United Health Care Medicare fraud

[CoachKandSportsguy]

UNH is an insurance company who is profit motivated above all else.:cus:

paywalled source: wsj.com (https://www.wsj.com/health/healthcare/unitedhealth-medicare-doj-diagnosis-investigation-66b9f1db)

exec summary: Added diagnoses to patients’ records for conditions that no doctor treated, which triggered an extra $8.7 billion in federal payments. Untreated diagnoses from in-home visits by nurses cost an avg of $2,735 in additional federal payments per visit.

If the government wanted to eliminate fraud, hiring more inspectors general and attorneys to prosecute, and increased the size of the court system for more throughput, would be the best answer, instead of cutting basic services. .

[ROCKETMAN]

I think of all the fraud Medicare and Medicare would be in the billions. Doctors ordering unnecessary tests, people not looking at their bills to see if they actually had this test, and the reasons go on forever. Unfortunately it’s so massive with the number of elderly increasing every day this would be a huge undertaking. And Medicare nursing homes that’s a story for another day.

[OrangeBlossomBaby]

And now, you won't be allowed to use telehealth anymore for MOST situations. Effective April 1. Telehealth became a "thing" during the pandemic when it wasn't really safe for everyone with COVID to be hanging out in the waiting room with healthy people just looking for a brief consultation with a doctor or nurse about a generic ache or muscle cramp.

But it became popular AND cost-effective for both the medical professionals and the patients. Patients who are home-bound, who -cannot- sit up by themselves and don't have handi-vans to roll their wheelchairs into, will not be able to get the care they need for routine visits anymore. They'll have to hire a handi-van from an ambulance company, which isn't covered by Medicare, and go ONLY to a doctor that has either really strong people or a hoyer lift to put them onto the exam table, and the process will take several hours instead of several minutes.

Talk about waste of taxpayer dollars.

[golfing eagles]

I think of all the fraud Medicare and Medicare would be in the billions. Doctors ordering unnecessary tests, people not looking at their bills to see if they actually had this test, and the reasons go on forever. Unfortunately it’s so massive with the number of elderly increasing every day this would be a huge undertaking. And Medicare nursing homes that’s a story for another day.

IMHO, the amount of fraud is in the tens of billions. Insurance companies adding diagnoses is fraud, same for hospitals and doctors.

"Unnecessary" tests are not fraud , and are driven by one thing and one thing only-----LAWYERS

It is estimated that the defensive practice of medicine costs us $600-700 BILLION/year. Want to cut costs?-----limit so called "pain and suffering" awards and penalize lawyers that bring frivolous lawsuits. There is real malpractice from unqualified or impaired providers, but that is a small fraction of what is going on---the majority of lawsuits are for "maloccurence"---a bad outcome through no fault of the provider.

[golfing eagles]

And now, you won't be allowed to use telehealth anymore for MOST situations. Effective April 1. Telehealth became a "thing" during the pandemic when it wasn't really safe for everyone with COVID to be hanging out in the waiting room with healthy people just looking for a brief consultation with a doctor or nurse about a generic ache or muscle cramp.

But it became popular AND cost-effective for both the medical professionals and the patients. Patients who are home-bound, who -cannot- sit up by themselves and don't have handi-vans to roll their wheelchairs into, will not be able to get the care they need for routine visits anymore. They'll have to hire a handi-van from an ambulance company, which isn't covered by Medicare, and go ONLY to a doctor that has either really strong people or a hoyer lift to put them onto the exam table, and the process will take several hours instead of several minutes.

Talk about waste of taxpayer dollars.

On the other hand, telemedicine is a poor alternative at best. There is no substitute for talking to the patient in person and hands on examining them. NONE. You cannot practice medicine over the phone. PERIOD.

[gatorbill1]

United healthcare has been excellent for me

[OrangeBlossomBaby]

On the other hand, telemedicine is a poor alternative at best. There is no substitute for talking to the patient in person and hands on examining them. NONE. You cannot practice medicine over the phone. PERIOD.

Telehealth isn't just a phone thing. It's also a video conference thing. If someone says "I have a new long dark line on my leg and it's sore, what should I do?" the doctor can look at it with the laptop camera, and he can ask questions - are you sore anywhere else? Feeling shortness of breath? Difficulty walking? Is it only sore when you touch it, like a bruise, or is it constantly throbbing? Are you feeling especially tired lately?

If it's just sore to the touch and you have no other symptoms, he can say "it's probably just a varicose vein. If you want we can schedule an appointment for you to come in, but it appears safe enough to leave alone for now."

And then you avoid a couple hours of dealing with going to the doctor for a varicose vein.

Telemedicine is a godsend for people who aren't merely "inconvenienced" by going to the doctor, but who put their own health at risk by leaving their homes. It's especially helpful to people who are immunocompromised, who shouldn't be sitting in a waiting room filled with sick people if they can avoid it with a simple video-chat with the doctor or nurse.

[CoachKandSportsguy]

sample size 1,

start getting to bigger sample sizes, you might find that there are some very unhappy people, and some doctors.

UNH is suing a doctor for slander after she posted actual UNH experience during surgery prep rescinding payment for pre approved surgery.

fraud generally has nothing to do with individual interactions but with billing interactions.

[CoachKandSportsguy]

Telehealth isn't just a phone thing. It's also a video conference thing. If someone says "I have a new long dark line on my leg and it's sore, what should I do?" the doctor can look at it with the laptop camera, and he can ask questions - are you sore anywhere else? Feeling shortness of breath? Difficulty walking? Is it only sore when you touch it, like a bruise, or is it constantly throbbing? Are you feeling especially tired lately?


Agreed, but there are other programs which have been started under the telehealth program, such as Hospital at Home, using hospital visiting nurses to do the patient review, and then communicate with the central doctor, which moves some outpatient visit from the the clinics and ER to the home.

https://www.cms.gov/blog/lessons-cms-acute-hospital-care-home-initiative

[golfing eagles]

Telehealth isn't just a phone thing. It's also a video conference thing. If someone says "I have a new long dark line on my leg and it's sore, what should I do?" the doctor can look at it with the laptop camera, and he can ask questions - are you sore anywhere else? Feeling shortness of breath? Difficulty walking? Is it only sore when you touch it, like a bruise, or is it constantly throbbing? Are you feeling especially tired lately?

If it's just sore to the touch and you have no other symptoms, he can say "it's probably just a varicose vein. If you want we can schedule an appointment for you to come in, but it appears safe enough to leave alone for now."

And then you avoid a couple hours of dealing with going to the doctor for a varicose vein.

Telemedicine is a godsend for people who aren't merely "inconvenienced" by going to the doctor, but who put their own health at risk by leaving their homes. It's especially helpful to people who are immunocompromised, who shouldn't be sitting in a waiting room filled with sick people if they can avoid it with a simple video-chat with the doctor or nurse.

Are you really trying to tell me how to take a history and physical???😂😂😂. Sorry, but it’s not that simple. The worst medical mistakes that I have seen have occurred when there was no in-person contact

[ElDiabloJoe]

IMHO, the amount of fraud is in the tens of billions. Insurance companies adding diagnoses is fraud, same for hospitals and doctors.

"Unnecessary" tests are not fraud , and are driven by one thing and one thing only-----LAWYERS

....

One of the biggest downfalls that has dragged the U.S. down into such a litigious society has been the decades-long lobbying influence of the U.S. Trial Lawyers Association. Tort law has been phenomenally expanded under their efforts.

[BrianL99]

IMHO, the amount of fraud is in the tens of billions. Insurance companies adding diagnoses is fraud, same for hospitals and doctors.

"Unnecessary" tests are not fraud , and are driven by one thing and one thing only-----LAWYERS

It is estimated that the defensive practice of medicine costs us $600-700 BILLION/year. Want to cut costs?-----limit so called "pain and suffering" awards and penalize lawyers that bring frivolous lawsuits. There is real malpractice from unqualified or impaired providers, but that is a small fraction of what is going on---the majority of lawsuits are for "maloccurence"---a bad outcome through no fault of the provider.

This an area of abuse, that folks on the receiving end of medicine, don't think about. We all know that once you're on Medicare, your health care providers can't wait to do more & more tests, and once you're "in the system", you'll be bombarded with tests and procedures they want to schedule.

The risk of malpractice lawsuits, is a daunting cloud that apparently hangs over the medical profession. In Massachusetts, it's almost impossible to sue for malpractice. In order to actually get anywhere with a lawsuit, the action has to be "validated" by a review board and the bar is fairly high.

I had a doctor who wildly misdiagnose an issue and like most everyone else, I was ready to sue. I talked to 3 fairly big time Malpractice attorneys, who all told me, I would be wasting my time.

I suspect other states don't have such barriers to malpractice claims and folks can sue for "maloccurance" or delayed care, due to misdiagnoses?

[CoachKandSportsguy]

The civil fraud investigation is examining the company's practices for recording diagnoses that trigger extra payments to its Medicare Advantage plans.

[blueash]

I would add that in my personal experience, n=1, the primary driver of excessive testing was not fear of lawyers but demanding patients who believed every cough needed a chest xray or later a CT. Every headache required a brain scan etc etc.

A simple reading of past medical threads here will find many postings from Villagers who helpfully suggest all the tests you should be getting for whatever medical symptom you post about.

You shouldn't worry about lawyers or malpractice if you don't commit malpractice and stay aware and conform to the standard of care. And yes, I am well aware that being innocent of malpractice is not the same as not being accused and dragged through the process.

But the original post here is correct. There is lots of fraud and firing the people who look for fraud is the exact opposite of cost cutting even if it saves the salary of the inspector that saving is completely cancelled by the lack of recovery of the fraudulent payments. And once the industries and individuals know there is no longer any oversight then the fraud, or creative accounting and billing will certainly get worse.

Same thing for IRS agents where they more than make up for their salary with increased collections of taxes owed, (a $1 increase in spending on the IRS's enforcement activities results in $5 to $9 of increased revenues. ), and the deterrent factor of not trying to get away with cheating adds even more.

[golfing eagles]

I would add that in my personal experience, n=1, the primary driver of excessive testing was not fear of lawyers but demanding patients who believed every cough needed a chest xray or later a CT. Every headache required a brain scan etc etc.

A simple reading of past medical threads here will find many postings from Villagers who helpfully suggest all the tests you should be getting for whatever medical symptom you post about.

You shouldn't worry about lawyers or malpractice if you don't commit malpractice and stay aware and conform to the standard of care. And yes, I am well aware that being innocent of malpractice is not the same as not being accused and dragged through the process.

But the original post here is correct. There is lots of fraud and firing the people who look for fraud is the exact opposite of cost cutting even if it saves the salary of the inspector that saving is completely cancelled by the lack of recovery of the fraudulent payments. And once the industries and individuals know there is no longer any oversight then the fraud, or creative accounting and billing will certainly get worse.

Same thing for IRS agents where they more than make up for their salary with increased collections of taxes owed, (a $1 increase in spending on the IRS's enforcement activities results in $5 to $9 of increased revenues. ), and the deterrent factor of not trying to get away with cheating adds even more.

Agree with you as well. As you know it is very hard to tell a patient that you are not going to order some ridiculous test that he looked up on the internet

[justjim]

I would add that in my personal experience, n=1, the primary driver of excessive testing was not fear of lawyers but demanding patients who believed every cough needed a chest xray or later a CT. Every headache required a brain scan etc etc.

A simple reading of past medical threads here will find many postings from Villagers who helpfully suggest all the tests you should be getting for whatever medical symptom you post about.

You shouldn't worry about lawyers or malpractice if you don't commit malpractice and stay aware and conform to the standard of care. And yes, I am well aware that being innocent of malpractice is not the same as not being accused and dragged through the process.

But the original post here is correct. There is lots of fraud and firing the people who look for fraud is the exact opposite of cost cutting even if it saves the salary of the inspector that saving is completely cancelled by the lack of recovery of the fraudulent payments. And once the industries and individuals know there is no longer any oversight then the fraud, or creative accounting and billing will certainly get worse.

Same thing for IRS agents where they more than make up for their salary with increased collections of taxes owed, (a $1 increase in spending on the IRS's enforcement activities results in $5 to $9 of increased revenues. ), and the deterrent factor of not trying to get away with cheating adds even more.

I agree 100%. Many of the so called “layoffs” will actually cost much more than the salaries/benefits of the persons being fired/laid off.

As a former government employee who worked in a department that monitored/audited government contracts and grants more staff was always needed to monitor fraud and abuse not fewer employees. We had data that proved employees found three to four times his total salary in fraud/abuse more than the cost of his/her employment. However popular, firing/laying off IRS employees, social security and Medicare employees is counterproductive IMHO.

[CoachKandSportsguy]

Agree with you as well. As you know it is very hard to tell a patient that you are not going to order some ridiculous test that he looked up on the internet

Agree with BlueAsh.

My mom is in hospice, for losing weight, in memory care, 98, post broken hip surgery.

She fell, I was in FL, and the nurse from Hospice sent her to the hospital for something he thought didn't look right. I was like, describe it, I am not sure what you are seeing, not sure I agree from the descriptions I have been receiving about the severity of the fall, but OK.

Came back nothing wrong.
total encounter cost Medicare $15K.
Recommendations: higher dosage of ibuprofen for the bruises.

CYA or the fear of the effects of lawsuits are everywhere.

A great book to read is by a Boston Surgeon Atuwal Gwandi
Amazon.com (https://www.amazon.com/Being-Mortal-Medicine-What-Matters-ebook/dp/B00JCW0BCY/ref=sr_1_1)

His description of the healthcare industry has come along way from the turn of the 20th center, 125 years ago. Some has been from the legal system forcing better practices.
However, the EMR of today are being created to prove behaviors are done, and that takes time, and can be very granular, and to push towards proactive medical care versus reactive medical care, which will always be there. Proactive medical care is very difficult and has a higher cost than pure reactive medical care

good luck to us!

[Stu from NYC]

Are you really trying to tell me how to take a history and physical???😂😂😂. Sorry, but it’s not that simple. The worst medical mistakes that I have seen have occurred when there was no in-person contact

We moved here a month after covid and the DR we found would only do telehealth visits for the next year. She had a family and wanted to protect herself. Perfectly understandable.

Nice to speak to her but she could not listen to our heart and lungs or look at our ears, throat etc.

A year later I pushed the issue wearing whatever she asked us to protect her and the visits were much more productive.

[bmcgowan13]

I think of all the fraud Medicare and Medicare would be in the billions.

And unfortunately it has been going on for some time. In 1997 Columbia/HCA paid the largest Medicare/Medicaid fraud FINE of 1.7 Billion.

This abuse has been going on for over 25 years and it appears we are no closer to having the safeguards in place to stop the grift or eliminate abusive and fraudulent billing practices.

Is UNH in the running to knock Columbia out of first place? How do we score? If adjusted for inflation Columbia's fine is equivalent to $3.3B in 2025...:shocked:

[CoachKandSportsguy]

sample example of UHC which you as patients don’t see:

My wife is a Clinical Psychologist. I’ve been sending the @BillAckman & @EPotterMD posts to her as she has always told me how stressful it is to get payments from UNH. She said that around 50% of the claims that she bills to UNH get denied because of weird codes and when she has her office manager call to question the codes, the people on the other end have no idea how to explain them.

Then the UNH rep says they will resubmit the claim with additional paperwork and then that gets denied as well. Then when you call again they say “It’s beyond the date of service to be reimbursed”. She said it’s a total mind-bender and the hours of work it takes to try to get your money is not worth the time it takes away from your practice and other patients.

That’s why 70% of her colleagues in the Psychology/Psychiatry field don’t take insurance. With United, she mentally writes the loss off as unrecoverable theft. She says she treats United like a slot machine…pull it, and grateful if anything comes out. She does the Psychological evaluations for patients who are about to undergo certain surgeries and if she says she no longer will take United, those surgeons would no longer refer any evaluations to her.

She likens it to a teacher who only would want to teach the well behaved children. UNH is that out of control kid whose parents don’t give a damn.

[Sabella]

IMHO, the amount of fraud is in the tens of billions. Insurance companies adding diagnoses is fraud, same for hospitals and doctors.

"Unnecessary" tests are not fraud , and are driven by one thing and one thing only-----LAWYERS

It is estimated that the defensive practice of medicine costs us $600-700 BILLION/year. Want to cut costs?-----limit so called "pain and suffering" awards and penalize lawyers that bring frivolous lawsuits. There is real malpractice from unqualified or impaired providers, but that is a small fraction of what is going on---the majority of lawsuits are for "maloccurence"---a bad outcome through no fault of the provider..
Unnecessary tests and unnecessary medication‘s people are put on ensure big business repeat visits and keeps the patient constantly coming in. Medicine sad to say is no longer about a person‘s health. It’s about how much money you can make. PS aren’t you a retired doctor?

[Cuervo]

If there is fraud or not in the health industry is not the problem. When a service is provided by an outside company the main goal is profits not the well-being of their clients. I know there are numerous problems with universal healthcare and I'm not suggesting it is implemented here overnight. What I am suggesting is to take a deep study to see if the problems that come with universal healthcare can be overcome. If we can achieve that, maybe we can eliminate the middleman.

[elevatorman]

And unfortunately it has been going on for some time. In 1997 Columbia/HCA paid the largest Medicare/Medicaid fraud FINE of 1.7 Billion.

This abuse has been going on for over 25 years and it appears we are no closer to having the safeguards in place to stop the grift or eliminate abusive and fraudulent billing practices.

Is UNH in the running to knock Columbia out of first place? How do we score? If adjusted for inflation Columbia's fine is equivalent to $3.3B in 2025...:shocked:
Columbia/HCA pled guilty to 14 corporate felonies in this case. Previously the CEO of Columbia/HCA took the 5th 75 times in a deposition.

[golfing eagles]

.
Unnecessary tests and unnecessary medication‘s people are put on ensure big business repeat visits and keeps the patient constantly coming in. Medicine sad to say is no longer about a person‘s health. It’s about how much money you can make. PS aren’t you a retired doctor?

Yes, which is why I know that post is, well to put it politely, untrue.

Love to hear an example where a physician puts a patient on "unnecessary" medication.

I addressed testing in a previous post, as well as the obvious solution (other than kill all the lawyers)

[spinner1001]

If the government wanted to eliminate fraud, hiring more inspectors general and attorneys to prosecute, and increased the size of the court system for more throughput, would be the best answer, instead of cutting basic services. .

‘… hiring more inspectors generals who actually find and stop fraud, waste and abuse of taxpayer monies…’. Fixed it.

[defrey12]

On the other hand, telemedicine is a poor alternative at best. There is no substitute for talking to the patient in person and hands on examining them. NONE. You cannot practice medicine over the phone. PERIOD.

AMEN! People used to get the Dr’s prior to Covid…just sayin’. Or the Dr could come to them; I remember house-calls.

[NotGolfer]

I hated televisits during the "plague". I have rheumatoid arthritis and my RA dr. did those with me. How in the world can she determine what's going on with a computer screen?? I'm surprised she didn't also wear a mask. I'm being sarcastic of course but I try not to have a dr's visit with any of my practitioners unless necessary. I'm sure fraud has been around for a very long time. We'll see if "they" clean it up....or not!!

Years ago before we moved here, the dr. I was seeing would always order tests. I changed primaries because even then I knew they weren't warranted. This would have been in the late 80's, early 90's.

[CoachKandSportsguy]

Yes, which is why I know that post is, well to put it politely, untrue.

Love to hear an example where a physician puts a patient on "unnecessary" medication.

I addressed testing in a previous post, as well as the obvious solution (other than kill all the lawyers)

With all due respect, my cardiologist asked me to go higher on the statins due to the ever decreasing level recommendations of the use of statins.

hypothetical example:
So if my cholesterol level up was 200 before statins were recommended,
"they" now recommend statins if the level is above 100.
Now "they" are recommended above 70.

A close colleague had his doctor recommend statins because of his age. . mid 60s
not because of his test results.

so I am a beneficiary of statins, due to very high fossilization test results. .
not bashing doctors, but I think that is from where the "rumors" originate, particularly as received by different personality types.

Now going back to my post about proactive versus reactive medical practices, that conflict sometimes causes problems between the sensory personality types (this is what I see factually right now, no interrelations with future outcomes) and the intuitives (this what i see relates to how that might evolve in the future which relates to a future outcome)

The sensors prefer reactive medical and the intuitive prefer proactive medical advice.

all comes down to hoomans, and there are a bazillion different types of them . .
and doctors also fall into the different personality types of medicine. My wife's supervisor is a practicing hospitalist physician, and is very sensory oriented, well illustrated with his administration skills, for which he also has responsibility. if the administrative situation can't be found as having a previous diagnosis with recommendations, he has no answer. . zero answer. happens all the time.

good luck to us. .

[golfing eagles]

With all due respect, my cardiologist asked me to go higher on the statins due to the ever decreasing level recommendations of the use of statins.

hypothetical example:
So if my cholesterol level up was 200 before statins were recommended,
"they" now recommend statins if the level is above 100.
Now "they" are recommended above 70.


With all due respect, surely you are not suggesting that prescribing a statin was "unnecessary" given the LDL levels you cited. He was actually following the standard of care---if he DIDN'T prescribe them, that would potentially be malpractice.

Now, if we want to get deeper into the weeds, why has the "standard" become LDL < 100 and <70 with risk factors? Studies show that improves outcome, but who has funded those studies???? Food for thought.

[kendi]

On the other hand, telemedicine is a poor alternative at best. There is no substitute for talking to the patient in person and hands on examining them. NONE. You cannot practice medicine over the phone. PERIOD.

I don’t need hands on examining for my doctor to discuss and show me the results of my MRI.

[golfing eagles]

I don’t need hands on examining for my doctor to discuss and show me the results of my MRI.

But you may need him to do EXACTLY that to determine if you actually need an MRI.

[RoboVil]

Yes, which is why I know that post is, well to put it politely, untrue.

Love to hear an example where a physician puts a patient on "unnecessary" medication.

I addressed testing in a previous post, as well as the obvious solution (other than kill all the lawyers)

Docs are not the problem. The insurance companies are the problem, not just the prior approval scam, but also in their denial of payment to healthcare providers.

By the way, anyone wondering about their treatment for their diagnosis - plenty of clinical guidelines out there for you to read. The American Diabetes Association for example publishes yearly updates, and free to anyone who wants to read them.

[golfing eagles]

Docs are not the problem. The insurance companies are the problem, not just the prior approval scam, but also in their denial of payment to healthcare providers.

By the way, anyone wondering about their treatment for their diagnosis - plenty of clinical guidelines out there for you to read. The American Diabetes Association for example publishes yearly updates, and free to anyone who wants to read them.

Unfortunately, there are way more than "plenty" of medical references out there, but unfortunately, I would say the majority are either wrong, half-truths, pushing an agenda or a product, or beyond the understanding of the non-professional. The problem is the internet information leads to the attitude of "I'm in charge", or "I can debate this with the doctor". WRONG!!! You can choose among reasonable options offered by a professional as well as his opinion as to which is best. But don't ever delude yourself into thinking you're on some kind of knowledge and experience parity with the physician. I wish I had a dollar for every time a patient brought in some nonsensical printout from the internet and handed it to me---those went straight in the garbage. (The printout, not the patient:1rotfl::1rotfl::1rotfl:)

[JRcorvette]

On my last Medicare summary there was a $6000 bill from a Village doctor that I have never seen. It was for medical equipment out to NC of all places. I contacted Medicare right away to report it. Apparently the doctor in the Villages had all my information. Medicare had prior complaints about this guy. I read on Nextdoor or here that recently people showed up at his office and it was locked and he was gone without notifying any patients. There is a lot of Fraud in Medicare… go get them DOGE.

[blueash]

Love to hear an example where a physician puts a patient on "unnecessary" medication.


As much as half of the Rx's for antibiotics are unnecessary. So often I have been told by neighbors that they are on a "strong" antibiotic because they have a "bad" virus.

ADD/ADHD medications to not just help kids who actually have those disorders. Adderall helps anyone concentrate a bit better. I am very aware of a high performing school in my home town where the expression was "There are two kinds of students, those who get straight A's and those who get medication" And yes, parents from that school would request drugs to help their kid's GPA even if they were simply B students if the meds might make them A students.

Do you want more examples? How about all those Vit B shots to those who do not have pernicious anemia. How about PPIs for everyone with any GI symptoms and SSRIs for anyone with the sadness or Thyroxine for subclinical hypothyroidism. Or while we are on unnecessary... bioidentical hormones, chelation products etc.

So sadly, the medical profession has a lot to answer for reaching for a prescription pad, ok now a keyboard. And I hadn't mentioned opioids which are both over and under used.

[golfing eagles]

As much as half of the Rx's for antibiotics are unnecessary. So often I have been told by neighbors that they are on a "strong" antibiotic because they have a "bad" virus.

ADD/ADHD medications to not just help kids who actually have those disorders. Adderall helps anyone concentrate a bit better. I am very aware of a high performing school in my home town where the expression was "There are two kinds of students, those who get straight A's and those who get medication" And yes, parents from that school would request drugs to help their kid's GPA even if they were simply B students if the meds might make them A students.

Do you want more examples? How about all those Vit B shots to those who do not have pernicious anemia. How about PPIs for everyone with any GI symptoms and SSRIs for anyone with the sadness or Thyroxine for subclinical hypothyroidism. Or while we are on unnecessary... bioidentical hormones, chelation products etc.

So sadly, the medical profession has a lot to answer for reaching for a prescription pad, ok now a keyboard. And I hadn't mentioned opioids which are both over and under used.

Perhaps I wasn't clear. My intention was to call out an example of a physician prescribing an "unnecessary" medication for the purpose of making a profit for himself or a pharmaceutical company, which seemed to be what the post I was responding to implied. Of course there are weak physicians who prescribe antibiotics for viruses and long term PPIs for a little indigestion. They are usually DO's with a 2 year "family practice" residency at a DO hospital. Thyroxine is a little more gray zone. And those chelation products are usually prescribed by those "holistic" and "alternative medicine" quacks.

[blueash]

There is a lot of Fraud in Medicare… go get them DOGE.

Who do you think is going to find this fraud? It is the inspectors. It is the guys and gals who sit in front of a computer and look for patterns of suspicious claims. It is the person who was at the other end of your complaint who entered it into the system. If you called in your complaint it was a human who answered, and is on the chopping block now. It is what you would call the bureaucrats. And guess who is getting fired? Yes you might hear there is less fraud next year, because nobody is looking anymore. Kind of like firing all the cops and the crime arrest rate drops.

The answer to Medicare/Medicaid fraud is more people not fewer. Spending billions to upgrade computer systems will save 100's of billions.

[ithos]

My biggest issue with our healthcare system is that it does not inform patients that most diseases and ailments are caused by or excaberated by poor diets and lack of exercise. Even most genetic predispositions can be overcomed. "Genes are not your destiny"
https://www.youtube.com/watch?v=qvGOXCiTPKc&t=110s
There are populations today and in history that have far lower incidences of cancer, diabetes, automimmune diseases , etc because diet and lifestyle are the biggest factors for health.
https://www.bluezones.com/
True North Center takes in patients that conventional medical care has failed.
https://www.youtube.com/watch?v=qrFbGyQG070 (28:14)
Most challenging patient. https://www.youtube.com/watch?v=qrFbGyQG070 (22:40)

[PugMom]

On the other hand, telemedicine is a poor alternative at best. There is no substitute for talking to the patient in person and hands on examining them. NONE. You cannot practice medicine over the phone. PERIOD.

Bingo! someone finally said it

[blueash]

Perhaps I wasn't clear. My intention was to call out an example of a physician prescribing an "unnecessary" medication for the purpose of making a profit for himself or a pharmaceutical company, which seemed to be what the post I was responding to implied.

I agree that prescribing to benefit a pharmaceutical company must be exceedingly rare. Writing a script to benefit Lilly makes no sense. I suppose there might occasionally be some tendency to choose a med from the company that has a nice rep or fed your employees when the med is one a several equal options.

But, when you give that worthless B12 shot and the patient has to come back every few weeks for another one you are increasing your profit. When you give the patient an antibiotic shot in the office for his viral sore throat or even documented strep, you are increasing your own profit. And yes I understand there are rare situations where strep might be treated with a shot... patient vomiting, history of not taking meds etc.

Friend went to an urgent care/freestanding ER here and diagnosed with a UTI. No vomiting, not dehydrated, not unable to take oral meds, not when pharmacies were closed. But in addition to the Rx for an appropriate oral antibiotic he was given a very expensive IM antibiotic to "get him started" Patient thought it was great that they did the shot, I think it was for profit.

By the way, my experience with DOs is that they are just as well, or poorly, trained as MDs.

[blueash]

On the other hand, telemedicine is a poor alternative at best. There is no substitute for talking to the patient in person and hands on examining them. NONE. You cannot practice medicine over the phone. PERIOD.

Bingo! someone finally said it

So all the times I was awakened by a phone call from a parent to help with a sick child at 2 AM I was NOT practicing medicine. PERIOD. All those calls from hospital floors reporting on the lab results or updating me, I was not practicing medicine PERIOD. The over 100 calls on a weekend during flu season to evaluate and advise was a waste of my time and useless or even dangerous as I wasn't hands on. Good to know. Wish I had just not answered my pager as there was nothing useful I could provide. PERIOD.

[62SkiDoo]

Bingo! someone finally said it

Yep

Telehealth has already been fingered for leaking personal health information to 3rd parties.

The whole premise is absurd in any case. No competent physician could ever reliably diagnose a patient through a remote app. (Any medical doctors here should chime in.)

It's another example of "technology" out of control, technology that continues to depersonalize us and remove us from any common sense or reason. And you can bet that the driving motivation is cheaper cost for providers while at the same time never translating into anything but higher costs for patients.

I was recently offered a Telehealth physical therapy evaluation for an injury I suffered doing yard work. I said, "no, no, no, I don't Telehealth any more." And so I did my evaluation at the facility instead.

Good grief! Anyway, that's my Saturday soapbox.

[Dexterconfetti]

Look it up!

[kkingston57]

United healthcare has been excellent for me

That is how they get away with it.

[RoboVil]

Unfortunately, there are way more than "plenty" of medical references out there, but unfortunately, I would say the majority are either wrong, half-truths, pushing an agenda or a product, or beyond the understanding of the non-professional. The problem is the internet information leads to the attitude of "I'm in charge", or "I can debate this with the doctor". WRONG!!! You can choose among reasonable options offered by a professional as well as his opinion as to which is best. But don't ever delude yourself into thinking you're on some kind of knowledge and experience parity with the physician. I wish I had a dollar for every time a patient brought in some nonsensical printout from the internet and handed it to me---those went straight in the garbage. (The printout, not the patient:1rotfl::1rotfl::1rotfl:)

The clinical guidelines are the clinical guidelines. If you are practicing outside the clinical guidelines then you better document your reasoning. Don't try to say the clinical guidelines are "nonsensical" internet garbage. Scary you would try to discourage patients from looking at the clinical guidelines from the medical associations.

[OrangeBlossomBaby]

So all the times I was awakened by a phone call from a parent to help with a sick child at 2 AM I was NOT practicing medicine. PERIOD. All those calls from hospital floors reporting on the lab results or updating me, I was not practicing medicine PERIOD. The over 100 calls on a weekend during flu season to evaluate and advise was a waste of my time and useless or even dangerous as I wasn't hands on. Good to know. Wish I had just not answered my pager as there was nothing useful I could provide. PERIOD.

I used zoom to have a brief update with my doctor during the Pandemic. I wasn't feeling well and was concerned. He asked me about my symptoms, and if I'd taken the home COVID test. Asked me a bunch of other questions, had me check my own pulse and heart rate using my phone (which had that ability) and temperature with my own thermometer.

He concluded that I probably did not have COVID (I'd tested twice in 2 days, both times negative). I probably DID have a bad cold, and possibly a mild sinus infection. He suggested I go for the nightly dose of Nyquil, acetaminophen during the day, plenty of fluids, rest, and I could continue using my Fluonase allergy nasal spray. If I didn't start feeling better in two days OR if I developed a fever over 100° then I should go to Urgent Care, as he didn't have any appointment openings available that day. He also said if I started feeling better within a day to call him and let him know. Total time for the call: under 15 minutes.

I started feeling better that night, called him the next day, and all was well. Total cost for the zoom meeting: $0. The Doctor got paid I believe $45 from the insurance company. If I had gone to the doctor's office first, it would've cost me $40, and the insurance company would've had to pay him over $100 for the office visit.

[blueash]

..... Total time for the call: under 15 minutes.

I started feeling better that night, called him the next day, and all was well. Total cost for the zoom meeting: $0. The Doctor got paid I believe $45 from the insurance company. If I had gone to the doctor's office first, it would've cost me $40, and the insurance company would've had to pay him over $100 for the office visit.

And this is an issue for the doctor. Had you been seen in the office the total physician time for your mild illness might have been 10 minutes face to face and five more for documentation. And he/she would have made say $120. Now instead the doctor spent 15 minutes face to face with you and still has to document for 5 minutes. So 20 minutes of time for $45. A pay rate of 135/hr which I 100% guarantee did not cover his overhead. (in the early 2000's my overhead, before I got any salary was nearly 200/hr. No idea what it is now)

[golfing eagles]

So all the times I was awakened by a phone call from a parent to help with a sick child at 2 AM I was NOT practicing medicine. PERIOD. All those calls from hospital floors reporting on the lab results or updating me, I was not practicing medicine PERIOD. The over 100 calls on a weekend during flu season to evaluate and advise was a waste of my time and useless or even dangerous as I wasn't hands on. Good to know. Wish I had just not answered my pager as there was nothing useful I could provide. PERIOD.

Those are NOT examples of telemedicine, and you know it. They are just the routine calls we get all the time. They are not scheduled office visits for an evaluation done over the laptop which is the basis of telemedicine. And I'm sure you love those 2 AM hospital calls that somebody's CO2 is 32 or their Na++ is 136 because it is "out of range" as much as I did. So now, be truthful---how many times did you make a major treatment decision over the phone???? I hope not very often at all.

[golfing eagles]

The clinical guidelines are the clinical guidelines. If you are practicing outside the clinical guidelines then you better document your reasoning. Don't try to say the clinical guidelines are "nonsensical" internet garbage. Scary you would try to discourage patients from looking at the clinical guidelines from the medical associations.

Yes, if a patient can find those "clinical guidelines, AND UNDERSTAND THEM, THAT'S FINE. But the majority of so-called medical information on the internet is garbage, usually snake oil sales pitches. But even legitimate sites such as Web MD so heavily edit content that it loses meaning---I had to have them pull 2 of the articles I wrote for them because the final version differed so greatly from my submission that I didn't want my name associated with it.

[CoachKandSportsguy]

With all due respect, surely you are not suggesting that prescribing a statin was "unnecessary" given the LDL levels you cited. He was actually following the standard of care---if he DIDN'T prescribe them, that would potentially be malpractice.

Now, if we want to get deeper into the weeds, why has the "standard" become LDL < 100 and <70 with risk factors? Studies show that improves outcome, but who has funded those studies???? Food for thought.

First, I gave example of how "criticisms" of the medical industry can start. I didn't say that I believed them, agreed with them, or that I was criticizing them.

Second, the thread was about medical billing fraud by insurance companies for govt reimbursement, not about medical malpractice, nor about doctors or hospitals malpractice.

Do you see where how billing fraud quickly turns into something other than insurance greedy behavior for profits?? and why people should think twice about which government health care plan they should select?

[OrangeBlossomBaby]

And this is an issue for the doctor. Had you been seen in the office the total physician time for your mild illness might have been 10 minutes face to face and five more for documentation. And he/she would have made say $120. Now instead the doctor spent 15 minutes face to face with you and still has to document for 5 minutes. So 20 minutes of time for $45. A pay rate of 135/hr which I 100% guarantee did not cover his overhead. (in the early 2000's my overhead, before I got any salary was nearly 200/hr. No idea what it is now)

I didn't take up a moment of the receptionist's time. I didn't have to take up the clerk's efforts in dealing with the copay. I didn't risk infecting everyone else in the waiting area. I didn't sit in the exam room, which means they didn't have to clean it when I left. They also didn't have to sanitize any of the equipment (remember this was during the Pandemic) in preparation for my visit, or as a result of my visit. They didn't have to waste another pair of gloves, or another tongue depressor. I also didn't risk infecting the doctor or anyone else on the staff at the offices there.

He was typing into his laptop while he was speaking with me and while he waited for the results of my thermometer, pulse, and heart rate tests. The only "overhead" he had to deal with was someone receiving the data and plugging the billing info into the report that gets sent to the insurance company. Also, he doesn't get to set his rates. He's an employee of The Villages Health. THEY pay him, whether he sees me or not.

[rsmurano]

It all boils down to the POS Advantage plans and corrupt Dr’s that charge for something they didn’t do.
UHC along with all the other Advantage plan providers get money from the government and they make money by not approving medical procedures that your Dr is asking for because now the insurance company will have to pay for something out of their pocket. The stats show that Advantage plans have a high 66% refusal rate for dr requested procedures, whereas Medicare does not require any approval process at all. This corrupt procedure has been in congress for years trying to fix this. More and more hospitals are refusing to accept Advantage plans because the way they are not being paid by the Advantage plan insurance companies. Go the supplemental route and you won’t have any issues.

As for tele visits with the dr or PA, there are a lot of times you can remotely do routine things. How about going over your blood work? Why do you need to be there? How about renewing a prescription that you have been on for years? I have a pacemaker and every qtr I lay in my bed and put a device on my chest and this device gathers all the info it needs from the pacemaker and sends it to multiple places. I could go in and they would do the same thing but I would have to spend an hour driving, maybe 30-60 mins of waiting before seeing the dr. New technology, actually it’s not new, is amazing and a lot can be done remotely.

I did have a dr (no longer around) that did put some questionable items on the bill that he did not perform. I called billing and argued for many mins and he wasn’t going to let it go, until I mentioned this looks like insurance fraud and this needs to be brought up to Medicare, he put me on hold, and when he came back on the phone, he cancelled the charge.

We now have the government efficiency group that is going over everything in all departments and is finding hundreds of billions of dollars of waste and corruption (I even heard trillions of $), so in the future we will see better ways to weed out this corruption, and save us tax $

[golfing eagles]

It all boils down to the POS Advantage plans and corrupt Dr’s that charge for something they didn’t do.
UHC along with all the other Advantage plan providers get money from the government and they make money by not approving medical procedures that your Dr is asking for because now the insurance company will have to pay for something out of their pocket. The stats show that Advantage plans have a high 66% refusal rate for dr requested procedures, whereas Medicare does not require any approval process at all. This corrupt procedure has been in congress for years trying to fix this. More and more hospitals are refusing to accept Advantage plans because the way they are not being paid by the Advantage plan insurance companies. Go the supplemental route and you won’t have any issues.

As for tele visits with the dr or PA, there are a lot of times you can remotely do routine things. How about going over your blood work? Why do you need to be there? How about renewing a prescription that you have been on for years? I have a pacemaker and every qtr I lay in my bed and put a device on my chest and this device gathers all the info it needs from the pacemaker and sends it to multiple places. I could go in and they would do the same thing but I would have to spend an hour driving, maybe 30-60 mins of waiting before seeing the dr. New technology, actually it’s not new, is amazing and a lot can be done remotely.

I did have a dr (no longer around) that did put some questionable items on the bill that he did not perform. I called billing and argued for many mins and he wasn’t going to let it go, until I mentioned this looks like insurance fraud and this needs to be brought up to Medicare, he put me on hold, and when he came back on the phone, he cancelled the charge.

We now have the government efficiency group that is going over everything in all departments and is finding hundreds of billions of dollars of waste and corruption (I even heard trillions of $), so in the future we will see better ways to weed out this corruption, and save us tax $

There are so many errors in that post that I couldn’t possibly address them in this format

[Indydealmaker]

UNH is an insurance company who is profit motivated above all else.:cus:

paywalled source: wsj.com (https://www.wsj.com/health/healthcare/unitedhealth-medicare-doj-diagnosis-investigation-66b9f1db)

exec summary: Added diagnoses to patients’ records for conditions that no doctor treated, which triggered an extra $8.7 billion in federal payments. Untreated diagnoses from in-home visits by nurses cost an avg of $2,735 in additional federal payments per visit.

If the government wanted to eliminate fraud, hiring more inspectors general and attorneys to prosecute, and increased the size of the court system for more throughput, would be the best answer, instead of cutting basic services. .

No surprises here! After all, UHC and AARP was ALL IN for Obamacare before anyone knew what the law said. UHC was positioned to become the sole provider of the new nationalized healthcare after Obamacare imploded. Fraud and Manipulation is part of the company charter.

[jimjamuser]

On the other hand, telemedicine is a poor alternative at best. There is no substitute for talking to the patient in person and hands on examining them. NONE. You cannot practice medicine over the phone. PERIOD.
Maybe in the long term future that the home robot computer could be linked to a real Doctor and could do tests on the, at home, patient as prescribed by the Doctor. In some sci/Fi movies the Doctor is eliminated by an on-board medical computer in all the large space ships. Today there is probably research about how to reach populations in remote mountainous regions of South America or other areas.

[JMintzer]

You shouldn't worry about lawyers or malpractice if you don't commit malpractice and stay aware and conform to the standard of care. And yes, I am well aware that being innocent of malpractice is not the same as not being accused and dragged through the process.

I disagree completely. The ONE time I was sued for malpractice was after seeing a diabetic patient twice (who had already seen another DPM). She claimed she stepped on "a piece of glass" and the other doc couldn't find it.

I examined the "wound" debrided it superficially and found nothing. I put her on a two week course of topical antibiotics, along with a daily dressing change.

When she returned there was a noticeable improvement, so I told her to continue the present treatment regime and come back in two more weeks. She just kept repeating "just cut out the glass"... I had let her know that being a diabetic increased the risk of excision, but if there was no improvement, we would take that chance once her MD cleared her for surgery.

She never showed for her appointment. We called, and sent har a post card reminding her that she missed her appointment and she should call for an appointment. The response? "Crickets"...

Apparently, about 8 months later she went to see a dermatologist for "a spot on her hand" and when she was there, she said "by the way could you look at my heel".

Turn out she had a "Melanoma in Situ" which is easily treated by excision (which the new doc performed).

5 years later, she decided to sue me (and the original DPM for malpractice, claiming that she was unable to work (she was a government secretary) and had to take care of her ailing mother.

My malpractice insurance company assigned an attorney and they decided it would be best to go to non-binding arbitration. The other DPM used the same company but had a different attorney.

They send their own attorney from the home office and she attended the depositions and arbitration of me and the other DPM.

I finally got to see the lady again in person and THERE WAS NOTHING WRONG WITH HER! I got to review HER medical records and after excision (which left a very faint 1.5" scar on the back of her heel), with no sign of spread or lymph node involvement. After 5 years there is a 99-100% survival rate for this type of melanoma, so it made little difference if the diagnosis was made when I first saw her, or a month later (when I had told her we would attempt an excision).

The arbitrator suggested a $650K settlement, split 40-60 between the first doc and me (I never could quite come to terms with that) and the representative from the insurance company suggested we accept, with no admission of guilt.

I was livid! There was NOTHING wrong with the lady and it had now been over 7 years since I had first seen her. When I brought this up to my attorney and the ins company rep, I was told "You just don't understand how these things work. We'll pay the claim, it wont affect your rates, but if you decline, any amount over this will be on you"...

I won't get into the racial and religious aspects they brought up trying a case in DC, but it didn't help to calm me down...

I just said, "Give me the papers. Where do I sign? Get me the hell out of here!"

All it cost was a bit of my sanity, 7-8 years out of my life and a stress level that no one should ever have to go thru...

I'll go to my grave with a clean conscious that I committed NO malpractice, and was unable to confirm to ANY standard of care, since the patient abandoned my (and the previous doctor's) practice.

But I guess, using your logic, that no one needed a pardon, if they were completely innocent of any crimes...

[golfing eagles]

I disagree completely. The ONE time I was sued for malpractice was after seeing a diabetic patient twice (who had already seen another DPM). She claimed she stepped on "a piece of glass" and the other doc couldn't find it.

I examined the "wound" debrided it superficially and found nothing. I put her on a two week course of topical antibiotics, along with a daily dressing change.

When she returned there was a noticeable improvement, so I told her to continue the present treatment regime and come back in two more weeks. She just kept repeating "just cut out the glass"... I had let her know that being a diabetic increased the risk of excision, but if there was no improvement, we would take that chance once her MD cleared her for surgery.

She never showed for her appointment. We called, and sent har a post card reminding her that she missed her appointment and she should call for an appointment. The response? "Crickets"...

Apparently, about 8 months later she went to see a dermatologist for "a spot on her hand" and when she was there, she said "by the way could you look at my heel".

Turn out she had a "Melanoma in Situ" which is easily treated by excision (which the new doc performed).

5 years later, she decided to sue me (and the original DPM for malpractice, claiming that she was unable to work (she was a government secretary) and had to take care of her ailing mother.

My malpractice insurance company assigned an attorney and they decided it would be best to go to non-binding arbitration. The other DPM used the same company but had a different attorney.

They send their own attorney from the home office and she attended the depositions and arbitration of me and the other DPM.

I finally got to see the lady again in person and THERE WAS NOTHING WRONG WITH HER! I got to review HER medical records and after excision (which left a very faint 1.5" scar on the back of her heel), with no sign of spread or lymph node involvement. After 5 years there is a 99-100% survival rate for this type of melanoma, so it made little difference if the diagnosis was made when I first saw her, or a month later (when I had told her we would attempt an excision).

The arbitrator suggested a $650K settlement, split 40-60 between the first doc and me (I never could quite come to terms with that) and the representative from the insurance company suggested we accept, with no admission of guilt.

I was livid! There was NOTHING wrong with the lady and it had now been over 7 years since I had first seen her. When I brought this up to my attorney and the ins company rep, I was told "You just don't understand how these things work. We'll pay the claim, it wont affect your rates, but if you decline, any amount over this will be on you"...

I won't get into the racial and religious aspects they brought up trying a case in DC, but it didn't help to calm me down...

I just said, "Give me the papers. Where do I sign? Get me the hell out of here!"

All it cost was a bit of my sanity, 7-8 years out of my life and a stress level that no one should ever have to go thru...

I'll go to my grave with a clean conscious that I committed NO malpractice, and was unable to confirm to ANY standard of care, since the patient abandoned my (and the previous doctor's) practice.

But I guess, using your logic, that no one needed a pardon, if they were completely innocent of any crimes...

She was able to sue after 5 years??? Generally the statute of limitations is 30 months unless the patient is a minor, in which case they have until age 20 1/2 or if a surgical implement is left in a body in which case it is 30 months from the time it was discovered

[Stu from NYC]

I used zoom to have a brief update with my doctor during the Pandemic. I wasn't feeling well and was concerned. He asked me about my symptoms, and if I'd taken the home COVID test. Asked me a bunch of other questions, had me check my own pulse and heart rate using my phone (which had that ability) and temperature with my own thermometer.

He concluded that I probably did not have COVID (I'd tested twice in 2 days, both times negative). I probably DID have a bad cold, and possibly a mild sinus infection. He suggested I go for the nightly dose of Nyquil, acetaminophen during the day, plenty of fluids, rest, and I could continue using my Fluonase allergy nasal spray. If I didn't start feeling better in two days OR if I developed a fever over 100° then I should go to Urgent Care, as he didn't have any appointment openings available that day. He also said if I started feeling better within a day to call him and let him know. Total time for the call: under 15 minutes.

I started feeling better that night, called him the next day, and all was well. Total cost for the zoom meeting: $0. The Doctor got paid I believe $45 from the insurance company. If I had gone to the doctor's office first, it would've cost me $40, and the insurance company would've had to pay him over $100 for the office visit.

Doctor was unable to listen to your heart and do other tests that might have been indicated.. As I mentioned before telemedicine has flaws as compared to being in front of your doctor.

[JMintzer]

She was able to sue after 5 years??? Generally the statute of limitations is 30 months unless the patient is a minor, in which case they have until age 20 1/2 or if a surgical implement is left in a body in which case it is 30 months from the time it was discovered

I believe it's 30 months after you discover the "injury"...

My timeline may have been off bit, but the premise remains the same. There was no harm, yet she was paid $650K...

[mraines]

I think of all the fraud Medicare and Medicare would be in the billions. Doctors ordering unnecessary tests, people not looking at their bills to see if they actually had this test, and the reasons go on forever. Unfortunately it’s so massive with the number of elderly increasing every day this would be a huge undertaking. And Medicare nursing homes that’s a story for another day.
But let's just fire people willy nilly and put incompetents in charge. That'll fix it.

[mraines]

Agree with BlueAsh.

My mom is in hospice, for losing weight, in memory care, 98, post broken hip surgery.

She fell, I was in FL, and the nurse from Hospice sent her to the hospital for something he thought didn't look right. I was like, describe it, I am not sure what you are seeing, not sure I agree from the descriptions I have been receiving about the severity of the fall, but OK.

Came back nothing wrong.
total encounter cost Medicare $15K.
Recommendations: higher dosage of ibuprofen for the bruises.

CYA or the fear of the effects of lawsuits are everywhere.

A great book to read is by a Boston Surgeon Atuwal Gwandi
Amazon.com (https://www.amazon.com/Being-Mortal-Medicine-What-Matters-ebook/dp/B00JCW0BCY/ref=sr_1_1)

His description of the healthcare industry has come along way from the turn of the 20th center, 125 years ago. Some has been from the legal system forcing better practices.
However, the EMR of today are being created to prove behaviors are done, and that takes time, and can be very granular, and to push towards proactive medical care versus reactive medical care, which will always be there. Proactive medical care is very difficult and has a higher cost than pure reactive medical care

good luck to us!
While taking care of my mom with dementia, I learned you really need to be on top of everything.

[mraines]

We moved here a month after covid and the DR we found would only do telehealth visits for the next year. She had a family and wanted to protect herself. Perfectly understandable.

Nice to speak to her but she could not listen to our heart and lungs or look at our ears, throat etc.

A year later I pushed the issue wearing whatever she asked us to protect her and the visits were much more productive.
And I had a doctor who did not wear masks and did not require his patients to wear them. He wanted me to come in for a yearly Medicare exam and I refused due to lack of masks. He actually sent me a certified letter that he would no longer be my doctor. I never heard of such a thing but he actually did me a favor.

[golfing eagles]

And I had a doctor who did not wear masks and did not require his patients to wear them. He wanted me to come in for a yearly Medicare exam and I refused due to lack of masks. He actually sent me a certified letter that he would no longer be my doctor. I never heard of such a thing but he actually did me a favor.

Res ipsa loquitur