You do more public service than most. Your subtle satire while taking a stab at the burning issues in current medicine is nothing but genius. Great going, Will!
Also, being genius at taking stabs in current medicine does no public service at all. Not even getting people informed, as this does not go into specifics and doesn't encourage self-research. Sorry to tell you this but media tends to do the opposite and make people less active in the pursuit of the defense for their well-being by taking the media as a form of protest and, as you mention, public service.
@@Justin-sy6ns Yeah, he’s not unfunny, but I definitely don’t come here when I want to feel joy in the world. Doc Glauc is about as subtle as a hammer.
"One word ...metrics." Just hearing that sent shivers down my spine, for Barty Banks is one horrible despicable villain. Business people have no business making decisions when it comes to patient care in the healthcare system. Metrics is essentially the reasons why so many patients that are legitimately in need of care , get denied. Being high risk, low outcome, questionable circumstance, etc., ...all of that could lead to a patient being denied care or being transferred around , so they can be someone else's problem. Might as well tell patients that if they are not at the epitomy of good health, be prepared NOT to recieve care , for a hospital would not want their precious metrics to be trashed.
Technically it’s the present state of medicine too, not just the future. The future is now! 😅 This literally caused me to lose my job for “performance issues” less than 2 months after having an annual performance evaluation that reflected above-average performance & noted consistent signs of ongoing improvement.
I hope you had a soft landing. It's truly disgusting what the oligarchs have done to medicine. People profiting off death and disease (you too, pharms and insurance companies) is super gross.
On one of the early seasons of House MD, they had a rich guy come in and donate $100 000 to the hospital in exchange for a position at the head of the board of directors. And the entire board basically just said, "well, seems like a small price to pay!" and then everyone was so shocked when the guy started fucking everything up, insisted on running the hospital "like a business", and took complete control by firing every board member who disagreed with him. It's just weird because the whole time, I was thinking how it was obviously unrealistic and made no fucking sense from the start. You can't just BUY a job without having any qualifications and have people go along with it. At the very least, it would be under the table because it's clearly a bribe and not a legitimate hire. This just made me think of that.
Yeah, but that's the thing. Being on a board of directors isn't itself a job. Anybody can be on the board of directors of a company if shareholders or some similar authority chooses you for it. Some companies will even make sure to have directors on the board who aren't directly involved in the business, for perspective reasons. Also, it's possible to buy qualifications, like Heather Bresch did by bribing WVU to give her an Executive Master of Business Administration degree, which helped her become CEO of Mylan where she was one of the people who cranked up Epipen prices. But she's rich and her father is Senator Joe Manchin, so she suffered no consequences for the degree scandal and probably won't suffer any for the Epipen thing either. Yay capitalism!
@@MissQueen131 mostly things like average handling time for patients, minimum patient quotas, number of drugs dispensed, number of procedures accomplished, etc. (though these differ across hospitals and across countries), which are partly the reason many patients get denied healthcare
I’ve been an RN for almost 30yrs. The best hospital I ever worked at was one owned by Sisters of Charity. They sold it to CHRISTUS, which made some changes but weren’t so horrible. But when I moved to an HCA hospital…hoo boy. My mom recently retired from that same CHRISTUS hospital-now owned by an even bigger corporation. We both agree that working at a corporate hospital whose focus is money first, then patients, then staff (although they do like to pretend otherwise) is the worst thing ever. I have never believed more strongly that capitalism should NOT be running healthcare.
As a devout Catholic (whose heritage and traditions are bashed daily), I appreciate your post. As everyone will soon find out, as goes the Catholic Church so goes the world.
@@thedudeabides3930 Exactly. Especially in my home country of Ireland, it was the church that set up the majority if hospitals and schools, which the government js now trying to take over. Their attempts to destroy the church will destroy them and everyone else in the process. I'd almost be funny if it wasn't so sad. Hell the sisters if Mercy over here are being demonised for not giving the state full control of their hospital
I've been playing Project Hospital lately and there was this quest called "Earn profit for (X) days". I was having difficulty the first round so I looked up for some advice for this task. Apparently the solution was "get rid/close all ER and ICU departments to focus on surgery departments". 😷
You mean the outpatient, elective surgery department - "Center of Excellence" for knees, hips, shoulders etc... When something goes awry, ship them to the local tertiary care center, or better yet, just call 911.
@@ratpH1nk Oh you have a Center of Excellence? Our whole hospital used to be one. It quietly went away, I think it was about the time that CMS busted the hell out of us. Now we have kindness. (No skills, or knowledge necessary.) 💖
@@patti6194 Cash cows prefer to graze on their own fields if you know what I'm saying. Those cows are surgeons, and the hospital doesn't necessarily own them. Sure, they make the hospital boatloads of money, but they prefer to do private work making their own fortunes-- as you should if you've spent your entire life training to become a surgeon.
"If you can't afford to get hurt or sick, don't." This is the mantra US healthcare works around. Which is interesting because ever since the 50s US economy been revolving around people getting and doing things they can't afford with money they don't have.
Yea stuffing your face with McDonald’s doesn’t help either…. The system was designed for people who truly needed it and not by their own choosing. It was expected that kids would still be active, have gym class at school, Parents were expected to make good nutritious choices, limit consumption, be more nutritiously literate. I would argue that 50% of the healthcare problem can be solved via working out and healthy eating.
@@cs7623 I mean yes and no. I eat very healthily and am active with a physical demanding job in food service and as a tattoo artist (yes it’s more work than just drawing on people) and I’ll tell you right now that as someone with an autoimmune disease that would cost over $400 a month to treat appropriately I can’t afford that, but if I get sick with something like COVID it’s gonna put me in the ER. Yes to some degree illness preventable and I do what I can, but then there’s injury. If I get into a bad car crash or something and get severely injured I’m not going to have to money for a several thousand dollar medical bill. Not to mention if someone has a hereditary disease that they have no control over or something like diabetes (even with a healthy lifestyle) that goes undiagnosed it can cause massive complications. It’s so incredibly reductive to assume that healthy choices will mitigate medical expenditures. That’s just not how the world works. Shit happens and most time sun emergency medicine like this skit discusses is out of anyones control.
@@scallywag1716 exactly my point thank you. My Med school is so woke right now that they said the greatest economic problem facing healthcare is “transgender health”. During the QA portion I asked why would they say that when obesity is much more of a problem. Had a professionalism meeting shortly after with student progress I’ll never vote for those liberals as long as I live. They ruin everything including medicine.
I worked for one political campaign in my life that seemed like the easiest thing on earth. Just a nurses union pushing for safe guidelines on how many patients can be assigned to a nurse, already done in California which saved people money in the end. We were winning by a landslide until a couple of weeks before voting where private hospital CEOs dumped $13,000,000 into ads that took our "nurses say yes on Question one" and made it "Nurses say no on question one" then we lost through pure confusion and advertisement tactics. Taught me what a joke voting and healthcare ethics was in the US
I left corporate pharmacy because of those unrealistic metrics which can use as leverage to fire you whenever they want. Work at an independent that is lower pay but at least I not on antidepressants.
Yeah, worked at a hospital like that. They rationed alcohol wipes and turned the lights off at 9:00 p.m. When I complained about the safety issue of not being able to see when preparing meds (did not have pixis in those days) and increased potential for infection I received a shrug. All the while the Administrator was earning 6 figures. Had to bring a flashlight and buy my own alcohol wipes. They moved CABG patients from the ICU to a step down unit after 24 hours with PA and A lines and chest tubes where the nurse to patient ratio was 6:1 and none of the nurses, except myself, had ICU experience. Even with my experience and despite empatically telling my day 2 post op CABG patient not to get out of bed for any reason without me and that I would be watching him closely he almost immediately got up and pulled his chest tube out. I just happened to be close enough to hear an odd rhythmic whoosing noise so I checked. When I called the surgeon I was berated for not watching the patient closely enough. I finally said "who of my 5 other patients would you suggest I neglect to stay at your patients bedside?" You know how that went over with a surgeon in a private hospital... We nurses reported them to the union who did absolutely nothing about that or any other safety issue. I requested to be withdrawn from the union and was told once you sign on you can't sign out. The only way out was to quit so I did and traveled 35 mins to get to another hospital that was a nonprofit, not unionized and patient care was more of the focus. The hosp I left changed Administrators about every 3 years. They collect their high salaries while raping the institution and then move on to the next small hospital.
Never understood why so many of my fellow medical staff keep their complience up. We often get told that we "cant just strike and not work, think of the patients". I see it this way: "We can strike, we can set a price and yes exactly - Think of the patients." I wonder how quick our politicians will suddenly move their asses if they realize that entire hospitals would threat to lay down their work.
Who would have thought that the most scathing and critically accurate representation of our messed up healthcare system would come from a UA-cam celebrity. (A much loved and well respected celebrity, I might add 😉). Keep up the amazing , and humorous social commentary, Doc!
Dont believe the lies. Physicians have much worth and MANY transferable skills. Yes they tend to have high student loan debt; what if more just stopped paying into the system ????
Yes 💯 this! It’s a myth that physicians do not have transferable skills - communication skills, leadership, team working, organisational skills, lateral thinking, the list goes on!
Yeah you're right. Basic understanding of other sciences and absolutely nothing to show for in any field other than **applied** medicine. Talk about a one-way road...
"It's not supposed to make money" - For some reason everyone skips over that fact that healthcare shouldn't revolve around making money. I have nothing nice to say about our current healthcare system in the USA.
Welcome to the future of veterinary medicine as well! Did you know that Mars owns Banfield AND VCA, as well as many other large veterinary groups? And I'm sure Mars candy cares much more about your pet's health than it does about heaps and heaps of cash.
Doubt the people will allow that. We see what is happening in America. Instead we facing increasingly being crushed to have private insurance that covers less than 20% of hospital expenses but still charges an exorbitant rate and have our taxes which we are trying to avoid at a higher rate by paying for private insurance picking up the rest. Oh wait...
In Germany there is a worrying phenomenon going on right now with more and more ophthalmology clinics being taken over by (international) investors, which results in more treatments being done than are necessary. Additionally, it is very difficult to find out whether the clinic you want to go to is run by an investment company. Hopefully we'll manage to stop this and make it very transparent, which clinics are profit machines. Making medical decisions based on financial gain is just wrong.
Sadly not only that, we have ton of other issues due to privatization of hospitals and Healthcare in general. Like unnecessary operations because they bring more money. Our idol was the united States, so yeah I expect it will only get worse for our german Healthcare system sadly
@@paddleduck5328 the flat-rate payment for patients it is how hospital get paid and that's really similar to the US one and cause a ton of problems in our system. Like unnecessary operations, patients aren't as long as they should be in the hospital. It's not a popular concept around doctors since it forces them to do things which result in higher profit, but might not be necessary
Please dont believe these lies. Physicians have MUCH worth and many transferrable skills. Yes, they tend to have high student loan debt; what would happen if we stopped paying into the system ???
This is so sad & true!! 30yr icu nurse & breaks my heart to see this change happen in our healthcare system. I’ve always had insurance yet have huge medical bills to the point I refuse to go to doctor anymore. Not just because I can’t afford more med bills but I also know that my $$ doesn’t go to doctors nurses etc but into the pockets of the extremely wealthy man’s briefcase
@@AT-il2ej well, not if we give into hopelessness. But I see your point; that's why I added "eventually". I mean, how many decades did it take for Worker's Comp, OSHA, etc to become a thing? Oh, I know they're often ignored and/or abused, but at least they exist. IIRC, it took the US...what, 6+ decades to get that? Change is possible, but it takes a depressingly long time
And to their delight, each healthcare worker they drive away increases the scarcity of their 'product' so that they can further increase prices and profit, and makes it easier to withhold treatment from the underprivileged.
That was a good storyline. Season 1 I think. Although House would’ve been fired for what embarrassing the Chairman like that in public. Try Royal Pains if you haven’t seen it already. That’s another good medical show.
"They don't have transferable skills" Yup, going into medicine is like getting married. And only then do you find out about the horrible things going on in the background... It's a miracle how some things manage to work in today's society.
sounds like the government entity I work for. we tell management on what contractors are doing wrong and management over rides pretty much saying it will be fine and we wonder why everything is falling apart or why taxes keep going up. we also use to have meetings where management would usually ask employees about what we thought needed to be fixed but they didn't want to hear the facts.
Never realized how fucked our healthcare system is till your videos exposed it to me. There are few entities I possess greater hatred for than insurance company execs, and the leaders of our country that have willingly allowed such a system to exist
Private Equity is single handedly ruining this country. They buy businesses extract as much value from them as they possibly can and then sell off or bankrupt them.
"they have no transferable skills"... this sentence hit the spot. we indeed have no other skills than medicine due to so much studying and working. even if you are talented or skilled at something else, still after so many years, you feel debilitated at doing anything but medicine
Yes....I am an anesthesiologist..my friends and classmates from junior years are way more socially intelligent and talented than me..I am just a doc...😢😢😢
thank you for creating this.. we get metrics crammed down our throats everyshift and it makes working in the ER feel like an assembly line. And the worst part is i just cant seem to understand what the point is of hitting all these numbers. I wish we truly put patients first
I should be retweeting every single one of your videos omfg, such crude and humoristic depiction of real real life conversations between bad and worse people. I start with bad cos in real life there must be little to none at all objections toward this sad society crushing financial trend in hospitals. Keep us informed yet smiling at the end anyway Doc !
I have some pretty extensive chronic conditions and paraplegic. Hospital visits are ungodly at times as far as care. I am blessed to have a doctor that cares more than any other as my primary. A while back he was so fed up with the corporate system him and three doctors and their entire nursing staff quit on the same day and set up their own private clinic. I would like to add that that clinic had to shut down the entire wing of their walk in/family care unit, so there are ways to make them pay ultimately you physicians are their ticket to money and you can pull it.
As an RN, I can say that the issue of corporate profit over patient care and the C oV I d debacle, I quit after 45 years of nursing, a masters degree, and 2 advanced certifications. I do my absolute best at trying to stay healthy and staying away from hospitals as much as possible. God bless everyone.
"You're trying to put patient care first when you should be trying to maximize profits." I may be working in private GP as a veterinary nurse, but I get that feel a lot from my practice owners. To that I say: No. I am a medical professional, so patient care has always been and will always be my first priority. Not only will I die on this hill, I'll also fight for it and defend it.
As sickening as this is, it’s important that patients understand the pressures that medical staff are under. I have a severe chronic illness, and it’s easy to feel like doctors in emergency just don’t care. I’m so thankful for the ones who value patient care and go the extra mile.
We do care. We’re just manipulated, overworked and burnt out and the person next door probably screamed obscenities at us over the wait time. And maybe we’re also working while sick because of staffing shortages.
this is beautiful in the sense that it not just captures modern medical systems, but in all fields of profession including Education, Entertainment industry(Music, Video Games etc.) and even Technology...
Damn, I really needed this. Started new position in the ER from PACU a few weeks ago. I'm nearly ready to walkout due to lack of support, no help when needed, yet getting warnings for not completing tasks within the mandated time frame. I'm an RN of 22 years experience! What massive hellhole of a mistake have I made going to the ER?
This is also the reason why hospitals bought by companies have high staff turnover. They exploit workers causing burnout by understaffing on purpose to increase profits. What they don't want to acknowledge is this creates unsafe situations for patients. It has been proven in studies to shorten length of stay for patients and decrease medical errors if you have adequate nursing staff. We should have federal nurse to patients ratios. COVID highlighted the weaknesses in the system, but the chronic understaffing had been going on for several decades before. Corporate hospitals also buy the least expensive materials, I'm sure we used to have ppe manufacturers in the USA. I would guess they all went out of business as hospitals started getting supplies from other countries.
"Preach it, my dear brother, preach it!!!” I know that this is meant to be comedy with a purpose, but what you say on this is all too true!!! As being both an RN and a Pastor, I've been living this for the past 2 years with my husband's serious illnesses. (My specialties are Cardiology/Electrophysiology, with some ICU work in the past.) I'm writing this from an ICU room where my husband is being treated at a University Hospital. If a patient has significant, serious illness, the average local hospital under treats. The monetary bottom line drives care. A patient has to travel to a larger hospital, preferably to a teaching University Hospital, in order to get top notch care. If the patient doesn't do that, he or she gets onto an endless merry-go-round where the smaller hospital gets the patient just well enough to say that the patient is "cured" on paper, but then within a very short time the patient is seriously ill again and back into the hospital. Or, worse yet, the patient dies.
Based on my medical bills for services my very expensive employer offers I thought this already WAS the state of medicine. (I work for a great company that offers great insurance, but I do have the highest coverage, by choice.)
I used to work for a major automobile manufacturer and had top notch insurance as well. Only I had a PPO plan as opposed to HMO. When I had to get an MRI done my insurance company called me and said they could get me in a day earlier and save $20 by going to a different imaging specialist that was the same distance away. Just in the other direction. Between the urgent care visit plus X-ray, several trips to my primary, multiple podiatry appointments, physical therapy, and the MRI, I paid less than $300 out of pocket. If I had HMO coverage, even at the top tier, I’d have paid thousands for that.
@@dr.floridamanphd Man thats messed up, in the uae i got 3 mris done 5 xrays, 6 different tests including a TB test had a bronchoscopy and multiple visits all i paid was 10 dollars.
It is the current state of medicine. Unless we the people do something about it to get these type of things outlawed, then it will just continue to pervade everyone everywhere and there won't be a single private practice doctor in business anymore.
As someone who works EVS in hospitals for years. This is happening with the evs departments too. They want fast turn arounds and bare minimum done. So to get patients in the rooms and get their money. Not caring if the room is dirty. I take way longer in rooms. Scrubbing walls and moving stuff to clean underneath it. I am a black sheep in my department. They avoid giving me patients rooms and keep me on cleaning departments/areas. 🤷♀️🤣
The real title of your job should include infection control! Those rooms can get gnarly - I'm an RN working in an ER, I see it all the time. Thank you for recognizing how important a good cleaning is! Even Florence Nightengale preached cleanliness for health reasons.
@@aylan.6212 My first supervisor I had in my journey down my EVS path. He gave me his wisdom and I try to live it today. After you clean a room take a step back. Look at the room and ask yourself. Would I put a family member in this room? That is how you base if you did a good job.
You are a saint. I’m an ER doc and I can tell the pressure is on EVS and nursing to rapidly turn over rooms. It shows. More than a few times I’ve had to disconnect and clean disgusting dirty cables while talking to a patient. We have to increase EVS staffing to allow for better cleaning and infection control.
Dude exactly, I love how the only problems of our medical system are from the three private health insurers we have left over and their lobbying, every state health service and medicare are just phenomenal
@@DGlaucomflecken so true! Please give it a few months before introducing Barty Banks Sr, the cruel neglectful father who has pushed Barty Jr into the world of greedy corporate America. I need a while to cope with today's new dynamic shift 😵💫
So true. I can’t wait to retire. Love my patients but I hate all the other bullshit that goes along with it. Once you hit the metric, next year they change the goal post. The metrics don’t take patient responsibility into account. The blame is all put on the doctor by withholding money.
That metrics game isn't limited to healthcare. It's deeply embedded in the information technology world too. I aggressively paid down my mortgage and finally quit worrying about metrics, and concentrated on being the best at my job. Took their corporation wide early retirement buyout because I knew they were ready to get rid of employees in their late 50s and older. So much knowledge walked out that door.
“A handful of ultra rich exploiting the altruistic health care providers…” a recent graduate in medicine, can’t agree more. Both health system owners and abusing patients take advantage of those with the inherent defect of people in health care, the desire to care for people. So sad.
This hits home as a soon to be graduating ER resident looking for my first attending job. My choices are essentially Corporate Group A in city A, Corporate Group A in city B, Corporate Group B in city A, Corporate Group C in city B, Travel position with Corporate Group D, or Small Independent Group A in city A that will probably be taken over by Corporate Group C within the next 5-10 years. All of these big groups claim to be "physician owned" in some sense but we all know what they really are. I'm sad to say I'm really having second thoughts about the small group after the conversation with Corporate Group C in which the doc told me he signed on because he saw the writing on the wall and didn't want to waste time and money trying to be partner in a small group only to have them lose their contract to a corporate group and waste all of his efforts. I'll still probably sign with the small group if they give me an offer, but yikes. I try not to think about the fact that I like to think I have above average patient care because I'm a little slower than some of my colleagues and take more time talking to patients, but I know I'll be pushed (even more than in residency) to stop that once I'm an attending. Everyone calls it "efficiency," but I'm plenty efficient with my charting and orders. It's really about "shortcutting actual time with patients to move them as fast as possible," in which missing some important things is considered acceptable risk. Then, at the same time, we teach more and more defensive medicine, aka "how to chart such that no one can sue you when the insane expectations of your job inevitably cause you to miss important things or even cause harm to patients."
This began in 1973 and I recall my decades experienced Physician/Surgeon dad being told by insurance companies how they would allow him to practice medicine. He rarely got upset, but on the phone this time, he did. He asked the person, "Which Medical School did you graduate from?". I still ask insurance jerks that question.
This hits home and is something that is not in the best interest of patients! We are to be efficient yes but maximizing profit? We should maximize the care we give with the money we get
I agree with you, but what happens when there’s simply no money because Medicare and Medicaid either aren’t reimbursing or are low balling what they’ll pay for? You run out of money and lose your department. Catch-22.
@@dr.floridamanphd To start with, I love your name. And to the point: As a fledgling psychiatrist, it's mind-boggling how many people think we're prowling the streets looking for patients to drag kicking and screaming into an involuntary hospital stay. Psychiatric units aren't profitable...and a lot of hospitals don't bother having one because of that.
I love the disclaimer on each one of these videos that states "From a doctor licensed in the US". From a nurse, please keep doing what you're doing Dr. G!
The punch line is that as soon as any profits have been pulled from the community, they declare bankruptcy and move on. Wait…let me get back to you all, that doesn’t seem like a very funny punch line.
They did this to the community hospital that I was born in and now it is shut down and is a condemned building 🏚. Now that community has to drive 30-45 minutes or more to get to the nearest hospital whereas before it was less than 30 mins for most people in that county.
it's funny because people from the us still boast about how their medical procedures are the best in the world, while I can just go to the ER whenever I want and not pay a cent out of pocket :3 but then these same people try to tell me that "socialized medicine is baaaaaad and eeeeeeeevil" because it has "social" in the name :3
Now I know why the last time I went to an emergency room, for a second degree burn larger than the size of my hand, the doctor poked the blister that was coming up and unwashed hand and told me there was nothing they can do for that and to go home. Then I was charged me $650 for seeing a doctor.
@@TheInfectous actually a lot of ppl think that, and it's a huge problem bc it's a gross mistargeting of the frustration towards the healthcare system. Your statement is just plain ignorant and your desire to want to soapbox me with your silly burn anecdote as if I've had no negative encounters with the healthcare field is cute but also very simple minded
Once upon a time, I thought letting Business management taking over medicine was a good thing. Bringing in efficiencies reducing waste would be a win win. Today's reality shows it went way too far and patients are paying the price.
Maybe you can help because I'm conflicted about this. On one hand, yeah, putting business into medicine can stop patients who actually need care from getting it. On the other hand, with compassionate medicine and universal healthcare, there is the issue of overtreating, giving patients treatments that have only a minuscule improvement to the patient's life, but have high cost to the environment and the economy. Unsure where the happy medium is.
@@japanpanda2179 Medicine is only a tiny fraction of the systemic issues, which, if we were able to magically wave a wand and immediately fix, would include a complete overhaul of transportation, infrastructure, and labor. The truth is that our whole system is geared towards consumption and we don't value wellness - because if we did, we would have set up a 20 hour work week and automated the rest so that people could have time to exercise, socialize, build communities, grow their own food...instead we would rather they eat processed junk and require a quadruple bypass. It's good for GDP. Medicine is wasteful on purpose because of business. As for your specific question...I don't really think we would need to worry about that if we fixed these issues. You would have a doctor who could take the time to sit down and explain the pros and cons...and quite frankly, if a treatment is only going to have minimal benefit, that doctor could refuse to go through with it. But most people aren't going to pursue a treatment if they actually had the time to understand what they're signing up for...and they might not request it at all if they had a more healthy relationship with purpose and living than they're forced to do now. Source: The many dementia patients I've had, many of whom might not be demented if they were in a healthier society, and many of whose families have had to learn the hard way that letting go is kinder (and cheaper).
I think we can almost all agree that it is a complex and complicated problem. Sadly, I believe, that neither party in Congress has people up to the task to fix it.
This is happening right now in PA with Crozer Health systems. Or should say, its already happened. The problem now is that the entire network of Crozer properties are on the verge of collapse.
This is true, in everything. Not just healthcare and it's scary, but when our clinic went to you get paid by how many patients you can see a day model, I knew we were screwed
ER doctor here !!!! I cannot believe I waited 6 days to watch this. Waw ! The truth spoken like a real financial entity. Exactly I could make a video on all these however it will be boring and no body would care ! Just know is real. All I got to say. Metrics, RVU, etc. STAY SAFE !
I’m a primary care doc. Video is completely true in my region. Admin of large health systems prey on altruistic nature of hard working, non-complaining providers who struggle to meet metrics + deliver ethical medicine - so provider can keep their job and sleep at night.
Private equity started getting involved in healthcare about ten years ago. Kinda correlates with the Affordable Care Act that we needed to pass before we would know what was in it. Now we know
This is so true and so sad! One thought if people would use a clinic instead of an ER for not emergency appointments this could help. In our area this has been working well, and helping the overall health of the hospital. Such a sad state the US is in with healthcare and insurance companies 😡😡😡
Medicine should ALWAYS be measured by a metric of good patient care and outcomes first and foremost. Everything else is second. Otherwise, why tf are we even doing this, if not to help patients feel better? Sigh.
Every time I see your content, the only thing I can think of is: God bless that I live in Germany, where you don't go bankrupt if you have to go to the hospital
As an economist student i can tell.it started as a better solution only to turn the worst the problem is Healthcare is a Merit good essentially it not only benefits you but others around you too and therefore should never be privatised as Mr. Banks said his aim is to maximize profits and merit goods are the worst to get any profit off as you cannot set a price. Now if Mr Banks only ran that 1 ER and no other department in the Hospital it may had worked very well in the long run but as he also owns all the ERs he is the nightmare economists get as now he is the Monopoly and that is literally the worst market ever and all Economists hate it
One of the biggest arguments in the US against universal healthcare is wait times. Here's my experience in Canada's ERs: Tetanus shot a day after dog bite (no bleeding, no obvious infection) - seen, treated, on my way in 3 hours. $0 Migraine with visual aura (aka vision went weird) - eyes tested immediately, determined safe, given meds and sent on my way in about 2 hours. $0 Weird chest pain - interviewed, tested, determined safe, on my way in under 30 mins. $0 In all cases, I was healthy, 18-22 and turned out to be fine. Imagine how fast you'd be seen and treated if you had a real emergency!
@@firstlast8258 Sure, but we pay about half per capita ($6300USD per person) vs the US ($12500USD per person), have better health outcomes, and no one has to beg for their lives on GoFundMe sooo
@@firstlast8258 I mean, it makes sense we're paying less. Americans aren't just paying for healthcare, they're paying for insurance companies too. Paying the salaries of every agent and exec, paying for ads, buildings, and more. Plus, when people can get preventative care or treat problems as soon as they start (which people do when doctor's visits cost nothing out of pocket and requires no paperwork), it costs FAR less than waiting until it's killing them
@@firstlast8258 That's by far the best reason for universal healthcare. American health insurance is so expensive, and medical debt is a crippling problem there. People are stuck rationing medications like insulin, and sometimes die from it. People often don't get life-saving medical care and die from it. They can't afford to go when problems are small, and the problems can grow into debilitating issues. Canada's system, being paid through taxes, means that the poor (who pay very little or even recieve money) can always go to the doctor and get all the help they need. The system is designed so that every citizen in every situation can afford to see a doctor.
My father was an RN for over thirty years. He worked over twenty at the same hospital, who transitioned him to a desk job during COVID (he's in his sixties) and then one day, just decided that desk job didn't exist any more. Tossed twenty years of service to the curb without even a single day of warning. If they had told him in advance, he could have had social security and such lined up by the time he left. As it was he and my mom had to live on his back vacation time and sell a piece of property they'd had. They didn't get to do anything fun from selling my childhood home; just pay bills.
Oh man...been researching medicare fraud and private equity's takeover of the American healthcare system (and the UK, I just realized, re. HCA Healthcare)...I needed this humor break. Love you, Dr. G! Also love you're a fellow Oregonian!!!!
I got out of private practice before the VCs bought out my old group. Now they are scattered to the four winds and their tightly run ship employing 100s of staff is GONE and replaced with a faceless blob of evil. I get to stay altruistic, working for the largest socialized medical org in the country aka the VA. It's really sad and awful. People, this is why your doc has 5 min with you and spends the entire time clicking on radio buttons while trying to get actionable history from you.
I’m a retired, highly trained RN with 45 years experience in the ICU, Cath lab, and ER. Worked hard to get my masters degree and 2 certifications in ICU and cardiology. Yep. No transferable skills. I’d love to get a small part time job outside medicine but nobody will hire me because I’m over qualified and don’t have retail or delivery experience. That’s not what I expected! I can’t even get a $16.50 an hour job. I used to make $50 a hour!
Everybody welcome Barty Banks to the Glaucomflecken cinematic universe! He’s awful!
Owned and controlled by the same insurance companies that will not pay
@@avirajsinghmehta1857 the insurance companies don’t own him. He owns them.
@@dr.floridamanphd the money is the same
A reminder that Texas has a horrifying thing called private ERs that are actually urgent cares that charge ER rates
Some say the day he was born HE billed the hospital..
As an ER physician this is the definition of "the truth hurts".
It's happening in dentistry, too 😬
just signed on to a large CMG and it felt dirty. we got to take the power back
Anesthesia as well.
@@tmoore121 ew. Also, awesome username 😎
Yep, that’s our world…😢
You do more public service than most. Your subtle satire while taking a stab at the burning issues in current medicine is nothing but genius. Great going, Will!
What about this is subtle lol
@@Justin-sy6ns “heavy-handed” would certainly be a more appropriate term to use here LOL
Also, being genius at taking stabs in current medicine does no public service at all. Not even getting people informed, as this does not go into specifics and doesn't encourage self-research.
Sorry to tell you this but media tends to do the opposite and make people less active in the pursuit of the defense for their well-being by taking the media as a form of protest and, as you mention, public service.
@@Justin-sy6ns Yeah, he’s not unfunny, but I definitely don’t come here when I want to feel joy in the world. Doc Glauc is about as subtle as a hammer.
@@Electric-Gal Evidently the subtle points went over your head.
"One word ...metrics."
Just hearing that sent shivers down my spine, for Barty Banks is one horrible despicable villain.
Business people have no business making decisions when it comes to patient care in the healthcare system.
Metrics is essentially the reasons why so many patients that are legitimately in need of care , get denied.
Being high risk, low outcome, questionable circumstance, etc., ...all of that could lead to a patient being denied care or being transferred around , so they can be someone else's problem.
Might as well tell patients that if they are not at the epitomy of good health, be prepared NOT to recieve care , for a hospital would not want their precious metrics to be trashed.
Please everyone read about Tenet and DMC
We could just leave bad reviews.
@Quentin Styger sure, but at this stage, it’s easier said than done.
@Quentin Styger no, of course not.
"Metrics is why so many patients legitimately in need get ....dead." Here I fixed that for you.
I am a CPA...and daughter of a physician. Keep those GREASY business people out of medicine.
Businessmen aren't people. They're blood sucking nats more than anything.
Too late.
yeah, too late. They're already everywhere
They're already there. Should've prevented it. Say, aren't CPAs usually in bed with business ppl?
One word : F U T I L E.
Technically it’s the present state of medicine too, not just the future. The future is now! 😅 This literally caused me to lose my job for “performance issues” less than 2 months after having an annual performance evaluation that reflected above-average performance & noted consistent signs of ongoing improvement.
I hope you had a soft landing. It's truly disgusting what the oligarchs have done to medicine. People profiting off death and disease (you too, pharms and insurance companies) is super gross.
Well that makes we want to puke. Hope you are able to keep your chin up. And I hope they at least gave you a copy of the evaluation.
Ooh, you too? My boss said he put me in for a raise because I was doing very well. The next week, said my performance was lousy and out I went.
Happened to me too.
Happened to me too.
On one of the early seasons of House MD, they had a rich guy come in and donate $100 000 to the hospital in exchange for a position at the head of the board of directors. And the entire board basically just said, "well, seems like a small price to pay!" and then everyone was so shocked when the guy started fucking everything up, insisted on running the hospital "like a business", and took complete control by firing every board member who disagreed with him.
It's just weird because the whole time, I was thinking how it was obviously unrealistic and made no fucking sense from the start. You can't just BUY a job without having any qualifications and have people go along with it. At the very least, it would be under the table because it's clearly a bribe and not a legitimate hire.
This just made me think of that.
"Edward Vogler"
Yeah, but that's the thing. Being on a board of directors isn't itself a job. Anybody can be on the board of directors of a company if shareholders or some similar authority chooses you for it. Some companies will even make sure to have directors on the board who aren't directly involved in the business, for perspective reasons.
Also, it's possible to buy qualifications, like Heather Bresch did by bribing WVU to give her an Executive Master of Business Administration degree, which helped her become CEO of Mylan where she was one of the people who cranked up Epipen prices. But she's rich and her father is Senator Joe Manchin, so she suffered no consequences for the degree scandal and probably won't suffer any for the Epipen thing either.
Yay capitalism!
100k to be in a board of director is very small money
You have no idea how many of the people running these corporations are absolutely incompetent in every aspect other than making quick cash
I think it was 100 million
The way you depict we millenial physicians' bleak, nihilistic, and abjectly futile outlook on healthcare is just *chef's kiss*
So like… what are the “benchmarks“ he’s talking about? Does he mean prescribing certain medicines or benchmarks of something else?
@@MissQueen131 mostly things like average handling time for patients, minimum patient quotas, number of drugs dispensed, number of procedures accomplished, etc. (though these differ across hospitals and across countries), which are partly the reason many patients get denied healthcare
Lol I'll just die
I’m there
I’ve been an RN for almost 30yrs. The best hospital I ever worked at was one owned by Sisters of Charity. They sold it to CHRISTUS, which made some changes but weren’t so horrible. But when I moved to an HCA hospital…hoo boy. My mom recently retired from that same CHRISTUS hospital-now owned by an even bigger corporation.
We both agree that working at a corporate hospital whose focus is money first, then patients, then staff (although they do like to pretend otherwise) is the worst thing ever. I have never believed more strongly that capitalism should NOT be running healthcare.
As a devout Catholic (whose heritage and traditions are bashed daily), I appreciate your post. As everyone will soon find out, as goes the Catholic Church so goes the world.
Stop raping nuns and molesting children and we might give you a listen. You were the dominant religion for 1500 years. You totally blew it.
CAPITALISM=EXPLOITATION
Thanks for addressing the real issue a system that puts profits over people.
@@thedudeabides3930 Exactly. Especially in my home country of Ireland, it was the church that set up the majority if hospitals and schools, which the government js now trying to take over. Their attempts to destroy the church will destroy them and everyone else in the process. I'd almost be funny if it wasn't so sad. Hell the sisters if Mercy over here are being demonised for not giving the state full control of their hospital
I've been playing Project Hospital lately and there was this quest called "Earn profit for (X) days". I was having difficulty the first round so I looked up for some advice for this task. Apparently the solution was "get rid/close all ER and ICU departments to focus on surgery departments". 😷
You mean the outpatient, elective surgery department - "Center of Excellence" for knees, hips, shoulders etc... When something goes awry, ship them to the local tertiary care center, or better yet, just call 911.
Lol, that's some realism.
@@ratpH1nk Oh you have a Center of Excellence? Our whole hospital used to be one. It quietly went away, I think it was about the time that CMS busted the hell out of us. Now we have kindness. (No skills, or knowledge necessary.) 💖
Why don't they have a Plastic Surgery Department cash cow to offset the cash drain of the ER and ICU? Wouldn't that be the logical thing to do?
@@patti6194 Cash cows prefer to graze on their own fields if you know what I'm saying. Those cows are surgeons, and the hospital doesn't necessarily own them. Sure, they make the hospital boatloads of money, but they prefer to do private work making their own fortunes-- as you should if you've spent your entire life training to become a surgeon.
"If you can't afford to get hurt or sick, don't." This is the mantra US healthcare works around. Which is interesting because ever since the 50s US economy been revolving around people getting and doing things they can't afford with money they don't have.
Yea stuffing your face with McDonald’s doesn’t help either….
The system was designed for people who truly needed it and not by their own choosing.
It was expected that kids would still be active, have gym class at school,
Parents were expected to make good nutritious choices, limit consumption, be more nutritiously literate.
I would argue that 50% of the healthcare problem can be solved via working out and healthy eating.
@@cs7623 🙄
@@amiesparkle00 do you realize the economic cost of obesity in America? $500 billion annually and it is growing every year.
@@cs7623 I mean yes and no. I eat very healthily and am active with a physical demanding job in food service and as a tattoo artist (yes it’s more work than just drawing on people) and I’ll tell you right now that as someone with an autoimmune disease that would cost over $400 a month to treat appropriately I can’t afford that, but if I get sick with something like COVID it’s gonna put me in the ER. Yes to some degree illness preventable and I do what I can, but then there’s injury. If I get into a bad car crash or something and get severely injured I’m not going to have to money for a several thousand dollar medical bill.
Not to mention if someone has a hereditary disease that they have no control over or something like diabetes (even with a healthy lifestyle) that goes undiagnosed it can cause massive complications.
It’s so incredibly reductive to assume that healthy choices will mitigate medical expenditures. That’s just not how the world works. Shit happens and most time sun emergency medicine like this skit discusses is out of anyones control.
@@scallywag1716 exactly my point thank you.
My Med school is so woke right now that they said the greatest economic problem facing healthcare is “transgender health”. During the QA portion I asked why would they say that when obesity is much more of a problem.
Had a professionalism meeting shortly after with student progress
I’ll never vote for those liberals as long as I live. They ruin everything including medicine.
I worked for one political campaign in my life that seemed like the easiest thing on earth. Just a nurses union pushing for safe guidelines on how many patients can be assigned to a nurse, already done in California which saved people money in the end. We were winning by a landslide until a couple of weeks before voting where private hospital CEOs dumped $13,000,000 into ads that took our "nurses say yes on Question one" and made it "Nurses say no on question one" then we lost through pure confusion and advertisement tactics. Taught me what a joke voting and healthcare ethics was in the US
This, this is just sad 😢
Ah, Massachusetts in 2018? I was working on Question 3 to preserve trans rights!
Don't ICU nursing making$130,000- $150,000.
What is the patient charged?
I agree, this is terribly sad
Thats depressing. The rich do anything to stay rich.
I left corporate pharmacy because of those unrealistic metrics which can use as leverage to fire you whenever they want. Work at an independent that is lower pay but at least I not on antidepressants.
Yeah, worked at a hospital like that. They rationed alcohol wipes and turned the lights off at 9:00 p.m. When I complained about the safety issue of not being able to see when preparing meds (did not have pixis in those days) and increased potential for infection I received a shrug. All the while the Administrator was earning 6 figures. Had to bring a flashlight and buy my own alcohol wipes. They moved CABG patients from the ICU to a step down unit after 24 hours with PA and A lines and chest tubes where the nurse to patient ratio was 6:1 and none of the nurses, except myself, had ICU experience. Even with my experience and despite empatically telling my day 2 post op CABG patient not to get out of bed for any reason without me and that I would be watching him closely he almost immediately got up and pulled his chest tube out. I just happened to be close enough to hear an odd rhythmic whoosing noise so I checked. When I called the surgeon I was berated for not watching the patient closely enough. I finally said "who of my 5 other patients would you suggest I neglect to stay at your patients bedside?" You know how that went over with a surgeon in a private hospital... We nurses reported them to the union who did absolutely nothing about that or any other safety issue. I requested to be withdrawn from the union and was told once you sign on you can't sign out. The only way out was to quit so I did and traveled 35 mins to get to another hospital that was a nonprofit, not unionized and patient care was more of the focus. The hosp I left changed Administrators about every 3 years. They collect their high salaries while raping the institution and then move on to the next small hospital.
So sorry that happened to you and your patients. It sounds like something from a dystopian horror.
Looks like the union failed you.
Don't all doctors get 6 figures?
@@srirampatnaik9164
Yes, and they go to medical school 10 to 16 yrs and have high malpractice, continuing education,
and board fees.
...wait what? The union wouldn't let you leave???? That's...anyways I reckon you stop paying your union fees they'd let you go
Horrifying future reality depicted with a sense of humour 👍🏼 Kudos to you Dr Will (our Glaucomflecken genius)
It’s Dr Bill Bill.
why "future"?
current reality. You need a reality check.
This is has been the reality in America for nearly a decade.
Future? You meant present.
Never understood why so many of my fellow medical staff keep their complience up. We often get told that we "cant just strike and not work, think of the patients".
I see it this way: "We can strike, we can set a price and yes exactly - Think of the patients."
I wonder how quick our politicians will suddenly move their asses if they realize that entire hospitals would threat to lay down their work.
Agree !!!!!!
Do it. Y'all should of been done it with the pandemic how horrible they treated y'all thank you for your service
I'm not interested in seeing the pile of bodies that produces. These people don't value our lives. Not an ounce.
Got to love having both "be fired for any reason" clauses and non-compete agreements in your contract. Especially as a pathologist.
What is a non-compete agreement?
@@andynonymous6769 can't work anywhere within like 30 miles of where I currently work.
Yikes!
Double bind, for sure!
@@TheMedengineer Most of those clauses are usually illegal and can't be enforced.
Who would have thought that the most scathing and critically accurate representation of our messed up healthcare system would come from a UA-cam celebrity. (A much loved and well respected celebrity, I might add 😉). Keep up the amazing , and humorous social commentary, Doc!
Damn, went straight from gut-busting to heart wrenching with "no transferable skills".
Talk about a good news bad news kind of situation.
Dont believe the lies. Physicians have much worth and MANY transferable skills. Yes they tend to have high student loan debt; what if more just stopped paying into the system ????
Yes 💯 this! It’s a myth that physicians do not have transferable skills - communication skills, leadership, team working, organisational skills, lateral thinking, the list goes on!
Yeah you're right. Basic understanding of other sciences and absolutely nothing to show for in any field other than **applied** medicine. Talk about a one-way road...
@@DoctorRhys most fields require more than those skills. Unless a doctor has some degree or certification in other fields you’re kind of stuck.
@@DoctorRhys Damn dude, retail workers have those same skills!
"It's not supposed to make money" - For some reason everyone skips over that fact that healthcare shouldn't revolve around making money.
I have nothing nice to say about our current healthcare system in the USA.
This is ironically the most absurd and realistic film I've even seen. Garcia Marquez cannot match the Magical Realism here.
Welcome to the future of veterinary medicine as well! Did you know that Mars owns Banfield AND VCA, as well as many other large veterinary groups? And I'm sure Mars candy cares much more about your pet's health than it does about heaps and heaps of cash.
VCA completely underwhelmed me. Care of my cat was way below par. Now I understand why.
As a future Emergency doc, this is freaking me out
Come to Australia 🇦🇺
@@GregPolkinghorne Meh, once the Govt floats Medicare on the ASX our healthcare will head the same way.
@@snes1234 Yeah no lmao
Doubt the people will allow that. We see what is happening in America. Instead we facing increasingly being crushed to have private insurance that covers less than 20% of hospital expenses but still charges an exorbitant rate and have our taxes which we are trying to avoid at a higher rate by paying for private insurance picking up the rest. Oh wait...
@@MrThefoxyone NO U
I can’t even laugh at this one Glauc. After working in a safety net hospital it’s just too real. Thanks for tackling this issue ❤️
The way this is posted one day after his Yale School of Medicine commencement speech 💀
Damn! Gotta give it up for Dr. Glaucomflecken!
In Germany there is a worrying phenomenon going on right now with more and more ophthalmology clinics being taken over by (international) investors, which results in more treatments being done than are necessary. Additionally, it is very difficult to find out whether the clinic you want to go to is run by an investment company. Hopefully we'll manage to stop this and make it very transparent, which clinics are profit machines. Making medical decisions based on financial gain is just wrong.
Sadly not only that, we have ton of other issues due to privatization of hospitals and Healthcare in general. Like unnecessary operations because they bring more money. Our idol was the united States, so yeah I expect it will only get worse for our german Healthcare system sadly
They want the bio info the iris holds
@@LetsplayAori ack the USA as a model? No!
@@paddleduck5328 the flat-rate payment for patients it is how hospital get paid and that's really similar to the US one and cause a ton of problems in our system. Like unnecessary operations, patients aren't as long as they should be in the hospital. It's not a popular concept around doctors since it forces them to do things which result in higher profit, but might not be necessary
I will just outright ask who they are run by .
“Student loans and no transferable skills”
Once you’re in medicine you stay in medicine…
It's a prison. Doctors are the inmates and admin are the prison guards.
As a doctor, this is a sad reality
Please dont believe these lies. Physicians have MUCH worth and many transferrable skills. Yes, they tend to have high student loan debt; what would happen if we stopped paying into the system ???
Indentured servitude model.
@@peanut228 if you can read a job description, you can understand exactly what I said.
This is so sad & true!! 30yr icu nurse & breaks my heart to see this change happen in our healthcare system. I’ve always had insurance yet have huge medical bills to the point I refuse to go to doctor anymore. Not just because I can’t afford more med bills but I also know that my $$ doesn’t go to doctors nurses etc but into the pockets of the extremely wealthy man’s briefcase
Smh
It's sad.
The truth of this hurts my soul and scares me silly, but I fervently hope that Dr. G's method of revealing the truth will eventually spark change
It probably won't. America is against leftist ideals.
It won't
🤞
🤞
@@AT-il2ej well, not if we give into hopelessness. But I see your point; that's why I added "eventually". I mean, how many decades did it take for Worker's Comp, OSHA, etc to become a thing? Oh, I know they're often ignored and/or abused, but at least they exist. IIRC, it took the US...what, 6+ decades to get that? Change is possible, but it takes a depressingly long time
And to their delight, each healthcare worker they drive away increases the scarcity of their 'product' so that they can further increase prices and profit, and makes it easier to withhold treatment from the underprivileged.
Honestly, this reminds me of the House MD episodes where a rich man runs the hospital.
Kinda freaky how spot on it was
That was a good storyline. Season 1 I think. Although House would’ve been fired for what embarrassing the Chairman like that in public.
Try Royal Pains if you haven’t seen it already. That’s another good medical show.
@@dr.floridamanphd I appreciate the recommendation. I'll gladly check it out then.
"They don't have transferable skills"
Yup, going into medicine is like getting married. And only then do you find out about the horrible things going on in the background... It's a miracle how some things manage to work in today's society.
sounds like the government entity I work for. we tell management on what contractors are doing wrong and management over rides pretty much saying it will be fine and we wonder why everything is falling apart or why taxes keep going up. we also use to have meetings where management would usually ask employees about what we thought needed to be fixed but they didn't want to hear the facts.
Health care economics for dummies. Excellent content again sir!
"It's no measure of health to be well adjusted to a profoundly sick society".
Also, hospital admin getting shushed with a $100 bill! 😂
Never realized how fucked our healthcare system is till your videos exposed it to me. There are few entities I possess greater hatred for than insurance company execs, and the leaders of our country that have willingly allowed such a system to exist
Private Equity is single handedly ruining this country. They buy businesses extract as much value from them as they possibly can and then sell off or bankrupt them.
"they have no transferable skills"... this sentence hit the spot. we indeed have no other skills than medicine due to so much studying and working. even if you are talented or skilled at something else, still after so many years, you feel debilitated at doing anything but medicine
Yes....I am an anesthesiologist..my friends and classmates from junior years are way more socially intelligent and talented than me..I am just a doc...😢😢😢
thank you for creating this.. we get metrics crammed down our throats everyshift and it makes working in the ER feel like an assembly line. And the worst part is i just cant seem to understand what the point is of hitting all these numbers. I wish we truly put patients first
I should be retweeting every single one of your videos omfg, such crude and humoristic depiction of real real life conversations between bad and worse people. I start with bad cos in real life there must be little to none at all objections toward this sad society crushing financial trend in hospitals. Keep us informed yet smiling at the end anyway Doc !
I have some pretty extensive chronic conditions and paraplegic. Hospital visits are ungodly at times as far as care. I am blessed to have a doctor that cares more than any other as my primary. A while back he was so fed up with the corporate system him and three doctors and their entire nursing staff quit on the same day and set up their own private clinic. I would like to add that that clinic had to shut down the entire wing of their walk in/family care unit, so there are ways to make them pay ultimately you physicians are their ticket to money and you can pull it.
"What are they gonna do, quit?"
U N I O N T I M E
As an RN, I can say that the issue of corporate profit over patient care and the C oV I d debacle, I quit after 45 years of nursing, a masters degree, and 2 advanced certifications. I do my absolute best at trying to stay healthy and staying away from hospitals as much as possible. God bless everyone.
"You're trying to put patient care first when you should be trying to maximize profits." I may be working in private GP as a veterinary nurse, but I get that feel a lot from my practice owners. To that I say: No. I am a medical professional, so patient care has always been and will always be my first priority. Not only will I die on this hill, I'll also fight for it and defend it.
Hey! There's pizza for everyone in the break room! Just wanted to say how much we appreciate your hard work during these trying times!
As sickening as this is, it’s important that patients understand the pressures that medical staff are under. I have a severe chronic illness, and it’s easy to feel like doctors in emergency just don’t care. I’m so thankful for the ones who value patient care and go the extra mile.
We do care. We’re just manipulated, overworked and burnt out and the person next door probably screamed obscenities at us over the wait time. And maybe we’re also working while sick because of staffing shortages.
@@jessica20625 thank you for all of your hard work and dedication.
this is beautiful in the sense that it not just captures modern medical systems, but in all fields of profession including Education, Entertainment industry(Music, Video Games etc.) and even Technology...
Damn, I really needed this. Started new position in the ER from PACU a few weeks ago. I'm nearly ready to walkout due to lack of support, no help when needed, yet getting warnings for not completing tasks within the mandated time frame. I'm an RN of 22 years experience! What massive hellhole of a mistake have I made going to the ER?
This is also the reason why hospitals bought by companies have high staff turnover. They exploit workers causing burnout by understaffing on purpose to increase profits. What they don't want to acknowledge is this creates unsafe situations for patients. It has been proven in studies to shorten length of stay for patients and decrease medical errors if you have adequate nursing staff. We should have federal nurse to patients ratios. COVID highlighted the weaknesses in the system, but the chronic understaffing had been going on for several decades before. Corporate hospitals also buy the least expensive materials, I'm sure we used to have ppe manufacturers in the USA. I would guess they all went out of business as hospitals started getting supplies from other countries.
“Well, I have evidence of my YACHT.” 💀🤣😭 I mean, who can argue against that?
"Preach it, my dear brother, preach it!!!” I know that this is meant to be comedy with a purpose, but what you say on this is all too true!!! As being both an RN and a Pastor, I've been living this for the past 2 years with my husband's serious illnesses. (My specialties are Cardiology/Electrophysiology, with some ICU work in the past.) I'm writing this from an ICU room where my husband is being treated at a University Hospital. If a patient has significant, serious illness, the average local hospital under treats. The monetary bottom line drives care. A patient has to travel to a larger hospital, preferably to a teaching University Hospital, in order to get top notch care. If the patient doesn't do that, he or she gets onto an endless merry-go-round where the smaller hospital gets the patient just well enough to say that the patient is "cured" on paper, but then within a very short time the patient is seriously ill again and back into the hospital. Or, worse yet, the patient dies.
Based on my medical bills for services my very expensive employer offers I thought this already WAS the state of medicine. (I work for a great company that offers great insurance, but I do have the highest coverage, by choice.)
I used to work for a major automobile manufacturer and had top notch insurance as well. Only I had a PPO plan as opposed to HMO.
When I had to get an MRI done my insurance company called me and said they could get me in a day earlier and save $20 by going to a different imaging specialist that was the same distance away. Just in the other direction.
Between the urgent care visit plus X-ray, several trips to my primary, multiple podiatry appointments, physical therapy, and the MRI, I paid less than $300 out of pocket.
If I had HMO coverage, even at the top tier, I’d have paid thousands for that.
@@dr.floridamanphd Man thats messed up, in the uae i got 3 mris done 5 xrays, 6 different tests including a TB test had a bronchoscopy and multiple visits all i paid was 10 dollars.
Oh, good for you!
@@dr.floridamanphd HMO=Human Murdering Organization (my mother, a nurse, LOATHE HMOs)
It is the current state of medicine. Unless we the people do something about it to get these type of things outlawed, then it will just continue to pervade everyone everywhere and there won't be a single private practice doctor in business anymore.
reminds me of how it went when they privatized the ambulances in my area. the ambulance fee went from $50 to $500 overnight.
Normally these make me laugh. All I feel is sad though. :(
Much Love Dr G!
Oh my God, this turn to the political is so needed and helpful. Thank you for your wisdom (and of course creative humor)!
As someone who works EVS in hospitals for years. This is happening with the evs departments too. They want fast turn arounds and bare minimum done. So to get patients in the rooms and get their money. Not caring if the room is dirty. I take way longer in rooms. Scrubbing walls and moving stuff to clean underneath it. I am a black sheep in my department. They avoid giving me patients rooms and keep me on cleaning departments/areas. 🤷♀️🤣
The real title of your job should include infection control! Those rooms can get gnarly - I'm an RN working in an ER, I see it all the time. Thank you for recognizing how important a good cleaning is! Even Florence Nightengale preached cleanliness for health reasons.
@@aylan.6212 My first supervisor I had in my journey down my EVS path. He gave me his wisdom and I try to live it today. After you clean a room take a step back. Look at the room and ask yourself. Would I put a family member in this room? That is how you base if you did a good job.
You are a saint. I’m an ER doc and I can tell the pressure is on EVS and nursing to rapidly turn over rooms. It shows. More than a few times I’ve had to disconnect and clean disgusting dirty cables while talking to a patient. We have to increase EVS staffing to allow for better cleaning and infection control.
CVS Pharmacy be like yeah we made 40 billion last quarter but we can only staff one pharmacist and maybe a tech because money is so tight
Yeah. And require the jibby jab of all 9$/ hr employees smh
THANK GOD I LIVE IN AUSTRALIA!!!
THANK GOD I LIVE IN INDIA!
Dude exactly, I love how the only problems of our medical system are from the three private health insurers we have left over and their lobbying, every state health service and medicare are just phenomenal
THANK GOD I LIVE IN BRITAIN!
The pharmacy lobby is incredibly powerful.
Thank god i live in IRAQ.
I can't believe that the introduction of Barty Banks into the GCU has made me start to like and empathise with Hospital Admin 🤔
There's always a worse person
@@DGlaucomflecken so true! Please give it a few months before introducing Barty Banks Sr, the cruel neglectful father who has pushed Barty Jr into the world of greedy corporate America. I need a while to cope with today's new dynamic shift 😵💫
So true. I can’t wait to retire. Love my patients but I hate all the other bullshit that goes along with it. Once you hit the metric, next year they change the goal post. The metrics don’t take patient responsibility into account. The blame is all put on the doctor by withholding money.
That metrics game isn't limited to healthcare. It's deeply embedded in the information technology world too. I aggressively paid down my mortgage and finally quit worrying about metrics, and concentrated on being the best at my job. Took their corporation wide early retirement buyout because I knew they were ready to get rid of employees in their late 50s and older. So much knowledge walked out that door.
Dr G this might be my favorite one yet
Spot on with satire and painfully accurate
You could for sure make the best medical show since Scrubs
"Doom and Gloom" - Every Attending of all time
Doing God's work my man. Loved every second of it 😆
“A handful of ultra rich exploiting the altruistic health care providers…” a recent graduate in medicine, can’t agree more. Both health system owners and abusing patients take advantage of those with the inherent defect of people in health care, the desire to care for people. So sad.
This hits home as a soon to be graduating ER resident looking for my first attending job. My choices are essentially Corporate Group A in city A, Corporate Group A in city B, Corporate Group B in city A, Corporate Group C in city B, Travel position with Corporate Group D, or Small Independent Group A in city A that will probably be taken over by Corporate Group C within the next 5-10 years. All of these big groups claim to be "physician owned" in some sense but we all know what they really are. I'm sad to say I'm really having second thoughts about the small group after the conversation with Corporate Group C in which the doc told me he signed on because he saw the writing on the wall and didn't want to waste time and money trying to be partner in a small group only to have them lose their contract to a corporate group and waste all of his efforts. I'll still probably sign with the small group if they give me an offer, but yikes.
I try not to think about the fact that I like to think I have above average patient care because I'm a little slower than some of my colleagues and take more time talking to patients, but I know I'll be pushed (even more than in residency) to stop that once I'm an attending. Everyone calls it "efficiency," but I'm plenty efficient with my charting and orders. It's really about "shortcutting actual time with patients to move them as fast as possible," in which missing some important things is considered acceptable risk. Then, at the same time, we teach more and more defensive medicine, aka "how to chart such that no one can sue you when the insane expectations of your job inevitably cause you to miss important things or even cause harm to patients."
This is exactly the situation right now. Whatever ethics they teach in med school r never applied in real life. It's sad reality!
This began in 1973 and I recall my decades experienced Physician/Surgeon dad being told by insurance companies how they would allow him to practice medicine. He rarely got upset, but on the phone this time, he did. He asked the person, "Which Medical School did you graduate from?". I still ask insurance jerks that question.
This hits home and is something that is not in the best interest of patients! We are to be efficient yes but maximizing profit? We should maximize the care we give with the money we get
I agree with you, but what happens when there’s simply no money because Medicare and Medicaid either aren’t reimbursing or are low balling what they’ll pay for?
You run out of money and lose your department. Catch-22.
Both are excellent points.
@@dr.floridamanphd To start with, I love your name. And to the point: As a fledgling psychiatrist, it's mind-boggling how many people think we're prowling the streets looking for patients to drag kicking and screaming into an involuntary hospital stay. Psychiatric units aren't profitable...and a lot of hospitals don't bother having one because of that.
I love the disclaimer on each one of these videos that states "From a doctor licensed in the US". From a nurse, please keep doing what you're doing Dr. G!
The punch line is that as soon as any profits have been pulled from the community, they declare bankruptcy and move on. Wait…let me get back to you all, that doesn’t seem like a very funny punch line.
They did this to the community hospital that I was born in and now it is shut down and is a condemned building 🏚. Now that community has to drive 30-45 minutes or more to get to the nearest hospital whereas before it was less than 30 mins for most people in that county.
it's funny because people from the us still boast about how their medical procedures are the best in the world, while I can just go to the ER whenever I want and not pay a cent out of pocket :3
but then these same people try to tell me that "socialized medicine is baaaaaad and eeeeeeeevil" because it has "social" in the name :3
This is what promedica is doing in small communities like fostoria ohio
😕
My dad already has worked under this conditions for years, its genuinelly creepy how normal it is overseas
Now I know why the last time I went to an emergency room, for a second degree burn larger than the size of my hand, the doctor poked the blister that was coming up and unwashed hand and told me there was nothing they can do for that and to go home. Then I was charged me $650 for seeing a doctor.
Consider yourself lucky that it was not $6500
The biggest issue is that ppl like you actually think the doctor is the one that makes all that money. They don't
@@Ewang2727 No-one thinks that and it is quite literally irrelevant. The fact is it costs $650 dollars for a
@@TheInfectous actually a lot of ppl think that, and it's a huge problem bc it's a gross mistargeting of the frustration towards the healthcare system. Your statement is just plain ignorant and your desire to want to soapbox me with your silly burn anecdote as if I've had no negative encounters with the healthcare field is cute but also very simple minded
@@Ewang2727 lets not pretend like doctors are underpaid. Please get a grip its pathetic.
Once upon a time, I thought letting Business management taking over medicine was a good thing. Bringing in efficiencies reducing waste would be a win win. Today's reality shows it went way too far and patients are paying the price.
Maybe you can help because I'm conflicted about this. On one hand, yeah, putting business into medicine can stop patients who actually need care from getting it. On the other hand, with compassionate medicine and universal healthcare, there is the issue of overtreating, giving patients treatments that have only a minuscule improvement to the patient's life, but have high cost to the environment and the economy. Unsure where the happy medium is.
@@japanpanda2179 Medicine is only a tiny fraction of the systemic issues, which, if we were able to magically wave a wand and immediately fix, would include a complete overhaul of transportation, infrastructure, and labor. The truth is that our whole system is geared towards consumption and we don't value wellness - because if we did, we would have set up a 20 hour work week and automated the rest so that people could have time to exercise, socialize, build communities, grow their own food...instead we would rather they eat processed junk and require a quadruple bypass. It's good for GDP. Medicine is wasteful on purpose because of business.
As for your specific question...I don't really think we would need to worry about that if we fixed these issues. You would have a doctor who could take the time to sit down and explain the pros and cons...and quite frankly, if a treatment is only going to have minimal benefit, that doctor could refuse to go through with it. But most people aren't going to pursue a treatment if they actually had the time to understand what they're signing up for...and they might not request it at all if they had a more healthy relationship with purpose and living than they're forced to do now.
Source: The many dementia patients I've had, many of whom might not be demented if they were in a healthier society, and many of whose families have had to learn the hard way that letting go is kinder (and cheaper).
I think we can almost all agree that it is a complex and complicated problem. Sadly, I believe, that neither party in Congress has people up to the task to fix it.
@@dreamsinmonochrome I love hearing my elders are dispensable 🙄
@@japanpanda2179 Don't use the S-word. It scares the Murkans. Because Russia.
This is happening right now in PA with Crozer Health systems. Or should say, its already happened. The problem now is that the entire network of Crozer properties are on the verge of collapse.
Just needed a “I hope you sterilised that $100 bill” but other wise great video as always! 🤣
That was depressing. I'm going to watch a nice one to cleanse my palate. Something about Jonathan, I think.
Priceless! Completely in stitches for the last half hour watching your videos. This one just nailed it 😂
This is true, in everything. Not just healthcare and it's scary, but when our clinic went to you get paid by how many patients you can see a day model, I knew we were screwed
ER doctor here !!!! I cannot believe I waited 6 days to watch this. Waw ! The truth spoken like a real financial entity. Exactly I could make a video on all these however it will be boring and no body would care ! Just know is real. All I got to say. Metrics, RVU, etc. STAY SAFE !
Ouch, right in the humanitarianism.
Thanks glaucomflecken. You’re giving us ER docs some hope.
I imagine Barty and the CEO of the hospital know each other through their book club
I think you mean yacht club…
@@bobbyjohnson3928 that makes much more sense. Haha!
I’m a primary care doc. Video is completely true in my region. Admin of large health systems prey on altruistic nature of hard working, non-complaining providers who struggle to meet metrics + deliver ethical medicine - so provider can keep their job and sleep at night.
Capitalism at it's finest
Private equity started getting involved in healthcare about ten years ago. Kinda correlates with the Affordable Care Act that we needed to pass before we would know what was in it.
Now we know
Doc Glauc makes a great sleazeball.
This is so true and so sad! One thought if people would use a clinic instead of an ER for not emergency appointments this could help. In our area this has been working well, and helping the overall health of the hospital. Such a sad state the US is in with healthcare and insurance companies 😡😡😡
Medicine should ALWAYS be measured by a metric of good patient care and outcomes first and foremost. Everything else is second.
Otherwise, why tf are we even doing this, if not to help patients feel better? Sigh.
Love your stuff always!! Keep shining a light on those private interest entities😊
Every time I see your content, the only thing I can think of is: God bless that I live in Germany, where you don't go bankrupt if you have to go to the hospital
Don't bless a sky fairy, vote like your system depends upon it. It does.
“Evidence of my Yaht” 😂😂😂 That got me good
man this hit hard
As an economist student i can tell.it started as a better solution only to turn the worst the problem is Healthcare is a Merit good essentially it not only benefits you but others around you too and therefore should never be privatised as Mr. Banks said his aim is to maximize profits and merit goods are the worst to get any profit off as you cannot set a price.
Now if Mr Banks only ran that 1 ER and no other department in the Hospital it may had worked very well in the long run but as he also owns all the ERs he is the nightmare economists get as now he is the Monopoly and that is literally the worst market ever and all Economists hate it
One of the biggest arguments in the US against universal healthcare is wait times. Here's my experience in Canada's ERs:
Tetanus shot a day after dog bite (no bleeding, no obvious infection) - seen, treated, on my way in 3 hours. $0
Migraine with visual aura (aka vision went weird) - eyes tested immediately, determined safe, given meds and sent on my way in about 2 hours. $0
Weird chest pain - interviewed, tested, determined safe, on my way in under 30 mins. $0
In all cases, I was healthy, 18-22 and turned out to be fine. Imagine how fast you'd be seen and treated if you had a real emergency!
nothing is free you are paying through all that in your taxes being high
@@firstlast8258 Sure, but we pay about half per capita ($6300USD per person) vs the US ($12500USD per person), have better health outcomes, and no one has to beg for their lives on GoFundMe sooo
@@firstlast8258 I mean, it makes sense we're paying less. Americans aren't just paying for healthcare, they're paying for insurance companies too. Paying the salaries of every agent and exec, paying for ads, buildings, and more. Plus, when people can get preventative care or treat problems as soon as they start (which people do when doctor's visits cost nothing out of pocket and requires no paperwork), it costs FAR less than waiting until it's killing them
@@Tsukaiyo not everybody can afford health insurance
@@firstlast8258 That's by far the best reason for universal healthcare. American health insurance is so expensive, and medical debt is a crippling problem there. People are stuck rationing medications like insulin, and sometimes die from it. People often don't get life-saving medical care and die from it. They can't afford to go when problems are small, and the problems can grow into debilitating issues.
Canada's system, being paid through taxes, means that the poor (who pay very little or even recieve money) can always go to the doctor and get all the help they need. The system is designed so that every citizen in every situation can afford to see a doctor.
Dr. G can now accurately represent different specialties in medicine and businesses? He’s so talented!
My father was an RN for over thirty years. He worked over twenty at the same hospital, who transitioned him to a desk job during COVID (he's in his sixties) and then one day, just decided that desk job didn't exist any more. Tossed twenty years of service to the curb without even a single day of warning. If they had told him in advance, he could have had social security and such lined up by the time he left. As it was he and my mom had to live on his back vacation time and sell a piece of property they'd had. They didn't get to do anything fun from selling my childhood home; just pay bills.
As someone with nearly a decade in some of the toughest jobs in healthcare, this flipped my emotional bike.
Holy shit I just got out from a meeting that the facility I work for is being "acquired" by another company... here come the cuts.
Oh man...been researching medicare fraud and private equity's takeover of the American healthcare system (and the UK, I just realized, re. HCA Healthcare)...I needed this humor break. Love you, Dr. G! Also love you're a fellow Oregonian!!!!
I got out of private practice before the VCs bought out my old group. Now they are scattered to the four winds and their tightly run ship employing 100s of staff is GONE and replaced with a faceless blob of evil. I get to stay altruistic, working for the largest socialized medical org in the country aka the VA. It's really sad and awful. People, this is why your doc has 5 min with you and spends the entire time clicking on radio buttons while trying to get actionable history from you.
I’m a retired, highly trained RN with 45 years experience in the ICU, Cath lab, and ER. Worked hard to get my masters degree and 2 certifications in ICU and cardiology. Yep. No transferable skills. I’d love to get a small part time job outside medicine but nobody will hire me because I’m over qualified and don’t have retail or delivery experience. That’s not what I expected! I can’t even get a $16.50 an hour job. I used to make $50 a hour!