I just don't want people to waste time with treatments that don't work. Medication worked great for a couple of years, but when it didn't work anymore I feel like my doc should have been more proactive. And the fact that it takes 3-4 months in small town America to even get an appointment doesn't help. I got "lucky" this time because my kidney infection kicked in the day I finally had my appointment and it was pretty clear to everyone that as soon as the infection was gone I had to have the surgery. I often wonder how many people die waiting for their crucial initial visit? Specialists can make so much more money in a big town so they are not willing to serve small town America. We are 3 hours from El Paso, 3 hours from Tuscon, which are both pretty big cities, but who wants a 6 hour round trip to see a doctor.
Yep. All of this, I agree with. In France, the way the system works is that doctors don't make a ton, but then their education is subsudized, med mal is structured so it's nowhere near as costly as here, so they don't need to clear $1M yearly just to pay off med school and cover their insurance premiums. From French satisfaction reports, it works out well - for them. Every country's culture is different.
Relatedly, seems to me incentives need to be put in place to get doctors out to the rural areas. Lower education costs in return for X years of service (reminds me of military in some ways), creating practice areas in rural medicine - I can see that as a subset of internal or family medicine, since rural areas experience different needs than typical urban concentrations, increased funding to "mobile" clinics or secondary services - something of the Methodist Church peripatetic existence, but on 4 wheels, and medicine.
I know very little about it but know of the "locum tenens" system, basically temp workers to fill in need in rural facilities, but they are physicians.
It goes to culture, again. If this country is willing to see this is a vital area worth all of us trying to remediate, we will bear the costs happily. If not, I'm afraid, it's a tough sell. And I think that sucks. I'm a democratic socialist so I'd have a different viewpoint from bwarbiany, whose view I'm interested in, here.
I'm very glad you caught it, Corky. I was in some pretty deep doodoo last year from a severe, acute pancreatitis attack, causes unknown. My system hospital (I'm University of WI, for my team) is literally about 10 minutes away, and I'm extremely grateful for it. Quality healthcare is something I believe is a national priority - no citizen should suffer or worse, for lack of access.
