How is the system running?

Just wondering if anybody has a read on how the medical system is holding up in general?

I ask because so many people I know who work in healthcare have been laid off or moved to part time. When I call to schedule appointments, its a 30-60 min wait time. People in insurance say things are rough - as in broken.

The house of cards that is the medical system just feels a little unstable up here.

I’m not experiencing this at all. See my eye dr tomorrow, other contact via email or conference.

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The front line healthcare peeps I know are all pulling double shifts. I don’t think anyone is being laid off.
Maybe in private practice dr offices. I don’t know.

I think appointments and clinic openings are wonky. I was able to get my retinal exam, my friend’s Mom got a diabetes visit but my elderly parent has not been seen because her clinic is still only doing phone calls. And then they told her to have me bring her in, but then told me they are not open. They don’t even know what’s going on and they work there! My insulin and all has been completely available, but I messed up or had three bad sensors. It seems to be taking Dex awhile to replace them…

Check this out, Timothy. I dont know who’s working anymore, but peeps at the insurers say that the hospital staff is understaffed and having trouble even filing the paperwork for claims. Its all broken.

https://www.usnews.com/news/health-news/articles/2020-05-06/layoffs-and-losses-covid-19-leaves-us-hospitals-in-financial-crisis

@mohe0001 et al:

I think that the folks dealing with COVID-19, particularly in hot spots, are getting hammered … but a lot of more routine things are sparsely loaded because a lot of us don’t want to go in.

I personally have had one endo and one CDE visit … both remotely. I went in for a blood draw which actually was handled well. I went in for a quick dental clean because I have one trouble spot that is getting close to needing a more serious procedure that I’m hoping to delay until this mess blows over. I’m not sure I would do that again though …

Fortunately my annual retinal exam doesn’t come up to Nov or Dec.

My conclusion is that the system is somewhat bipolar at the moment … frantic for some but significantly depressed for others.

Stay safe!

John

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Our U.S. health system has been broken for a long time. Now it is all political.

Maybe that’s a good summary of what is going on.

Although, from what the insurance dudes are saying, they don’t even know the magnitude of services that are being utilized, like they can’t tell if they are loosing money or they are rich with money because nobody is filing any paperwork.

Its super hard to tell what is going on out there.

BTW, speaking of ‘broken,’ (Portland) where is @Terry4? Anybody seeing him around or is he off the grid?

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Mostly virtual appt. No bp checks or other things that need a face to face done.
this is internal medicine and endocrinology most other areas are face to face

You could hear crickets in the ER every time I’ve been there lately. However, medicine seems very understaffed, in general, here. We might be seeing a general decline in use, accompanied with an even larger decline in staffing.

I have had a couple appointments with specialists canceled with no sign they will ever be back in business.

My PCP and Endo are still in business although they strongly encourage telemedicine over in-person where possible.

I had PCP and Endo in-person visits last week and the office and support staff were VERY different than the folks I had grown used to working with over the years. And of course everyone was wearing masks/visors/etc.

I had an endo and CDE appointments via teleconference earlier this year. More recently I had an in-clinic appointment with my PCP, including a blood draw at the lab. No issues what-so-ever.

Last Friday I had an urgent visit with my Opthomologist because of a raptured blood vessel in one of my eyes. No issues there.

Overall I think the providers I use have their acts together with procedures in place that make me feel safe and completely comfortable when I visit.

I went in for cataract surgery yesterday. I was impressed with all the attention to the Covid-19 protocol. I was tested for Covid-19 last Friday and the result came back, “not detected” 24 hours later. I felt guilty that so many others facing infection concerns in many parts of the country have a hard time getting a test done and sometimes have to wait two weeks for the results.

Overall, the nurses, doctors and support staff all performed well.

I was surprised, however, when the pre-surgery telephone nurse told me that I would have to disconnect from my insulin pump and they would put me on IV insulin. Cataract surgery is known for its brief duration and this proposal seems ill-informed and inappropriate.

I asked for the anesthesiologist to call me to sort this out. When he called, he quickly agreed that a transition to IV-insulin was not a good plan. I got the impression that he would have no glucose monitor in place to guide his insulin delivery rate. I wore my insulin pump through the surgery without event. I was walking out the door one hour after the surgery started.

I was hooked up to an IV line for the surgery mostly to provide a way for drugs to be delivered quickly. The nurse intended to hang a bag of Ringers Lactate and I appealed to change it to normal saline. Dr. Bernstein doesn’t like Ringers Lactate. I don’t understand all his reasoning but normal saline seemed a safe choice.

In general, I give this facility and staff operation during a pandemic a high grade. My only gripe is that I wish they’d up their institutional knowledge of diabetes. Diabetes is the hidden pandemic.

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Glad that your cataract surgery was easy. Mine was too for both eyes. I think surgeons and nurses are given standard info about insulin and that becomes their gold standard. I always argue with them about how much and when to take my insulin and they always, once they realize that I know what I am talking about, do it my way. It seems very odd to me that they would want you to disconnect your pump for such a short surgery.

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Glad your cataract surgery went well! My surgery 4 years ago did, too. In my case knowing that I wore an insulin pump, the ophthalmologist’s staff never even mentioned it. They did do a finger stick to test BG on their own tester right before surgery. The surgery took minutes and I, too, was on my way home in an hour. I do hope that the results of your surgery were as good as mine. My far vision was perfect and I got dollar store readers for prolonged close up reading.

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Only local anecdotal experience. The docs I must see in person (for chemo and eye injections) are meticulous and make me feel very safe. They’ve put remarkable protocols in place.

Had a rescheduled lithotripsy a month ago when they started to allow elective surgeries because it was necessary to prevent an emergency at an even worse time. All went well, but I found the insurance paperwork comments interesting. I am on Medicare with supplement and things are 100% covered. But - got a bill from Quest for a lab test from that day saying my PCP from two years ago (who closed her practice and moved out of state) had requested it. Called them - and they said no insurance info was sent, and my old doc listed as requester. Anyway, the paperwork comments explain it!

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