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USA vs UK healthcare - physician perspective

USA vs UK healthcare - physician perspective

Old Sep 8th 2019, 6:53 pm
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Default Re: USA vs UK healthcare - physician perspective

Originally Posted by expatdoc
As an example I saw last week an individual case of a patient who had a delay of 4 days to find a mental health bed and that made the front page of a national newspaper in the UK. No way period would such a thing be reported in the NY Times for example.
Well, of course something like that wouldn't be reported in the New York Times - it isn't news in the US because it happens all the time - and if you don't have insurance nobody is even going to bother looking for a mental health bed for you.

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Old Sep 8th 2019, 7:22 pm
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Default Re: USA vs UK healthcare - physician perspective

Originally Posted by Jsmth321
Are house calls common in the UK? (curious is all, haven't any clue.)
Not common in the small town where I live but there is a doctor on call every day for the occasional time a house call is urgently required. The doctor on call is always listed in the surgery so that you know if you have an appointment with that particular doctor you may have a long wait.

There is a small bus that runs just around the town, population about 8,000, calling at the supermarkets, market street, the 2 GP surgeries, and small outpatient hospital.

We can always get an appointment to see a GP the same day which is very convenient. The NHS availability and patients/doctor is a post code lottery as far as I can tell.
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Old Sep 8th 2019, 10:47 pm
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Default Re: USA vs UK healthcare - physician perspective

Originally Posted by durham_lad
We can always get an appointment to see a GP the same day which is very convenient. The NHS availability and patients/doctor is a post code lottery as far as I can tell.
My previous experiences in the UK were mostly playing telephone tennis - you had to call the surgery at 8.30am and hope that you got through before all the same-day appointments were booked.

I don't think I ever waited longer than a week for an appointment to see a GP, but the real fun began whenever you needed to be referred onto a consultant at a hospital, assuming you could convince the GP to even write the referral letter in the first place.

Honestly, the fact that I could just call a specialist here in the US - any specialist, of my choice - and just book an appointment directly was a revelation to me.

I appreciate that it does depend on whether you're a member of an HMO/PPO or whatever, but I feel it's a better system if you're willing (and able, granted) to take the time to make it work for you.
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Old Sep 8th 2019, 11:22 pm
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Default Re: USA vs UK healthcare - physician perspective

Originally Posted by Jsmth321
Are house calls common in the UK? (curious is all, haven't any clue.)
You wouldn't request a GP to house call unless you felt it really necessary . However , house calls do happen. It was heaven sent when I was looking after my Dad as there is no way he could have got to any surgery. I would have ended up having to call emergency service ambulances . GPs will make regular house calls for those patients that are house bound, frail or incredibly ill in their own home. There are also district nurses which make regular house calls

Here in NZ you pay for a visit to see a GP in their surgery. From memory, a house call can be made as there is an on-call GP. The cost for that I think is double .

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Old Sep 9th 2019, 12:44 am
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Default Re: USA vs UK healthcare - physician perspective

Originally Posted by BEVS
You wouldn't request a GP to house call unless you felt it really necessary . However , house calls do happen. It was heaven sent when I was looking after my Dad as there is no way he could have got to any surgery. I would have ended up having to call emergency service ambulances . GPs will make regular house calls for those patients that are house bound, frail or incredibly ill in their own home. There are also district nurses which make regular house calls

Here in NZ you pay for a visit to see a GP in their surgery. From memory, a house call can be made as there is an on-call GP. The cost for that I think is double .
I don't know if GP's in Canada would do such work, I find it interesting. We don't pay anything directly out of pocket for doctor visits here though. I know my GP wouldn't, she wont even speak on the phone, if one is too ill to go to the GP office, one would expected to call for an ambulance and go to the ER.

Originally Posted by TexanScot
My previous experiences in the UK were mostly playing telephone tennis - you had to call the surgery at 8.30am and hope that you got through before all the same-day appointments were booked.

I don't think I ever waited longer than a week for an appointment to see a GP, but the real fun began whenever you needed to be referred onto a consultant at a hospital, assuming you could convince the GP to even write the referral letter in the first place.

Honestly, the fact that I could just call a specialist here in the US - any specialist, of my choice - and just book an appointment directly was a revelation to me.

I appreciate that it does depend on whether you're a member of an HMO/PPO or whatever, but I feel it's a better system if you're willing (and able, granted) to take the time to make it work for you.
One upside if one has insurance in the US that allows it is self referral to specialists, my last insurance did and it was so nice being able to go directly to most specialists without having to wait months for a GP to attempt to figure out an issue, then being referred then waiting again for an appointment with specialist. I went a 4 solid months with a store throat and cough seeing my GP every 2 weeks for it while she guessed what it might be, but then finally gave in that she didn't know what it was, and I finally got a referral and specialist solved the issue with 1 visit and a simple prescription.
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Old Sep 9th 2019, 1:54 am
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Default Re: USA vs UK healthcare - physician perspective

Originally Posted by BEVS

Here in NZ you pay for a visit to see a GP in their surgery. From memory, a house call can be made as there is an on-call GP. The cost for that I think is double .
Oz healthcare isn't perfect but seeing a GP is an area they do really well. If you need to see a GP after hours, you just call one of the 'Doctor On Call' numbers and a GP comes to your home at no cost. Everyone who has a Medicare card can get this service, which is all Oz citizens, all permanent residents and some people on temporary visas.
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Old Sep 9th 2019, 1:56 am
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Default Re: USA vs UK healthcare - physician perspective

Originally Posted by Jsmth321
I went a 4 solid months with a store throat and cough seeing my GP every 2 weeks for it while she guessed what it might be, but then finally gave in that she didn't know what it was, and I finally got a referral and specialist solved the issue with 1 visit and a simple prescription.
What was the diagnosis JS? I remember it took a looooong time for you to get!
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Old Sep 9th 2019, 2:10 am
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Default Re: USA vs UK healthcare - physician perspective

Not USA vs UK, but isn't GP one of the professions that articles have claimed will be replaced by AI in short order? A saving of $250k per quack per annum seems like AI will be the way to go. I have this mental image of a Dalek issuing advice in terrifying metallic orders to "Lose Weight!!!" and "Eat Less Carbs!!!". Probably more effective than current practice of nodding to the Doc and then completely ignoring good advice.

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Old Sep 9th 2019, 2:46 am
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Default Re: USA vs UK healthcare - physician perspective

Originally Posted by spouse of scouse
What was the diagnosis JS? I remember it took a looooong time for you to get!
Gastroesophageal reflux disease, I just say acid re-flux as its shorter, that is the diagnoses the specialist is confident it is, and since starting the medication, adjusting diet, and lifting the head of the bed a bit, most of the symptoms have gone away, there is still some tightness in the throat but its slowly going away, the cough is completely gone, and largely feeling better, so it appears to be the correct diagnoses. The specialist sent down a small camera, well sent a small camera through my nose into my throat and while my esophagus was red and irritated he didn't see anything to indicate something more serious which is a plus, I was getting paranoid it was cancer or something more serious.

Its all very likely linked to a hiatal hernia which I knew I had as does my GP, and guess with age the muscle holding back acid is becoming weaker, and the hernia doesn't exactly help.
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Old Sep 9th 2019, 2:51 am
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Default Re: USA vs UK healthcare - physician perspective

Interesting.

We have a shortage of GP's so not even sure we could have such a system here considering there isn't enough GP's to go around to begin with, my GP for example is on vacation for 5 weeks, and her office couldn't find anyone to even cover for her.

Originally Posted by spouse of scouse
Oz healthcare isn't perfect but seeing a GP is an area they do really well. If you need to see a GP after hours, you just call one of the 'Doctor On Call' numbers and a GP comes to your home at no cost. Everyone who has a Medicare card can get this service, which is all Oz citizens, all permanent residents and some people on temporary visas.
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Old Sep 9th 2019, 7:31 am
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Default Re: USA vs UK healthcare - physician perspective

Being able to see a specialist easily in the USA was definitely nice but our PPO retiree plan from my ex employer was $12k/year. It had to be a PPO plan because we had retired and moved out of State and the company HMO networks were all in-State. I looked into an ACA plan but where we lived there were no PPO plans available, only HMO plans and none of those plans had doctors in the town we lived so it would be at least a 5 mile drive just to see a GP. And this was a town of 120k people.

Where we live now I have needed to be seen by a specialist twice, once for suspicious moles, and once for a heart condition and in both situations it happened within a couple of weeks. The skin cancer guy agreed with the GP that they were suspicious and 6 weeks later all 3 were removed and tested. (All clear thank goodness). The heart unit have been fantastic. Lots of tests and monitoring confirming it was paroxysmal atrial fibrillation and a few months later Ablation surgery to fix it. The surgery was 11 months ago and zero problems since then. It was like magic.

We do pay £40/month each for private insurance which kicks in if the waiting time is greater than 6 weeks on the NHS. One can also see a specialist quickly if they are prepared to pay to see one. I have heard of folks doing this as if the diagnosis means requiring further work such as surgery then at least you are now in the hospital system with a priority set by the seriousness of the condition. We have good friends in Scotland who kept on their private insurance after he retired and a year back he had a hip replacement and is due to go for his 2nd hip replacement soon.

I think the UK is a bit like the USA in that it is a 2-tier system, if you can afford it you can have more easily accessible healthcare. Even back in the 80s before we moved to the USA I had health insurance for the family through my employer.
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Old Sep 9th 2019, 9:01 am
  #102  
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Default Re: USA vs UK healthcare - physician perspective

Originally Posted by Jsmth321
Interesting.

We have a shortage of GP's so not even sure we could have such a system here considering there isn't enough GP's to go around to begin with, my GP for example is on vacation for 5 weeks, and her office couldn't find anyone to even cover for her.
The after hours ones are usually either doctors who've just finished their training and have yet to establish their own practice or join a group practice, and overseas doctors who have just finished their Oz registration and also are yet to establish themselves.
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Old Sep 9th 2019, 9:32 am
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Default Re: USA vs UK healthcare - physician perspective

Originally Posted by durham_lad
Being able to see a specialist easily in the USA was definitely nice but our PPO retiree plan from my ex employer was $12k/year. It had to be a PPO plan because we had retired and moved out of State and the company HMO networks were all in-State. I looked into an ACA plan but where we lived there were no PPO plans available, only HMO plans and none of those plans had doctors in the town we lived so it would be at least a 5 mile drive just to see a GP. And this was a town of 120k people.

Where we live now I have needed to be seen by a specialist twice, once for suspicious moles, and once for a heart condition and in both situations it happened within a couple of weeks. The skin cancer guy agreed with the GP that they were suspicious and 6 weeks later all 3 were removed and tested. (All clear thank goodness).
Here in Aus we have Skin Cancer clinics everywhere and they're all bulkbilled (free at point of sale). No one bothers a GP for an iffy mole. You go straight to the SC clinic and if it's in anyway dodgy, they'll remove or treat it there and then. We have the highest rate of skin cancer in the world but have relatively few deaths because of the speed of treatment.
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Old Sep 9th 2019, 1:07 pm
  #104  
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Default Re: USA vs UK healthcare - physician perspective

Originally Posted by moneypenny20
We have the highest rate of skin cancer in the world but have relatively few deaths because of the speed of treatment.
As an aside, do you feel people are complacent about the risks and the need to use UV protection because of the ease and speed of access of treatment?
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Old Sep 9th 2019, 1:40 pm
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Default Re: USA vs UK healthcare - physician perspective

Originally Posted by TexanScot
As an aside, do you feel people are complacent about the risks and the need to use UV protection because of the ease and speed of access of treatment?
Not in my experience but country wide it could be possible. You'd have to blind, deaf and dumb to ignore the warnings about skin cancer and no one wants bits of their flesh cut out/frozen off regardless of whether the biopsy comes back positive or negative.
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