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I can only speak about the medical system in the United States. Over the past several years, the insurance companies have effectively taken control of what medical procedures can happen and those that can not. I know many people believe that the Insurance companies do have the medical insight to make decisions based on financial reasons. I do know that many Insurance companies do in fact have medical staff on board to review requests. My only thought about that is the fact that they are representing their company, they are not going to approve just anything that is going to cost them something.
So, how do we get things done? How do we get those MRIs?, Cat Scans and all the other diagnostic tests that are so important into diagnosing our problems. Its the responsibility of the doctor to provide the proper justification and rationale to have any test(s) performed on their patients. But that also assumes that the doctor believes those actions should be done. Some times, patients come in because they are having a problem and insist on having diagnostic test (ABC) done. The doctor has to do a complete evaluation of that patient to determine what tests should or should not be done. If they are not done, many people will blame it on the doctor, or blame it on the insurance company. Before blame is placed, we need to review why that decision was made! If the doctor said, no tests, then Why? Everyone one of us deserves that answer and courtesy.
There are many times when the patient wants this, that and everything. I can understand that. They are hurting and want some answers. But insisting on some test being done is not always the best course of action. Instead, it would be WHY isnt that test important? Let the doctor explain that to you. And if they dont, thats when you do not GIVE UP
You deserve a rationale response.
The point of this is to just say, that we all cant march in and tell the doctor we want this or that. Instead we need to discuss this with your doctor and if nothing has identified the problem, then we say What else should we do? And that should be words enough to tell any respectable doctor to do their homework,
Many times in these forum discussions, I've talked about good and bad doctors, just as well as good and bad physical therapists, nurses, admin folks, etc. Its just the nature , we have good and we have bad. We only hope for the good. But when there is bad, so many times, we get shunned aside as a trouble maker for asking questions or wanting something else done. There is always a fine line here. I have found over the years, that having the opportunity to speak to the doctor directly makes a big difference. Some times, the admin staff will make a decision without the doctor's knowledge. That is so wrong, those admin folks do not have a degree in medicine and should never make decisions about health issue
What infuriates me more, is the connections that a person needs to have to make things move along. My mother in law just passed away last weekend. My wife was in Italy prior to this happening. So, I was up front in dealing with doctors and other medical staff. I was appalled at some of the answers and I am sure that some of the doctors were totally annoyed at me for speaking up. Sorry, to bad.
But the bigger problem was that my wife was able to text a few doctors, a few case workers to make things happen they way they should be. Everything was done in the proper sequence to care for my mother-in-law. From the time of moving her from the Hospital to short term Rehab to Hospice was done through some of the connections we have with the medical field.
That bothers me so much! If we didnt have these connections, if we didnt know these people, what would have happened? My Mother-in-law would have stayed in the hospital until they said nothing else can be done and then shipped off to rehab
I am very grateful for the care that the medical field took towards my Mother-in-law. I appreciate that! But what about the people that dont have connections, dont know who to call, basically dont know what to do and rely on the current medical team to tell them what will be done.
This bothers me, because it is is very clear without connections, things may never happen. That applies beyond the health field, it goes into just about any phases of our lives.
I dont know how to correct this or to make it stop. The only thing I know is words from my wife years ago.... Speak firmly, speak clearly and ask the right questions and do not take bogus answers. You have a right to know. We all have the right to know
I know folks like DavidG and EMSGuy who have been in the medical field understand all of this.
Life changing situations should always be about the patient and not who you know