It would be on a computer monitor and preferably recorded.

.....on a TV-LIKE screen.  What the hell is a Computer monitor, but a small TV screen     

I don't see any reason why remote medicine could not be as personal, efficient and accurate as in person medicine should be.

I see plenty, as a health care provider, 1st and foremost the severe decline in the quality of care to patients