Old folks getting older

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Originally Posted by commonlaw

It's more fashionable to claim doctors are part of a larger conspiracy to reupholster their mercs at the expense of the vulnerable. We are all living in the land of anecdote here, but there are many doctors in my family and I know more than a few oncologists that have a singular purpose, and that is to cure people, or at the very least, provide them with as many options as possible and let them make a decision. The oncologists I know deserve to drive whatever the fuck they want. We've seen Benny conflate material possessions with depth of character before dozens of time. It's a convenient way to look at the world, so its hard to blame him I suppose.

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QFT

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Originally Posted by Benny Profane

Sure you can. They have a lot of power in these situations. But, they aren't truthful, or just plain lie in order to maintain that "system", which they make a decent living from.

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i made a great show of trashing doctors a couple of months ago, but like anything, there are really good ones, good ones and bad ones. I have met some very dedicated people in healthcare

I can say it is not easy on the clinical side. I hope it is rewarding

The GP that insisted on giving my wife a breast exam at every visit was not one of the good ones. That line of mine about doctors curing and PA's caring was said by a PA.

Once again, Benny is full of shit, has had a few anecdotal experienes, probably mortly third hand, and is now an expert.

Are there bad, money hungry MDs out there? sure, but the are the exception not the rule. Most are in the healing arts because they want to heal and help. Sometimes that means doing what the patient wants even if it may not be the wisest financial choice.

Benny is the guy in the bar that is an expert on everything despite the fact he doesn't know shit and everybody keeps moving away from and try to avoid eye contact with.

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Originally Posted by commonlaw

That's exactly it. It all sounds so easy when you are relatively healthy and younger. Hell, I've told my wife that if I get some seriously bad news, I'm taking myself out to the back 20 with a shotgun before we drain our resources. But I've seen resolute men stare death in the face and wildly swing away against reason because its just fucking human nature most of the time. We are all Hunter Thompson or Hemingway in our own minds until it becomes real.

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I can't say that I'd have the strength of character to check myself out like you described. But, I do feel pretty confident that if I were presented with the option of suffering through chemo/radiation/surgery that in all likelihood won't cure me or meaningfully prolong my life, and may in fact kill me on its own, or just letting the disease run its course, I'm going to choose the latter option. In old age anyway, if it happened tomorrow I'd fight tooth and nail.

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Originally Posted by XXX-er

Are the Doctors making the decision to prolong life OR is it the family?

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It's ultimately the choice of the patient or their family. But, it is common for doctors to oversell the benefit of a treatment, and downplay the risks and side effects. Not that they commonly do so with any kind of malicious intent, people just want hope and it's hard to tell them that they are going to die no matter what. Benny is right that, when polled, most doctors say they would decline most treatments other than painkillers if confronted with a terminal diagnosis late in life. How many actually do so is an open question.

"Or as the [2013 JAMA] study’s conclusion put it, “dying patients continue to be hospitalized and subjected to ineffective therapies that erode their quality of life and their personal dignity” while doctors “have a striking personal preference to forego high-intensity care for themselves at the end-of-life and prefer to die gently and naturally.”"

"Sometimes, though, it’s more emotionally comfortable for doctors to simply dole out additional, albeit futile, treatment. “It’s a lot easier for a physician to prescribe one more line of chemotherapy than it is to have a conversation about why you’re stopping therapy,” he said. “I can see how a physician could postpone this conversation and go for one more line of chemo instead of taking a bigger step, doing the heavy lifting and talking about end-of-life.”"

http://www.fredhutch.org/en/news/cen...ctors-die.html

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Originally Posted by hutash

Once again, Benny is full of shit, has had a few anecdotal experienes, probably mortly third hand, and is now an expert.

Are there bad, money hungry MDs out there? sure, but the are the exception not the rule. Most are in the healing arts because they want to heal and help. Sometimes that means doing what the patient wants even if it may not be the wisest financial choice.

Benny is the guy in the bar that is an expert on everything despite the fact he doesn't know shit and everybody keeps moving away from and try to avoid eye contact with.

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Give me a break, dude. Really. Here, I posted this in polyass. http://ritholtz.com/2017/05/u-s-spen...sweden-canada/ We all have to be reminded of this evry,, oh, six months or so. It's fucking absurd when you look at it. All this churn, all this profit, all those Porsches. And, when's the last time you read about the awful medical care in France, Norway, or, even friggin' bitter old Brexit Britain? Where are the old sick, dying homeless people in Paris, Berlin, or Milan? Those doctors are doing ok, but they ain't driving shiny new Porsches. As it should be.

Physician around the world are doing fine, some are doing better then in the US, and nearly all of them don't have the educational burden and debt US MDs have.

https://journal.practicelink.com/vit...ion-worldwide/

Once again Benny, you are talking out your ass.

There are problems with the US health care system, no argument from me there, physician pay is only a small part of that.

I agree physician pay is only a small part. They are both actors and victims in a treatment based profit system, and, you know, you gotta make a living. But, man, to advise procedures on the dying for, eventually, profit when that same physician wouldn't dream of doing that for himself or his mother is just plain wrong, and immoral.

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Originally Posted by Benny Profane

I agree physician pay is only a small part. They are both actors and victims in a treatment based profit system, and, you know, you gotta make a living. But, man, to advise procedures on the dying for, eventually, profit when that same physician wouldn't dream of doing that for himself or his mother is just plain wrong, and immoral.

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So whats the hot take on pediatricians? Maybe OB/GYN's? How about regular old family practice doc?

All can easily afford this porche you are so pissed about.

You obviously haven't spent much time around real medical facilities. Nor have any idea what communications go on between MDs and patients/families. Many times these procedures are patient driven, people holding out for that last chance, their only hope. While I, and you, take a real pragmatic approach, many do not, I can't say it's wrong, just not what I would do. We each make our own choices. When an MD may offer such services and procedures, it is the patients choice. It would be malpractice to not offer them ( and have an honest discussion about outcomes.)

"Being Mortal" is a great read for anyone confronting their own or a loved ones mortality

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Originally Posted by hutash

You obviously haven't spent much time around real medical facilities. Nor have any idea what communications go on between MDs and patients/families. Many times these procedures are patient driven, people holding out for that last chance, their only hope. While I, and you, take a real pragmatic approach, many do not, I can't say it's wrong, just not what I would do. We each make our own choices. When an MD may offer such services and procedures, it is the patients choice. It would be malpractice to not offer them ( and have an honest discussion about outcomes.)

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Didn't you recently write this? It seems to contain the answer to the above issue:

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Originally Posted by hutash

Once again, Benny is full of shit, has had a few anecdotal experienes, probably mortly third hand, and is now an expert.

[...]

Benny is the guy in the bar that is an expert on everything despite the fact he doesn't know shit and everybody keeps moving away from and try to avoid eye contact with.

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Originally Posted by wooley12

The GP that insisted on giving my wife a breast exam at every visit was not one of the good ones. .

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I just wana put it out there that I will do then for free

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Originally Posted by XXX-er

I just wana put it out there that I will do then for free

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you just need a good advert as attached
https://www.youtube.com/watch?v=dUa5WCu7p8o

IME--both fee for service and salaried medicine--there are certainly docs who overtest and overtreat out of greed, but a more common situation is one in which the financial incentive is subconscious--very few of us a able to resist incentives when they are offered. However, most unnecessary medicine is practiced because it's how doctors are trained. As a resident you are almost never chastised for ordering a test or doing an operation, only for not doing it. It also comes from the way people are selected to go to med school--the process selects for the most compulsive people with the longest resumes. So we pick people to be doctors who study more, do more research, volunteer more and then we train them to do more. It would be surprising if we didn't have an overly expensive health care system.

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Originally Posted by hutash

You obviously haven't spent much time around real medical facilities. Nor have any idea what communications go on between MDs and patients/families. Many times these procedures are patient driven, people holding out for that last chance, their only hope. While I, and you, take a real pragmatic approach, many do not, I can't say it's wrong, just not what I would do. We each make our own choices. When an MD may offer such services and procedures, it is the patients choice. It would be malpractice to not offer them ( and have an honest discussion about outcomes.)

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With all due respect (none) can you please stop trying to present yourself as some kind of human healthcare expert. We'll let you know if a cat has a furball requiring veterinary attention.

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Originally Posted by Saul Alinsky

With all due respect (none) can you please stop trying to present yourself as some kind of human healthcare expert. We'll let you know if a cat has a furball requiring veterinary attention.

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Hey, fuck you buddy.

My dad's side of the family, who we mostly take after, we're all about 9 feet tall. low blood pressure thin as a rail (my dad was 6-2 112 at the outbreak of WWii. had to put pennies in pocket to past the weight test). No cancer, etc. ONly thing is, we all go batshit crazy about 75. So I told my wife.

Hold on tight sweetie. It's gonna be one hell of a ride. And I'm gonna have a good time!