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Posted: 4/17/2024 1:58:47 PM EDT
[#1]
Quote HistoryOriginally Posted By HELOBRAVO: Absolutely not true..... Quote HistoryOriginally Posted By HELOBRAVO: Originally Posted By Ryan_Scott: PAs and NPs are great for hospital systems because they refer and test at 4-5x the rate of physicians, which drives sales. If you actually want to go to the clinic and get the issue settled with finality, get a doc. Absolutely not true..... I agree, PA's need to increase. (If that's what you mean) they cost less as well. |
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Posted: 4/17/2024 1:59:24 PM EDT
[#2]
Quote HistoryOriginally Posted By HELOBRAVO: He will not let that stop him from posting.  Quote HistoryOriginally Posted By HELOBRAVO: Originally Posted By flightmed: Tell me you know nothing about prehospital care and air ambulances without telling me… He will not let that stop him from posting. Of course it won't.
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Posted: 4/17/2024 2:02:21 PM EDT
[#3]
Quote HistoryOriginally Posted By Waldo: You're free to take risks with your own life. I'm not going to judge those people for not wanting to fly in bad weather. And at best, helicopters are a barely contained mass of rotating parts that is continually trying to disassemble itself. Quote HistoryOriginally Posted By Waldo: Originally Posted By OregonShooter: If there is a cloud in the sky Life Flight won't fly. These organizations are pathetic. You're free to take risks with your own life. I'm not going to judge those people for not wanting to fly in bad weather. And at best, helicopters are a barely contained mass of rotating parts that is continually trying to disassemble itself. Air Medical is the most dangerous profession as of now. With crashes. My buddy's wife was killed in one years ago. It's definitely a risk. But it is solution as well. Living rural is a risk. Many people need to wake up. If it's important? Then funnel tax dollars to it. But that won't happen. |
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Posted: 4/17/2024 2:03:27 PM EDT
[#4]
Put illiterate booger eaters in charge of finances and administration…
Get illiterate booger eater results. You should see the third world shithole that is Jackson, MS, and the expensive clothes, cars and houses of the IBEs who run it. They tried to bilk the federal gub’mint out of something like $7M to fix the “water crisis,” because “the water don’t work no mo.” The Army Corps of Engineers sent a dude to the water treatment plant and he turned it back on. It worked fine. We are not a serious country anymore. |
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Posted: 4/17/2024 2:03:29 PM EDT
[#5]
Quote HistoryOriginally Posted By CTM1: Never forget running my little nephew to my rural county hospital after he crashed his quad and broke his arm in two places. It was around 5pm and they did not have a doctor on duty who could set his arm. It had to be done at a children's hospital the next day that was 200 miles away. No money to have a Doctor on duty but my governor is able to find all of this money to provide every need for the illegals flooding our state. Even in the city, they will probably splint it and refer you to an ortho later in the week. Like my daughter. |
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Posted: 4/17/2024 2:06:53 PM EDT
[#6]
Quote HistoryOriginally Posted By HIMARS13A: You mean secondary care, tertiary is the regional medical center level. Quote HistoryOriginally Posted By HIMARS13A: Originally Posted By skid2041: Very little a tertiary hospital can do for a fatal head bleed. Unless they can do burr holes or have ICP relief. You mean secondary care, tertiary is the regional medical center level. Sorry, I consider secondary to be Prim Care. I'm considering thombectomy capable & comprehensive centers. Tertiary would be neither. |
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Posted: 4/17/2024 2:08:06 PM EDT
[#7]
Quote HistoryOriginally Posted By HIMARS13A: EKGs are pretty easy to do now, you can even get a read remotely if you need one. Quote HistoryOriginally Posted By HIMARS13A: Originally Posted By skid2041: 12-leads and trops can now be done onscene with an ambulance. If they need a Cath, going to a tertiary can be a death sentence. EKGs are pretty easy to do now, you can even get a read remotely if you need one. 100%. Heck, there is an FDA approved 3/4lead you can read on your phone. Plus, filed Butterfly POCUS are more common now. |
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AZ, USA
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Posted: 4/17/2024 2:08:36 PM EDT
[#8]
Quote HistoryOriginally Posted By skid2041: Sorry, I consider secondary to be Prim Care. I'm considering thombectomy capable & comprehensive centers. Tertiary would be neither. Pretty hard to communicate with a guy that makes up his own language. |
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Posted: 4/17/2024 2:08:55 PM EDT
[#9]
Quote HistoryOriginally Posted By heavymetal762: Ignorance is biss, and you are very happy. What you propose is beyond unaffordable and would reduce medical care dramatically for most rural residents. Quote HistoryOriginally Posted By heavymetal762: Originally Posted By skid2041: Good, they are only "feeder" hospitals for bigger networks anyways. They have ambulances transport there instead of taking to the better, higher capable hospitals, so they can bill the insurance for a stay. Then transport the patient to the higher capable. Causing a delay I'm treatment & possibly death. Get more helicopters and fly the patients. Ignorance is biss, and you are very happy. What you propose is beyond unaffordable and would reduce medical care dramatically for most rural residents. Nope. Actually, it's not. It could improve care for them. |
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Posted: 4/17/2024 2:11:31 PM EDT
[#10]
Quote HistoryOriginally Posted By JoinDatePostCount: That’s all fine and good until the road closes and rotor AND fixed wing can’t fly due to the weather. Quote HistoryOriginally Posted By JoinDatePostCount: Originally Posted By skid2041: Good, they are only "feeder" hospitals for bigger networks anyways. They have ambulances transport there instead of taking to the better, higher capable hospitals, so they can bill the insurance for a stay. Then transport the patient to the higher capable. Causing a delay I'm treatment & possibly death. Get more helicopters and fly the patients. That’s all fine and good until the road closes and rotor AND fixed wing can’t fly due to the weather. Fixed wing can fly I'm quite a bit of weather. True that hero's cancel more than respond to scene calls. Also, interfacility transfer pay more for the helo-service. Trust me, the patient can be cared for very well in ground transport as well. But, hospitals can't bill for treatment PTA. So... |
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FL, USA
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Posted: 4/17/2024 2:12:03 PM EDT
[#11]
Quote HistoryOriginally Posted By Ryan_Scott: PAs and NPs are great for hospital systems because they refer and test at 4-5x the rate of physicians, which drives sales. If you actually want to go to the clinic and get the issue settled with finality, get a doc. My experience at teaching hospitals shows it would be difficult for a practitioner to order more labs, scans, or consults than an MD. |
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Posted: 4/17/2024 2:15:48 PM EDT
[#12]
Quote HistoryOriginally Posted By Smokey0844: The capability used to be there. It wasn’t a first aid center until the last few years after they closed the ER and stopped doing any procedures. The ICP that was done gave her a chance but the brain was too far compressed by the time they had her there to do it. Quote HistoryOriginally Posted By Smokey0844: Originally Posted By skid2041: Very little a tertiary hospital can do for a fatal head bleed. Unless they can do burr holes or have ICP relief. The capability used to be there. It wasn’t a first aid center until the last few years after they closed the ER and stopped doing any procedures. The ICP that was done gave her a chance but the brain was too far compressed by the time they had her there to do it. I'm sorry about your Mom @Smokey0844. But depending on her age, even if they could receive the pressure, she would be bedbound in a rehab facility until she became septic from pneumonia and died. Rural hospitals CAN have good capabilities. But even then, if the staff/doctors don't see many patients or disease processes, they will miss a bunch. Many doctors transfer because they don't know any better. |
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Posted: 4/17/2024 2:17:13 PM EDT
[#13]
Quote HistoryOriginally Posted By jsnappa: Mortality isn’t nearly that high, besides, no one (of course very few do) dies on the surgical table. Especially if you can get them to someone like Dr. Tomas Martin or the surgeons he’s trained. A robust transport network is key. Quote HistoryOriginally Posted By jsnappa: Originally Posted By skid2041: If they are dissecting, depending on how soon or what kind, they are probably dead anyways. Even on a surg table. Mortality isn’t nearly that high, besides, no one (of course very few do) dies on the surgical table. Especially if you can get them to someone like Dr. Tomas Martin or the surgeons he’s trained. A robust transport network is key. Having a Dr Martin nearby is key as well. Lol |
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Posted: 4/17/2024 2:18:10 PM EDT
[#14]
Quote HistoryOriginally Posted By HIMARS13A: Pretty hard to communicate with a guy that makes up his own language. Quote HistoryOriginally Posted By HIMARS13A: Originally Posted By skid2041: Sorry, I consider secondary to be Prim Care. I'm considering thombectomy capable & comprehensive centers. Tertiary would be neither. Pretty hard to communicate with a guy that makes up his own language. I didn't make it up. Sorry. |
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USA
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Posted: 4/17/2024 2:19:53 PM EDT
[#15]
Quote HistoryOriginally Posted By skid2041: @dirtyboy. They are $30,000 actually. And you can get subscriptions to them. Everyone should. I pay $60 a year for one of the local services, & $50 a year for the other. Covers my own family. They save my Lat/longs for landing. They cover transfers and one of them is a world-wide conglomerate so I can use them throughout the US and some European countries. Some of my neighbors have had to use them. If it doesn't need a copter, you can wait for an ambulance or drive yourself. Need to check. Most insurance will cover a flight if deemed "medically necessary". And here we have air evac lifeteam, and some other company. If you have air evac membership, and they're out on another call, and company two gets called in, you're not covered. In your case, you're covered with memberships with both, but again, might be something that's already covered with your health coverage. Mom got airlifted a few years back. Thought she was having a stroke (turned out she was just severly dehydrated). Air evac was already in the air for a car wreck. The other company was grounded due to bad weather. Ended up getting a bird out of Memphis, so in that case, even with memberships to both of the rural providers, not covered. Luckily, her insurance covered it if deemed "medically necessary" |
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MI, USA
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Posted: 4/17/2024 2:20:01 PM EDT
[#16]
Sounds like they need more cancer screenings, to bring in more customers.
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AZ, USA
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Posted: 4/17/2024 2:20:16 PM EDT
[#17]
Quote HistoryOriginally Posted By skid2041: I didn't make it up. Sorry. Go back and read the works "I consider primary care to be secondary care" again, and consult a dictionary. And we could have this whole thread about he predicament that primary are finds itself in. Without a hospital to pay for primary care (by overcharging for other services) a lot of those offices will close as well. |
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Posted: 4/17/2024 2:29:23 PM EDT
[#18]
Quote HistoryOriginally Posted By skid2041: I'm sorry about your Mom @Smokey0844. But depending on her age, even if they could receive the pressure, she would be bedbound in a rehab facility until she became septic from pneumonia and died. Rural hospitals CAN have good capabilities. But even then, if the staff/doctors don't see many patients or disease processes, they will miss a bunch. Many doctors transfer because they don't know any better. I am not trying to say she would have been fine. The speed by which she received treatment did play a role and rehab was going to be best case for her because of the pressure. We tried what we could to see if there was a chance but after it became clear that we had reached the apex of improvement after her heart became weak I made the decision that she needed peace and to keep her here in that state was selfish. |
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Posted: 4/17/2024 2:32:37 PM EDT
[#19]
Quote HistoryOriginally Posted By wm69: Need to check. Most insurance will cover a flight if deemed "medically necessary". And here we have air evac lifeteam, and some other company. If you have air evac membership, and they're out on another call, and company two gets called in, you're not covered. In your case, you're covered with memberships with both, but again, might be something that's already covered with your health coverage. Mom got airlifted a few years back. Thought she was having a stroke (turned out she was just severly dehydrated). Air evac was already in the air for a car wreck. The other company was grounded due to bad weather. Ended up getting a bird out of Memphis, so in that case, even with memberships to both of the rural providers, not covered. Luckily, her insurance covered it if deemed "medically necessary" Quote HistoryOriginally Posted By wm69: Originally Posted By skid2041: @dirtyboy. They are $30,000 actually. And you can get subscriptions to them. Everyone should. I pay $60 a year for one of the local services, & $50 a year for the other. Covers my own family. They save my Lat/longs for landing. They cover transfers and one of them is a world-wide conglomerate so I can use them throughout the US and some European countries. Some of my neighbors have had to use them. If it doesn't need a copter, you can wait for an ambulance or drive yourself. Need to check. Most insurance will cover a flight if deemed "medically necessary". And here we have air evac lifeteam, and some other company. If you have air evac membership, and they're out on another call, and company two gets called in, you're not covered. In your case, you're covered with memberships with both, but again, might be something that's already covered with your health coverage. Mom got airlifted a few years back. Thought she was having a stroke (turned out she was just severly dehydrated). Air evac was already in the air for a car wreck. The other company was grounded due to bad weather. Ended up getting a bird out of Memphis, so in that case, even with memberships to both of the rural providers, not covered. Luckily, her insurance covered it if deemed "medically necessary" Yes, insurance will cover and yes, if they have a preferred service, it won't be covered. But often, even in transfers, there is still a cost to you. $60 a yr is negligible. Glad your were covered. Not all insurance will cover it. |
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Posted: 4/17/2024 2:34:12 PM EDT
[#20]
Quote HistoryOriginally Posted By skid2041: I'm sorry about your Mom @Smokey0844. But depending on her age, even if they could receive the pressure, she would be bedbound in a rehab facility until she became septic from pneumonia and died. Rural hospitals CAN have good capabilities. But even then, if the staff/doctors don't see many patients or disease processes, they will miss a bunch. Many doctors transfer because they don't know any better. Wanted to separate the responses. The hospital in question was going downhill due to many of the same issues being discussed in this thread. I don’t fault the business side of things and there were multiple attempts to save it. The death blow happened when it has been shut down for a few months and then there was a buyer that became interested. During inspection they discovered black mold in enough random locations that the building couldn’t be repaired but would have to be rebuilt. They pulled out after that and it was razed. |
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Posted: 4/17/2024 2:35:36 PM EDT
[#21]
Quote HistoryOriginally Posted By HIMARS13A: Go back and read the works "I consider primary care to be secondary care" again, and consult a dictionary. And we could have this whole thread about he predicament that primary are finds itself in. Without a hospital to pay for primary care (by overcharging for other services) a lot of those offices will close as well. Quote HistoryOriginally Posted By HIMARS13A: Originally Posted By skid2041: I didn't make it up. Sorry. Go back and read the works "I consider primary care to be secondary care" again, and consult a dictionary. And we could have this whole thread about he predicament that primary are finds itself in. Without a hospital to pay for primary care (by overcharging for other services) a lot of those offices will close as well. Lol, thank you. Tertiary, as a word, is third order. I apologize for how I think it. We only consider for Thrombectomy capable (which most of our rural hospitals don't do anymore) and comprehensive centers (neurosurgical intervention) 
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Posted: 4/17/2024 2:36:24 PM EDT
[#22]
Quote HistoryOriginally Posted By Smokey0844: I am not trying to say she would have been fine. The speed by which she received treatment did play a role and rehab was going to be best case for her because of the pressure. We tried what we could to see if there was a chance but after it became clear that we had reached the apex of improvement after her heart became weak I made the decision that she needed peace and to keep her here in that state was selfish. Quote HistoryOriginally Posted By Smokey0844: Originally Posted By skid2041: I'm sorry about your Mom @Smokey0844. But depending on her age, even if they could receive the pressure, she would be bedbound in a rehab facility until she became septic from pneumonia and died. Rural hospitals CAN have good capabilities. But even then, if the staff/doctors don't see many patients or disease processes, they will miss a bunch. Many doctors transfer because they don't know any better. I am not trying to say she would have been fine. The speed by which she received treatment did play a role and rehab was going to be best case for her because of the pressure. We tried what we could to see if there was a chance but after it became clear that we had reached the apex of improvement after her heart became weak I made the decision that she needed peace and to keep her here in that state was selfish. You did great! Which is all I'm saying. |
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AZ, USA
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Posted: 4/17/2024 2:41:38 PM EDT
[#23]
Quote HistoryOriginally Posted By skid2041: Lol, thank you. Tertiary, as a word, is third order. I apologize for how I think it. We only consider for Thrombectomy capable (which most of our rural hospitals don't do anymore) and comprehensive centers (neurosurgical intervention) Yes, secondary care is a basic rural hospital, tertiary is a regional hospital and quarternary is a well equipped urban hospital. You seem to think that the only reason to have a hospital is to have a neurosurgery service. I don't think that is accurate. |
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FL, USA
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Posted: 4/17/2024 2:45:59 PM EDT
[#24]
Quote HistoryOriginally Posted By skid2041: Having a Dr Martin nearby is key as well. Lol Not making a stop so someone can administer maalox, do a chest xray and check serial troponins is probably most helpful. |
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USA
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Posted: 4/17/2024 2:48:52 PM EDT
[#25]
Quote HistoryOriginally Posted By skid2041: Yes, insurance will cover and yes, if they have a preferred service, it won't be covered. But often, even in transfers, there is still a cost to you. $60 a yr is negligible. Glad your were covered. Not all insurance will cover it. Negligible, yes, but I did piss the rep off who came here scaring all of my employees into buying air evac every year. When I notified all of them that they were covered for such under our employee insurance plan, those who are barely making minimum wage were glad to have saved an unnecessary expense. The rep came in expecting everyone to sign up again, and no one did. |
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Posted: 4/17/2024 2:59:58 PM EDT
[#26]
Quote HistoryOriginally Posted By HIMARS13A: Yes, secondary care is a basic rural hospital, tertiary is a regional hospital and quarternary is a well equipped urban hospital. You seem to think that the only reason to have a hospital is to have a neurosurgery service. I don't think that is accurate. Quote HistoryOriginally Posted By HIMARS13A: Originally Posted By skid2041: Lol, thank you. Tertiary, as a word, is third order. I apologize for how I think it. We only consider for Thrombectomy capable (which most of our rural hospitals don't do anymore) and comprehensive centers (neurosurgical intervention) Yes, secondary care is a basic rural hospital, tertiary is a regional hospital and quarternary is a well equipped urban hospital. You seem to think that the only reason to have a hospital is to have a neurosurgery service. I don't think that is accurate. :You seem to think that the only reason to have a hospital is to have a neurosurgery service." Where did I say that? If you want critical care level, heart, brain, trauma? You the need the patient numbers so you can bill and afford it. There is much a small rural hospital can do. But many don't or can't, nor have the expirence to know. "Rural" definition seems pretty broad in this thread. I wouldn't Classify HELOBRAVO's hospital as rural. More regional. He services a large area. They can take care of most things. But will then x-fer out things that need higher level of care. It's mostly money but also the ability of the clinicians to have the will and ability, to do what is needed. This is a fun thread. this is a great discussion. I appreciate it.
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Posted: 4/17/2024 3:00:32 PM EDT
[#27]
Quote HistoryOriginally Posted By jsnappa: Not making a stop so someone can administer maalox, do a chest xray and check serial troponins is probably most helpful. Quote HistoryOriginally Posted By jsnappa: Originally Posted By skid2041: Having a Dr Martin nearby is key as well. Lol Not making a stop so someone can administer maalox, do a chest xray and check serial troponins is probably most helpful. One HUNDRED percent! |
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Posted: 4/17/2024 3:01:22 PM EDT
[#28]
Quote HistoryOriginally Posted By wm69: Negligible, yes, but I did piss the rep off who came here scaring all of my employees into buying air evac every year. When I notified all of them that they were covered for such under our employee insurance plan, those who are barely making minimum wage were glad to have saved an unnecessary expense. The rep came in expecting everyone to sign up again, and no one did. Quote HistoryOriginally Posted By wm69: Originally Posted By skid2041: Yes, insurance will cover and yes, if they have a preferred service, it won't be covered. But often, even in transfers, there is still a cost to you. $60 a yr is negligible. Glad your were covered. Not all insurance will cover it. Negligible, yes, but I did piss the rep off who came here scaring all of my employees into buying air evac every year. When I notified all of them that they were covered for such under our employee insurance plan, those who are barely making minimum wage were glad to have saved an unnecessary expense. The rep came in expecting everyone to sign up again, and no one did. Definitely understand. good job.
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Posted: 4/17/2024 3:03:22 PM EDT
[#29]
Quote HistoryOriginally Posted By skid2041: @dirtyboy. They are $30,000 actually. And you can get subscriptions to them. Everyone should. I pay $60 a year for one of the local services, & $50 a year for the other. Covers my own family. They save my Lat/longs for landing. They cover transfers and one of them is a world-wide conglomerate so I can use them throughout the US and some European countries. Some of my neighbors have had to use them. If it doesn't need a copter, you can wait for an ambulance or drive yourself. Not here, $30,000 wouldn't get you in the air. 150 miles one way, easy to be over $100,000. I have insurance for one of the 3 services here, if it is busy when I need it, guess who gets the bill? My brother got flown a couple years ago because there were no ambulances available. It was covered by his insurance. My mom got flown and Medicare paid it, even though she had insurance. My local hospital is not a place you want to be. |
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Posted: 4/17/2024 3:06:48 PM EDT
[#30]
Quote HistoryOriginally Posted By dirtyboy: Not here, $30,000 wouldn't get you in the air. 150 miles one way, easy to be over $100,000. I have insurance for one of the 3 services here, if it is busy when I need it, guess who gets the bill? My brother got flown a couple years ago because there were no ambulances available. It was covered by his insurance. My mom got flown and Medicare paid it, even though she had insurance. My local hospital is not a place you want to be. Quote HistoryOriginally Posted By dirtyboy: Originally Posted By skid2041: @dirtyboy. They are $30,000 actually. And you can get subscriptions to them. Everyone should. I pay $60 a year for one of the local services, & $50 a year for the other. Covers my own family. They save my Lat/longs for landing. They cover transfers and one of them is a world-wide conglomerate so I can use them throughout the US and some European countries. Some of my neighbors have had to use them. If it doesn't need a copter, you can wait for an ambulance or drive yourself. Not here, $30,000 wouldn't get you in the air. 150 miles one way, easy to be over $100,000. I have insurance for one of the 3 services here, if it is busy when I need it, guess who gets the bill? My brother got flown a couple years ago because there were no ambulances available. It was covered by his insurance. My mom got flown and Medicare paid it, even though she had insurance. My local hospital is not a place you want to be. Understand. Great! |
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Posted: 4/17/2024 3:10:50 PM EDT
[#31]
Closing most hospitals has been a Democrat plan for many years:
2015 link There are several factors contributing to the decline of rural hospitals, but the main culprit since 2010 has been Obamacare. The president’s health care law made cuts to Medicare providers, reduced federal payments to hospitals for the uninsured, caused massive increases in deductibles that discourage patients from seeking care, and mandated a host of new regulations. |
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Posted: 4/17/2024 3:14:35 PM EDT
[#32]
Quote HistoryOriginally Posted By skid2041: @dirtyboy. They are $30,000 actually. And you can get subscriptions to them. Everyone should. I pay $60 a year for one of the local services, & $50 a year for the other. Covers my own family. They save my Lat/longs for landing. They cover transfers and one of them is a world-wide conglomerate so I can use them throughout the US and some European countries. Some of my neighbors have had to use them. If it doesn't need a copter, you can wait for an ambulance or drive yourself. Same here. |
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PA, USA
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Posted: 4/17/2024 3:16:46 PM EDT
[#33]
People don't have as much money as you think they do.
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Posted: 4/17/2024 4:36:16 PM EDT
[#34]
Quote HistoryOriginally Posted By Chokey: VW or SEMC? Quote HistoryOriginally Posted By Chokey: Originally Posted By RocketmanOU: Originally Posted By Chokey: we keep taking them over here in Ohio, further and further away from central Ohio. Yup. OhioHealth now owns our local hospital (and I'm sure it's still operated at a loss even then). It's now the only hospital within a 1 hour radius. ER seems to have a constant flow of opioid seekers. VW or SEMC? O'Blenness |
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Posted: 4/17/2024 4:37:49 PM EDT
[#35]
Quote HistoryOriginally Posted By jsnappa: My experience at teaching hospitals shows it would be difficult for a practitioner to order more labs, scans, or consults than an MD. Quote HistoryOriginally Posted By jsnappa: Originally Posted By Ryan_Scott: PAs and NPs are great for hospital systems because they refer and test at 4-5x the rate of physicians, which drives sales. If you actually want to go to the clinic and get the issue settled with finality, get a doc. My experience at teaching hospitals shows it would be difficult for a practitioner to order more labs, scans, or consults than an MD. Has your methodology been peer reviewed? |
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Posted: 4/17/2024 4:40:56 PM EDT
[#36]
Quote HistoryOriginally Posted By RocketmanOU: O'Blenness Quote HistoryOriginally Posted By RocketmanOU: Originally Posted By Chokey: Originally Posted By RocketmanOU: Originally Posted By Chokey: we keep taking them over here in Ohio, further and further away from central Ohio. Yup. OhioHealth now owns our local hospital (and I'm sure it's still operated at a loss even then). It's now the only hospital within a 1 hour radius. ER seems to have a constant flow of opioid seekers. VW or SEMC? O'Blenness ah, O'Bleness has been part of us for several years now. We just went live with Van Wert Hospital and Southeaster Medical Center in Cambride is coming online later this year. |
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Posted: 4/17/2024 4:47:17 PM EDT
[#37]
Quote HistoryOriginally Posted By zoe17: HCMC- I am familiar with the whole process. The employees from what I hear, want WTH to lease and not be unemployed. Quote HistoryOriginally Posted By zoe17: Originally Posted By rob78: We're looking at a long-term lease for ours. A single hospital has no leverage during negotiations with insurance providers. The large providers have a huge pool of patients. Yes, I think the push is to drive expanded medicaid adoption, but I believe thst ship has sailed in TN. Our OB clinic is closed. A regular birth is reimbursed at ~$400 by TennCare/BcBs. A NICU birth is reimbursed at ~$1,300 by same. Private insurance reimbursements are fine, but any subsidized insurance is pretty poor. So we're entertaining offers for a long-term lease from a large Healthcare provider. Competition for market share is pretty fierce, the "big guys" can get fair reimbursement, and we've had significant interest. Our hospital is county owned. It's never been managed well in 60 years. The "good ol boys" had negotiated family members jobs and high pay. Watching them squirm has been fun. HCMC- I am familiar with the whole process. The employees from what I hear, want WTH to lease and not be unemployed. The employees want resolution. They want to know that they have a job. Which I totally understand. I am involved in the process. It isn't that simple nor clear. Negotiating from a weak position with no alternative proposal is not a good thing. No clawbacks, no contingencies, just take what we give you. This thing was fumbled. That's all I'll say about that on this forum. |
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FL, USA
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Posted: 4/17/2024 5:47:01 PM EDT
[#38]
Quote HistoryOriginally Posted By Ryan_Scott: Has your methodology been peer reviewed? Since covid, peer review is obsolete. We listen to “experts” instead, which I am. |
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Posted: 4/17/2024 7:24:55 PM EDT
[#39]
Quote HistoryOriginally Posted By rob78: The employees want resolution. They want to know that they have a job. Which I totally understand. I am involved in the process. It isn't that simple nor clear. Negotiating from a weak position with no alternative proposal is not a good thing. No clawbacks, no contingencies, just take what we give you. This thing was fumbled. That's all I'll say about that on this forum. 
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Posted: 4/17/2024 7:56:59 PM EDT
[#40]
Quote HistoryOriginally Posted By Chokey: ah, O'Bleness has been part of us for several years now. We just went live with Van Wert Hospital and Southeaster Medical Center in Cambride is coming online later this year. Quote HistoryOriginally Posted By Chokey: Originally Posted By RocketmanOU: Originally Posted By Chokey: Originally Posted By RocketmanOU: Originally Posted By Chokey: we keep taking them over here in Ohio, further and further away from central Ohio. Yup. OhioHealth now owns our local hospital (and I'm sure it's still operated at a loss even then). It's now the only hospital within a 1 hour radius. ER seems to have a constant flow of opioid seekers. VW or SEMC? O'Blenness ah, O'Bleness has been part of us for several years now. We just went live with Van Wert Hospital and Southeaster Medical Center in Cambride is coming online later this year. I mean, it was a main feeder to Riverside via life flight for years before it actually became Ohio health 
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Posted: 4/17/2024 8:00:38 PM EDT
[#41]
Quote HistoryOriginally Posted By skid2041: Good, they are only "feeder" hospitals for bigger networks anyways. They have ambulances transport there instead of taking to the better, higher capable hospitals, so they can bill the insurance for a stay. Then transport the patient to the higher capable. Causing a delay I'm treatment & possibly death. Get more helicopters and fly the patients. That's fuckin' stupid. But I won't pile on. Looks like others have been shining the light of truth on your short-sighted post. |
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Posted: 4/17/2024 8:21:00 PM EDT
[#42]
Quote HistoryQuote HistoryOriginally Posted By R_S: Closing most hospitals has been a Democrat plan for many years: 2015 link There are several factors contributing to the decline of rural hospitals, but the main culprit since 2010 has been Obamacare. The president’s health care law made cuts to Medicare providers, reduced federal payments to hospitals for the uninsured, caused massive increases in deductibles that discourage patients from seeking care, and mandated a host of new regulations. Watch what happens when Medicare goes kaboom. Its going to get way worse. |
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Posted: 4/17/2024 8:23:07 PM EDT
[#43]
Moat hospitals operate at a loss because of the unfunded mandates from the government.
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Posted: 4/17/2024 9:01:05 PM EDT
[#44]
The problems are
1. Lawyers- Most "good medicine" will pick up an emergency 98% of the time. This is safe and cost effective medicine. Lawyers hold us (I work in an ER) to a 0% miss rate. This in not only impossible (our tests aren't perfect), it also makes the cost of medicine essentially go to infinity. I get the comparisons to the airlines, etc. They're not applicable...the police don't bring a violent drunk aboard an airplane and tell the pilot to deal with it. 2. Patient expectations- patients want Monday 8am care at 2AM on Christmas morning, and want it to cost the same. That's not reasonable. Emergency care is THE most expensive healthcare. A Chlamydia test after hours will cost more than an outpatient one....it always will. "Just an xray" in the ER is a registration person, triage nurse, room nurse, physician/PA/NP, xray tech and radiologist. It costs more because an orthopedist has 3 less people to employ. Patients also want this care fast, so hospitals employ NPs and PAs...they really bad ones just let these two groups do EVERYTHING. We get some WILD transfers from these places. My shop has all Board Certified EM docs, and we're expensive, but we can generally get the job done. 3. Regulation- It's crushing....I think we have more nurses in admin than on the floor. "Trauma coordinators" trying to tell docs that trained at trauma centers how to practice, and "patient experience coordinators" doing endless spreadsheets and powerpoints about nothing. |
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AZ, USA
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Posted: 4/17/2024 9:07:15 PM EDT
[#45]
Quote HistoryOriginally Posted By Primetime_1: The problems are 1. Lawyers- Most "good medicine" will pick up an emergency 98% of the time. This is safe and cost effective medicine. Lawyers hold us (I work in an ER) to a 0% miss rate. This in not only impossible (our tests aren't perfect), it also makes the cost of medicine essentially go to infinity. I get the comparisons to the airlines, etc. They're not applicable...the police don't bring a violent drunk aboard an airplane and tell the pilot to deal with it. 2. Patient expectations- patients want Monday 8am care at 2AM on Christmas morning, and want it to cost the same. That's not reasonable. Emergency care is THE most expensive healthcare. A Chlamydia test after hours will cost more than an outpatient one....it always will. "Just an xray" in the ER is a registration person, triage nurse, room nurse, physician/PA/NP, xray tech and radiologist. It costs more because an orthopedist has 3 less people to employ. Patients also want this care fast, so hospitals employ NPs and PAs...they really bad ones just let these two groups do EVERYTHING. We get some WILD transfers from these places. My shop has all Board Certified EM docs, and we're expensive, but we can generally get the job done. 3. Regulation- It's crushing....I think we have more nurses in admin than on the floor. "Trauma coordinators" trying to tell docs that trained at trauma centers how to practice, and "patient experience coordinators" doing endless spreadsheets and powerpoints about nothing. ED spending is about $88B a year and about 60% of it should have been a primary care visit. You can generally buy a years worth of unlimited primary care, sometimes two, for the cost of a single ED visit. An STD panel, outpatient, costs about $23. The problem with this is that reforming primary care will make health care a lot cheaper... at the cost of strangling the hospitals. But you still need the hospitals for real emergencies. I'm not sure how to solve both those problems at the same time. |
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Posted: 4/17/2024 9:28:44 PM EDT
[#46]
Originally Posted By Primetime_1: The problems are 1. Lawyers- Most "good medicine" will pick up an emergency 98% of the time. This is safe and cost effective medicine. Lawyers hold us (I work in an ER) to a 0% miss rate. This in not only impossible (our tests aren't perfect), it also makes the cost of medicine essentially go to infinity. I get the comparisons to the airlines, etc. They're not applicable...the police don't bring a violent drunk aboard an airplane and tell the pilot to deal with it. 2. Patient expectations- patients want Monday 8am care at 2AM on Christmas morning, and want it to cost the same. That's not reasonable. Emergency care is THE most expensive healthcare. A Chlamydia test after hours will cost more than an outpatient one....it always will. "Just an xray" in the ER is a registration person, triage nurse, room nurse, physician/PA/NP, xray tech and radiologist. It costs more because an orthopedist has 3 less people to employ. Patients also want this care fast, so hospitals employ NPs and PAs...they really bad ones just let these two groups do EVERYTHING. We get some WILD transfers from these places. My shop has all Board Certified EM docs, and we're expensive, but we can generally get the job done. 3. Regulation- It's crushing....I think we have more nurses in admin than on the floor. "Trauma coordinators" trying to tell docs that trained at trauma centers how to practice, and "patient experience coordinators" doing endless spreadsheets and powerpoints about nothing. Originally Posted By HIMARS13A: ED spending is about $88B a year and about 60% of it should have been a primary care visit. You can generally buy a years worth of unlimited primary care, sometimes two, for the cost of a single ED visit. An STD panel, outpatient, costs about $23. The problem with this is that reforming primary care will make health care a lot cheaper... at the cost of strangling the hospitals. But you still need the hospitals for real emergencies. I'm not sure how to solve both those problems at the same time. |
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AZ, USA
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Posted: 4/17/2024 10:23:11 PM EDT
[#47]
Quote HistoryOriginally Posted By exponentialpi: Regulation is the gift that keeps on giving. More work for no value. You can't. How did it work before insurance fucked everything up? |
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Posted: 4/17/2024 10:57:14 PM EDT
[#48]
Quote HistoryOriginally Posted By Waldo: You're free to take risks with your own life. I'm not going to judge those people for not wanting to fly in bad weather. And at best, helicopters are a barely contained mass of rotating parts that is continually trying to disassemble itself. Quote HistoryOriginally Posted By Waldo: Originally Posted By OregonShooter: If there is a cloud in the sky Life Flight won't fly. These organizations are pathetic. You're free to take risks with your own life. I'm not going to judge those people for not wanting to fly in bad weather. And at best, helicopters are a barely contained mass of rotating parts that is continually trying to disassemble itself. I will judge. It's "life flight " There is inherent risk involved with flying in order to save a life. Apparently thier insurance companies are unwilling to allow flights in marginal weather. When my brother was in a logging accident life flight refused to fly due to cloud cover. Frustrated EMS called the coast guard which was able to fly inland and get him to a trauma center from the woods. If you want to call yourself an emergency air medivac you better have the fucking equipment and skills to fly. Apparently it's a glorified air tour operator with medics on staff. It's pathetic. |
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Posted: 4/17/2024 11:13:10 PM EDT
[Last Edit: Sartorius]
[#49]
Quote HistoryOriginally Posted By Primetime_1: The problems are 1. Lawyers- Most "good medicine" will pick up an emergency 98% of the time. This is safe and cost effective medicine. Lawyers hold us (I work in an ER) to a 0% miss rate. This in not only impossible (our tests aren't perfect), it also makes the cost of medicine essentially go to infinity. I get the comparisons to the airlines, etc. They're not applicable...the police don't bring a violent drunk aboard an airplane and tell the pilot to deal with it. 2. Patient expectations- patients want Monday 8am care at 2AM on Christmas morning, and want it to cost the same. That's not reasonable. Emergency care is THE most expensive healthcare. A Chlamydia test after hours will cost more than an outpatient one....it always will. "Just an xray" in the ER is a registration person, triage nurse, room nurse, physician/PA/NP, xray tech and radiologist. It costs more because an orthopedist has 3 less people to employ. Patients also want this care fast, so hospitals employ NPs and PAs...they really bad ones just let these two groups do EVERYTHING. We get some WILD transfers from these places. My shop has all Board Certified EM docs, and we're expensive, but we can generally get the job done. 3. Regulation- It's crushing....I think we have more nurses in admin than on the floor. "Trauma coordinators" trying to tell docs that trained at trauma centers how to practice, and "patient experience coordinators" doing endless spreadsheets and powerpoints about nothing. I get sued for that 1 in 10,000 case that I didn't find and, according to the attorney, if I had just done that one other test, their client would've been treated and cured. The economic incentives are severely misaligned. First thing to do in fixing medicine is kill all the lawyers. Second is kill 90% of the adminstrators. Third is to get rid of all insurance and 3rd party payers. Yeah, all of them. You have a deal between you and your doctor. The market will sort it out. In the very few cases where the market is allowed to function in medicine, it works quite well. That would be cosmetic plastic surgery, Lasik and concierge practice. |
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Posted: 4/18/2024 1:06:39 AM EDT
[#50]
Quote HistoryOriginally Posted By Sartorius: 1. Exactly. I don't get sued for ordering more tests. I don't get sued for doing an extra CT scan that may or may not have been needed. I don't get sued for running up a million dollar workup. I don't even get sued for the cancer that patient gets in 30 years because of all those scans. I get sued for that 1 in 10,000 case that I didn't find and, according to the attorney, if I had just done that one other test, their client would've been treated and cured. The economic incentives are severely misaligned. First thing to do in fixing medicine is kill all the lawyers. Second is kill 90% of the adminstrators. Third is to get rid of all insurance and 3rd party payers. Yeah, all of them. You have a deal between you and your doctor. The market will sort it out. In the very few cases where the market is allowed to function in medicine, it works quite well. That would be cosmetic plastic surgery, Lasik and concierge practice. Can’t get rid of all third party payers. If you and your wife get hit by a car tomorrow who is going to pay $200,000 to get you back to work? Probably a sensible future would have some kind of catastrophic coverage. |
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