| ▲ | pclowes 7 hours ago |
| I understand the concerns and I am not sure I would allow myself to be recorded until I knew more. However, I do think we are in a situation where everybody knows that healthcare costs need to come down that doctors and medical professionals are spread too thin, forced to see evermore patients in the same number of hours, and yet for every attempt to improve efficiency there is a “no, not that way“ response. |
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| ▲ | hansvm 7 hours ago | parent | next [-] |
| If I paid all my doctors $1200/hr and doubled how much time they spend with or on me, that'd still pale in comparison to healthcare expenditures attributed to me between actual insurance payments and actual money leaving my bank account. Doctors being spread too thin is very much a separate issue. |
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| ▲ | hyperific 7 hours ago | parent | prev | next [-] |
| I definitely agree that medical professionals are spread too thin and automation seems like it would be a boon but, as the article points out, the introduction of automation likely won't translate to more doctor-patient time it'll translate to doctors seeing more patients. The solution not only introduces a problem (decreased privacy) but could reinforce the existing problem it's trying to solve. |
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| ▲ | hamandcheese 7 hours ago | parent [-] | | > it'll translate to doctors seeing more patients. This is also a good thing. Even in supposedly developed parts of the world like San Francisco it can be difficult to find a PCP that is taking new patients. | | |
| ▲ | reptilian 7 hours ago | parent [-] | | Where healthcare is concerned, America is not what anyone considers "first world". Your healthcare system is more backward than most third world nations. I would rather leave the US than receive medical treatment there. I have never even considered trusting the US healthcare system. When I lived there I would rather fly home and get treated (in a third world country) than lose all my savings getting inadequate care in the US. I know people who have been through large and expensive treatment plans in the global south, who paid less for the complete treatment than Americans pay for the ambulance getting you to the hospital. | | |
| ▲ | mmonaghan 6 hours ago | parent | next [-] | | I think its two systems masquerading as one - employed-and-insured and everyone else. If you're the former, it works great. If you're the latter, it can be mediocre to BRUTAL. Medical debt is our #1 or 2 cause of bankruptcy iirc. Regardless of which class you are, if you can access the care, our outcomes are the best in the world for most things. | | |
| ▲ | kelnos 2 hours ago | parent [-] | | > If you're the former, it works great. I don't think that's true at all. "Insured" doesn't mean just one thing. There are many different kinds of insurance, levels of plans, etc. Most insurance companies will do their best to deny claims or push more responsibility onto the patient. My insurance is very good, but I see a therapist weekly and my insurance only covers about 40% of the cost. I'm fortunate that ~$500/mo isn't a problem for me, but many people in the US would find that impossible. A few months ago I went to the ER for what turned out to be gallstones, and was still on the hook for $200 of that visit. And I took a Lyft the the hospital; I don't want to think about what my out-of-pocket cost had been if I'd needed an ambulance. Last summer I hurt my hand in a bicycle accident, and went to PT once a week for 6 weeks. I had to pay a $35 co-pay for each visit; that's $210 for a single injury. And this is with fairly good insurance. Many, many insured Americans just have so-so insurance. From what I hear of most healthcare systems in countries that do this right, most (if not all) of this stuff would have been completely free. > If you're the latter, it can be mediocre to BRUTAL Yup, and in a way that's an even worse indictment, that really puts us in worse-than-third-world territory. |
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| ▲ | reaperducer 6 hours ago | parent | prev [-] | | Your healthcare system is more backward than most third world nations. I would rather leave the US than receive medical treatment there. And yet the wealthiest people in the world, who can have the best healthcare anywhere they want on the planet, even with private doctors, routinely choose to be treated in Rochester, Minnesota; Boston, Massachusetts; Houston, Texas; Baltimore, Maryland; and Los Angeles, California. The U.S. is by no means perfect, but there's a reason that there are entire medical facilities in the U.S. that cater exclusively to people from other countries. Just listen to local radio in Palm Springs and you'll hear commercials along the lines of "Tired of waiting, or simply can't get the medical care you need in Canada? Come to our hospital!" Meanwhile, if I wanted to have my recent surgery in Canada, I'd have to wait almost a year for a slot to open up. Here I waited all of two weeks. And the newspaper headlines in the UK are full of horror stories of patients dying in hospital hallways while doctors are on strike because everything is so great. |
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| ▲ | winrid 7 hours ago | parent | prev | next [-] |
| "healthcare company lowers cost instead of absorbing new found profits" sounds like an Onion headline |
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| ▲ | marricks 7 hours ago | parent | prev | next [-] |
| > I do think we are in a situation where everybody knows that healthcare costs need to come down that doctors and medical professionals are spread too thin The problem is over optimization AND lack of people. As soon as there's an excuse for less staff because we have "digital record keeping" we're going to have less money and even less staff. Having in person or remote notetakers is a great entry level job to do before you become a doctor. It could be boring but at least the terms are familiar and you get to know the person you're working with. It's not like healthcare is an impossible problem to solve that needs more tech, we just refuse to spend money on people and (inexplicably) cannot help but dump tons of money into tech. |
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| ▲ | toast0 7 hours ago | parent | next [-] | | > The problem is over optimization not lack of people or resources. As soon as there's an excuse for less staff because we have "digital record keeping" we're going to have less money and even less staff. At least in my area, it seems like lack of people is a problem. Sometimes it's lack of people because the pay is too low, but more of it it's lack of people because the pool of qualified people is too small. And increasing pay increases healthcare costs, and healthcare costs are already very high. If digital tools allow the available staff to see more patients while delivering the same level of care (and without burning out the providers), then that means more capacity and less times people want to see a doctor, but can't. Similar arguments for same number of patients ans greater level of care. If it's more patients, but worse level of care, then it becomes tricky. | | |
| ▲ | marricks 6 hours ago | parent | next [-] | | Holy wow, I meant to say lack of people is the problem. Edited to reflect that. | |
| ▲ | jimbokun 6 hours ago | parent | prev [-] | | The lack of people is too low because the organization tasked with accrediting new doctors has a financial incentive to its current members to keep the pool of doctors low. |
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| ▲ | pclowes 7 hours ago | parent | prev [-] | | I don’t necessarily disagree with you here. However, there is a timing concern. Training doctors takes too long and the boomers are aging now. | | |
| ▲ | kelnos 2 hours ago | parent [-] | | The best time to fix that was 20 years ago. The next-best time to fix that is today. But we're still not doing that, and that's a huge oversight. (Or is intentional, to protect the doctor-training to hospital-slot pipeline cartel.) |
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| ▲ | kelnos 2 hours ago | parent | prev | next [-] |
| The problem is that (as addressed by the article), any efficiency wins end up pushing more patients on the provider. So if you used to have a 15-minute appointment, and five minutes of that were spent with the doctor writing down notes, with AI transcription, now you'll have a 10-minute appointment, and the doctor will be forced to see two more patients per hour. |
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| ▲ | pj_mukh 7 hours ago | parent | prev | next [-] |
| Yes, and also almost all of these issues could be ascribed to all digital medical record-keeping. The fact that AI transcribed it matters relatively little. |
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| ▲ | vlovich123 7 hours ago | parent | prev | next [-] |
| One massive way to reduce healthcare costs is to remove caps from becoming a doctor; as long as you pass the tests and meet the requirements, why are we turning doctors away? So that existing doctors can be paid well above the market rate. There's a reason there's so many doctors in politics - it's very important for them to protect this business model. |
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| ▲ | bonsai_spool 7 hours ago | parent [-] | | > There's so many doctors in politics - it's very important for them to protect this business model. Uh... politics is almost uniformly lawyers and business people. Also tests are the table-stakes to being a doctor (like leet code and programming). | | |
| ▲ | vlovich123 2 hours ago | parent [-] | | Tests are table stakes but quotas are how they ensure there’s fewer doctors than is needed to meet demand to ensure doctors get paid large salaries. While you’re not wrong, there are far more doctors in politics at all levels (including influential fundraising) than engineers and teachers. |
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| ▲ | midtake 7 hours ago | parent | prev | next [-] |
| Is that why healthcare costs are up, or is it because of the insurance mafia? |
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| ▲ | jimbokun 6 hours ago | parent [-] | | It’s the doctors. Insurance company profit margins are capped by law and if anything their incentives are to pay the hospitals less. US physician salaries are astronomical compared to anywhere else in the world. | | |
| ▲ | cpburns2009 6 hours ago | parent | next [-] | | Profit margins are capped by percentage. That creates the perverse intensive for insurance companies to pursue ever increasing costs in order to increase profits. | | |
| ▲ | ars 4 hours ago | parent [-] | | You are forgetting about competition, increasing costs means directly increasing premiums, and higher premiums means lower business. |
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| ▲ | christophilus 6 hours ago | parent | prev [-] | | [dead] |
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| ▲ | gosub100 7 hours ago | parent | prev | next [-] |
| How do you know it's not the other way around? Give consent to incorporate another technology that will keep wages the same but allow them to treat more patients and extract more profit for the shareholders? |
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| ▲ | bluefirebrand 7 hours ago | parent | prev | next [-] |
| > for every attempt to improve efficiency there is a “no, not that way“ response They've tried everything except "train and hire more doctors" and they're just all out of ideas aside from "erode patients rights and lower overall quality of care" |
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| ▲ | pclowes 7 hours ago | parent [-] | | The economics of medical school cost, time, and capped residency spots (some would argue this is price-fixing with artificial scarcity) make it hard to just “make more doctors”. Combine this with a highly litigious society that always demands a full doctor (when for 90% of things an NP or PA would do) plus inverted population pyramid all exacerbate the problem. We need more doctors now and it takes 12 years to make a doctor and by then the boomer cohorts aging and medical needs will peak. Finally, even if we could do that, the top of the funnel candidate is substantially weaker with lower test scores and higher need for remedial classes. And for the good candidates, the ROI of medical school is not as good as it once was. | | |
| ▲ | bluefirebrand 4 hours ago | parent [-] | | Sure. All of that can be true and yet it's still something we need to do better about Just saying "it's really hard so we won't do it" isn't exactly an option when it comes to providing healthcare. :/ |
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| ▲ | johndhi 7 hours ago | parent | prev | next [-] |
| yes, this! |
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| ▲ | dheera 7 hours ago | parent | prev [-] |
| How about this: 1. I have health insurance 2. The point of insurance is they're supposed to pay for shit 3. You figure out how to get them to pay for shit, sign an agreement that removes me of any patient responsibility of the balance bill, and assure me in writing that I will owe $0 no matter what Then you can record me. |
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| ▲ | gedy 7 hours ago | parent [-] | | Insurance, like a lot of subsidies turns into "we will take all of that, and still make sure your share is at the limits of your carrying capacity" |
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