I intend no offense toward the talented members of the medical profession; however, I find some fees incurred for medical treatment to be quite preposterous. Consider the realm of automotive mechanics. If one has a problem with an automobile and desires resolution of said issue, one simply proceeds to the automotive mechanic of their choosing and requests an estimate. This diagnostic procedure is performed for a small fee and upon completion of this service, the automotive mechanic shall have an understanding of the work required to rectify the problem. At such a time, the automotive mechanic submits a price which shall not be exceeded for successful completion of the ensuing work.
Treatment of the human body is similar, albeit on a different scale, to that of an automobile. Where automotive mechanics deals primarily with simple properties of physics such as mechanics, electromagnetism and thermodynamics, medical treatment incorporates additional aspects of biology and chemistry. If one requests to have a fuel injector cleaned, the automotive mechanic selects the appropriate product for the particular vehicle, calculates the labor required and submits an estimate. If one seeks the service of an individual of the medical profession for an illness or injury, one must simply take the chance that the proper diagnostic procedures will be implemented and that pharmaceutical treatment will correct the problem. I have found that in some situations, repeated visits to a medical professional are necessary either verify the nature of the problem or correct the pharmaceutical treatment. Not only do these proceedings require one to allot additional time for said visits, they also incur additional expenses for general fees, lab tests, prescriptions, et cetera.
I fail to understand how some individuals in the medical profession can consider themselves professional when they display such incompetence as to require multiple treatments for a single illness or injury. Certain antihistamines do not produce the desired effect in some individuals. A bit of conversation with the ailing party would indicate which over the counter medications have proven themselves to be effective. The medical professional could then cross reference the information and prescribe the appropriate medication for treatment. Granted, the necessity for some procedures is not always ascertainable, but I doubt that given a truly competent professional such incidents would arise frequently.
If one was to have a radiator replaced, and the workmanship or replacement part was found to be deficient or defective, the problem would be corrected without incurring additional costs (i.e. the work would be completed under the premise of the initial estimate). I believe that the medical profession should initiate a similar procedure. Repeated treaments for the one illness should be covered under a single estimate. If the presciptions and/or procedures fail to resolve the problem, the additional prescriptions and/or procedure required to rectify the situation should incur no additional costs.
Reputable mechanics thrive due to good workmanship. The medical profession should strive to provide services on par with automotive mechanics. One cannot reasonably initiate a malpractice suit for inadequate treatment of a sinus infection, but I submit that implementing the automotive mechanics concept of an estimate would greatly reduce problems with more mundane medical treatments.
why the cost of medical treatment? let’s see…medical school, med mal insurance, administrative costs, people who don’t pay, insurance that pays a small percentage only…
And why not charge a fixed price? well, if you understood the difficulty of creating an accurate diagnosis AND cure, you wouldn’t even ask.
I don’t know if you read the full content of the OP, but I didn’t imply any reductions in the overall cost of medical services. I simply asserted a method which would reduce superfluous charges.
Again, I don’t know if you read the full content of the OP, but I didn’t recommend a fixed price for all treatments. For my personal edification, perhaps you would provide some information regarding this obstacle which makes an accurate diagnosis and treatment so difficult.
But the problem is that any symptom, or host of symptoms, could be abbout 400 things. Furthermore patients are not always good at communicating all of the relevant symptoms. And you can open up a human and sart pulling out parts like you can in a car.
Most importantly, if you mess up on a car, you can always repair the damage. If you mess up on a human, they can die. Kind of ups the ante a little.
My wife has been in medical school of one sort or another for 7 years. The hardest thing, according to her, is diagnosing. If you don’t know what is wrong, you can predict the cost of treatment well.
Pertaining to fixed price I misunderstood your point. I find it absurd that one should have to repeatedly visit a doctor for changes in medication for a single ailment at a particular time (i.e. go to the doctor, receive prescription, discover medicine doesn’t work or has severe side effects, return to doctor, receive different prescription, discover different medicine doesn’t work or has severe side effect, et cetera). I sought medical attention for an infection which, in brief, caused phlegm to develop in my lungs, nasal congestions, and fluid to develop in my ears. I elaborated much more during the meetings. Upon the third visit I encountered an individual who spent an hour with me discussing various medicines. That trip was successful. In my opinion, the results of the previous visits could be considered malpratice. I wouldn’t sue for a simple infection, but I believe a procedure should be implemented to reduce such superfluous visits.
Narrowing down possible causes for the symtoms is ascertained by tests. Tests are considered part of the diagnosis process. Hooking a vehicle up to a dyno and taking a blood test are very similar in that regard. Removing a spleen versus removing a wheel for a brake inspection isn’t a valid comparison. A more apt comparison would be moving an ankle to detect a sprain versus removing a wheel for a brake inspection.
That both understood and the reason why medical services are generally more costly than automotive repairs. Once more, the cost is not the issue here–it is the repeated expenses incurred.
I’m agreeing with MR. Z again???
But. your analogy human body vs. car engine is, I believe seriously flawed. The amount and extent of things that can go haywire in a human body are damned near infinate (and NOT all of them are cureable). variants like personal heridity and infection for example have no similar tangent in the auto (gee, my Chevy Nova is doing the same my old Impala did, maybe they’re related???, the car next to mine had an oil leak, you think that might be relevant?)
anyhow. given that people don’t always say and do what they claim or are told to do, the diagnostic arena for human medicine is periolous. Example: My ex was having minor surgery on his foot and was told to “fast” for 12 hours before the surgery. To HIM (numbnuts that he is) “fasting” meant that he shouldn’t eat anything substantial, so toast and coffee the morning of the surgery was ok… so, he ended up with respitory problems due to aspirating under anesthsia.
FEW people know to bring ALL meds being taken, including otc into the dr.s office. geez, I could go on and on with examples of people being idiots about their medical care. But trust me, it’s a much better bargain to pay my family Dr. $80 to have him check out my kid’s throat than the $30 it takes for the high school drop out down the street to change the oil in my car.
Yes, and if you’re lucky, those 400 causes will be narrowed down to 100. Another test might narrow it down to 20. Another may rule out five of those. As Mr. Z pointed out, arriving at a definitive diagnosis is quite difficult, and is frequently not possible.
It isn’t always prudent to get a definitive diagnosis before treatment. For instance, a few years ago I had a lab test that indicated an underactive thyroid. The doc could have run $1000 worth of labs and done a biopsy to confirm Hashimoto’s thyroiditis (the most common cause of hypothyroidism, a relatively benign condition), but he didn’t. Instead, he started me on the $8/month Synthroid necessary to manage the condition. I went back in a couple of months, and my tests were normal. If they hadn’t been, we would have tried something else. This course of action was just as effective, much more cost-effective, and much less intrusive than the definitive route.
Sounds like your docs just took a bad history. There’s no real excuse for that.
wring, I will grant you that the analogy is far from perfect, but it is the practice of an estimate and the related services which prompted the analogy. I don’t believe that discrepancies in the analogy negate the validity of my proposal.
Allow me to repeat myself again, the cost of a single procedure or prescription is not the issue at hand. My concern is incurring costs multiple times which, in my opinion, can be avoided.
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The amount and extent of things that can go haywire in a human body are damned near infinate (and NOT all of them are cureable). variants like personal heridity and infection for example have no similar tangent in the auto
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And autos don’t just make shit up. hypochondria, somatiform disorders, mental illness…people come up with treasons to want to be ill, and to want not to be cured.
But to get back tot the OP, doctors can give you a flat rate if they so choose. But to do so they have to price it in such a way that they will still make money. So you may get the flat rate, but it take into consideration the possibility that you may need a lot of visits to get a diagnosis.
not being able to diagnose and cure every ailment is not malpractice, BTW. No doctor in the world (except maybe Quincy) can make an accurate diagnosis the first time around. Doctors use the same procedure as the guy who fixes your car: I think x may be the problem. I will try this first and see if it fixs it. THen I will try something else. I will keep trying until I fix it.
Here’s the real trouble with the idea of a medical estimate.
Let’s say you come in with some stomach discomfort. My presumptive diagnosis? Indigestion. Estimate? $80 for the office visit plus $3 for some Pepto-Bismol.
However, the Pepto doesn’t help, the discomfort doesn’t go away, and it turns out you have, say, pancreatic cancer. Cost of treatment? Tens of thousands of dollars. Cost of diagnosis itself would be in the thousands.
Still, my estimate was for $83, so I’m obligated to fully treat your cancer for $83.
Another thing to consider–do you really want your doctor cutting corners just so he can come in under his estimate?
Besides, auto mechanics don’t really give you what you’re talking about, either.
Here’s perhaps a more accurate analogy.
Me: My car is making this noise.
Auto Mechanic (AM): What kind of noise?
Me: Well, sort of this clanking noise.
AM: Is it coming from the engine?
Me: Well, it might be coming from the engine. It seems to move around sometimes, though.
AM: And is it a constant noise, or does it change?
Me: Well, I already said that it moves. It also gets louder or softer depending on the weather. And sometimes it totally goes away.
AM: OK, let me look.
(a few hours pass)
AM: Well, I ran some tests, which are really the equivalent of standing across the room from your car and breathing the air for as much good as they may do me. And your problem could be several different things. Or it could be them all together.
Me: How much is this going to cost?
AM: I dunno. It depends on what it is.
Me: OK. Let me know when it’s done.
(three weeks later)
AM: OK, I fixed your car.
Me: Great! What do I owe you.
AM: $3,700.
Me: What?!?
AM: Well, Your transmission was going. The torque converter had eroded, and the smaller gap was allowing the axle to rub against the body frame. Because of that, We had to replace the axle. Also, because you let it go for so long without bringing it in, you tires were all unbalanced. So you needed four new tires, balancing, and an alignment.
Me: Oh.
AM: So, $3,700.
Me: Tell you what. Here’s my friend Bob. He’s going to pick up the tab for me.
Bob: Here you go, Mr. Mechanic. $1,200.
AM: $1,200?! The bill is $3,700!
Bob: Sure. But my client here is part of a Managed Maintenance Organization (MMO). And you’ve already done the work. Take it or leave it. In fact, all of your customers have joined our organization. So, you kinda have to take what we give you if you want to keep your bsuiness. Deal with it.
AM: Arggh!
I realize that the diagnosis procedure is less than absolutely definitive, but to borrow the analogy from Necros, consider the following (and please bear in mind that the automotive mechanic / medical professional analogy is not intended to be perfect):
I go to the mechanic because my exhaust manifold is cracked and needs to be replaced. The mechanic tells me that due to the extreme heat to which the bolts are subject, they have a tendency to break when removal is attempted. The mechanic tells me that if all goes well, the cost will be $300, but if bolts break, he will have to core and tap the block at a cost of $80 per bolt.
In my opinion, the doctor has the same leniency in providing an estimate. If I have a simple respiratory infection, the cost is $96, but if it turns out that I have lung cancer, the cost will be tens of thousands. The goal of the proposed estimate is not to inhibit medical professionals from receiving adequate compensation for the work performed, but to minimize multiple and unnecessary treatments.
I am aware that situation is not malpractice in legal terms. If you recall, I stated that in my opinion, the treatment I received on that particular occasion was malpratice.
In general, I am quite satisfied with the medical services which are rendered. Perhaps this dissatisfaction due to this particular instance would be best suited for the Pit, but it was my hope to postulate a procedure to resolve future incidents rather than rant. I understand that the implementation of such a procedure is not without failings, but given the leniency which is granted mechanics in the analogy, I fail to see how the postulation bears no merit. I concede that all points raised are valid, but I believe that the issue contained therein can be addressed.
Regarding the OP - interesting idea. The main reason why I think it won’t work is that in the case of an auto mechanic, generally once your car is in the shop it is not coming out until it is fixed. So the mechanic has the risk of having to do alot of extra work, but he knows that he will, ultimately get paid. In the case of a doctor, once you walk out at the end of your visit there’s no gaurentee that you will ever come back. Then the doctor is out the cost of your initial visits.