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Minnie80

Just a bizarre situation

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PuddingPlease
17 hours ago, CallMeFeral said:

Yes there seems to be lots of capacity, waitlists don't seem to be anything like as long as here. I'm guessing they let more into the profession so demand doesn't outstrip supply so much. 

It's probably worth keeping in mind that, in a completely user-pays system, a sizeable portion of the population will be unable to afford the fees and will have next to no access to specialist care at all.

That reduces demand substantially compared with countries like Australia for a range of reasons. 

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purplekitty

The gatekeeping is the ability to pay.

 

Cystitis just means inflammation of the bladder,that's the 'itis'.

Urethritis can have unpleasant symptoms similar to an infection also and often bacteria are involved.

 Bacterial cystitis is an infection,a UTI.

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Minnie80
4 hours ago, PuddingPlease said:

It's probably worth keeping in mind that, in a completely user-pays system, a sizeable portion of the population will be unable to afford the fees and will have next to no access to specialist care at all.

That reduces demand substantially compared with countries like Australia for a range of reasons. 

It's definitely a user pays system. But it doesn't reduce the demand at all. It just means that people will go to cheaper clinics or have to rely on family, friends, community support or even charity. 

Edited by Minnie80
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born.a.girl
On 18/09/2020 at 11:12 PM, MumsyToBigOnes said:

Yes, I’m also curious. I’m still reeling from the comment that an ophthalmologist would be called if your eye was uncomfortable. I don’t know any specialists who would be okay with this let alone facilitate it so must be a very different system to any I have ever worked in. Seems very odd and prone to ‘abuse by hysteria’ for want of a better term. 

As per CMF, I think it's your use of language - if you are familiar with different systems I'd not have thought calling a specialist directly would leave you 'reeling': 

Quote

lose one's balance and stagger or lurch violently.

As an admin on a worldwide Facebook group (half Americans) I'm very familiar with people who call their specialist directly for anything that might be associated with them.  In the USA it seems often you don't get past the nurse without good reason, so that's the 'gate', even though your insurance might pay the whole bill for a consultation.  In Australia they tend to be medical receptionists, then the doctor.

If it's that common in America that I see people talk about it frequently, I assume it's not that different in plenty of other countries.

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a letter to Elise.

If you have a chronic medical condition, you can sometimes call specialists directly. I have a rare auto immune disease that most gps and emergency doctors have very limited knowledge of. If I have a flare up, I can call my specialist directly. I can also call my gyno directly if I need pain meds for endo. If I have a flare up, I don’t even bother with a gp, as they won’t have any idea of what to prescribe. And it’s usually urgent enough that I can’t wait. 

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CallMeFeral
10 hours ago, PuddingPlease said:

It's probably worth keeping in mind that, in a completely user-pays system, a sizeable portion of the population will be unable to afford the fees and will have next to no access to specialist care at all.

That reduces demand substantially compared with countries like Australia for a range of reasons. 

I was thinking that, and it's definitely true for a huge portion of the population where I'm thinking of. 

But... it's also true here. Outpatient specialist services are SOOOO expensive and for the non emergency variety of illness are beyond so many people's reach (thinking of dentistry, mental health related). The difference here is that when it's dire, there is a public system that picks up SOME of the worst stuff, and over there there isn't (much). But I actually don't see it as being much different in the private/outpatient system here. I constantly see people who can't afford to see a specialist. My psychiatrist charges $600 for an initial consult - Medicare gives back maybe $100. That $100 is not doing much to make it more accessible to people with real financial issues, cost is still a massive gatekeeper both here and there (and psychiatrist fees over there are much much lower). I think it actually might go the other way, in that with more availability of medical professionals there is more cost competition. Whereas here there is someone on another thread who couldn't even find a psychiatrist with open books - that drives the situation where they can charge through the roof. 

I reckon if there were say 5 times as many psychiatrists as there are, some of them (the ones starting out) would have to provide consults at close to Medicare prices, and our 'user pays' system would come into it's own, making health accessible to more people. But with the shortage of specialists, it's really just supplementing their income, not increasing access. 

Edited by CallMeFeral
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