I'm Happy to Give You Some Advice on Choosing a Doctor

Hello
I'm a surgeon - waiting for theatre as often.
This site is a guilty pleasure of mine and i thought i'd post a thread giving advice on picking a doctor after i read this really dumb thread on another chat site.

https://propertychat.com.au/community/threads/blood-sucking-…

If you can be bothered with the link - the chat talks about a poor guy who racks up big bills for nothing really in return.
His surgeon charges him thousands for an arthroscopy which is a very minor procedure. He says it helps - its called PLACEBO.

Points to learn

  1. If you have joint pain over the age of 50 its arthritis. Live with it. Orthopods love the worried well who won't believe they are getting old until they get a scope, drain the medicare tank and pay for the privilidge. My GP friend says she has 70 year olds demanding to see a surgeon when it obviously arthritis.

  2. The guy thought he could haggle with the surgeon. No chance.

  3. If you don't want to pay gaps then phone, ask and shop around. Its well known amongst surgeons that the best don't charge the most - the ones who charge the most want to make the most money… duh. Sydney is overdoctored so you will get surgeons who don't charge GAPS but you may have to move west.

  4. As an aside - i worked in sydney and i didn't find standards there any better than in the regional centres. Overall Australia has an excellent surgical tradition and standards are high. That being said training is now watered down and there are rogues who can remain solvent despite being very poor. it also means some people can end up having too much surgery - surgery leads to more surgery… ancient proverb.

  5. How to find the best? Its actually easy. Beware chat rooms - some tech savvy docs pretend to be patients saying how awesome they are - is it a regular on the site or someone with 10 posts?
    Many GP's dont have a clue who is good unless they are experienced and involved. therefore they are the GP's in the most demand so wait for them. Dont be slimey or pushy or say "i demand to see the best" - you'll get sent to the big biller - also beware of saying "what if it was your family?" - i find it insulting to suggest that i would send one of my patients to someone no good. i would simply say to the GP or phone up the surgical ward and say "Who looks after doctors when they have this done?" Doctors dont go and see hacks, they may not want chat or bedside manner - the standard of surgery and knowing when NOT to operate is paramount.

Hope this helps - i'll swing by the thread from time to time to answer q's.

Comments

  • Do you think health insurance is worth it?

    Obviously if you have a lot of disposable income its a no brainer however before that cap and also at under 30 and over 50 y.o whats the worse that could happen?
    If you saved up the insurance premium without using it you may save 30,000$ per decade.

    Would there be life-saving surgery that requires out of pocket expense? Example AAA or aneurysms (ticking time bombs which are not considered urgent until 1st rupture or after an heart attack) ( Not talking about MVA's and CAT 1 trauma ) Public waiting lists for these seems to depend on severity of your condition is which can lead to worse outcomes.

    Do you find there is much difference in medical products ? Is there a difference between cheap and expensive? For example stents? keyhole surgery techniques? Would you yourself pay the premium for a medical product?

    What do you think of the da Vinci robotic surgical system ? Do you think Australia's medicine is on-par with the rest of the world?

    Is it true that you should only go to hospital for major surgery during the day? ie. Night work is always covered with registrars and specialist is on-call.

    What is the hardest specialty in medicine? (hard to get in)

    So many questions hope you arent overwhelmed !

    • If you saved up the insurance premium without using it you may save 30,000$ per decade.

      I know this is all 'what-ifs', but what if you needed a particular surgery asap and have only got a couple thousand saved up? Considering it cost a few hundred for a day stay, that few grand won't last very long. You could go public, but may have to wait a year and during that time, you cant work = loss income, and the problem may worsen/be more painful each day it's not fixed. You can earn money, but you can't earn more time/life/health.

      Also, if you're very very obese, it'll be $1k per day alone just to hire the special bed!

    • +4

      Hi
      If premiums keep rising there will be a lot to be said for saving and then just going private for a procedure
      The killer (no pun intended) is ICU or if u have a return to theatre for a complication, could get nasty
      I would avoid funds with shareholders. Nib , even Medibank now have a lot of small print to screw you. If ever I have someone finding out their cover is a lie its nib
      The non profit funds eg Phoenix, teachers. Very good

      I don't know enough about cardiology but I can tell you robots etc is really only minimal improvement if you have someone good
      Robots are like lasers. The public like it as they think of Star Wars but really it's a dud
      I've done robot training and what put me off was each case uses $3000 of consumables. And most funds won't cover that. It will happen here but not for quite a while.
      Sadly I have to go in at night a fair amount. We try to keep night surgery to a minimum but for serious cases a boss has to either be there or supervising
      Hardest speciality? Ophthalmology is hardest. Most pay for least work. Not for people of character

      • Although if premiums keep rising, assume costs are rising too. So the amount of risk you take on by staying uninsured increases.

    • +1

      i remember reading a newspaper article a while back saying that even with private health insurance, you might still get stung with huge out-of-pocket expenses. in some cases going to a public hospital for treatment worked out cheaper.

      bottom line: prevention is much cheaper than treatment. the food you are eating now is affecting your health. not just in the short term but also in the long term. eat healthy.

  • Thanks for the advice.

    I booked with a surgeon several GPS recommended to me. Public patient- 6 month waiting period. Anyway I'm lying on the trolley waiting to be wheeled in to surgery when I see my excellent surgeon wandering around in street clothes- he's on holidays just come to check on things. The first time I see the surgeon who operates on me is after I wake up.

    • +3

      In the public the registrar will usually do the case under supervision by the specialist
      When I had poor trainees and did the cases myself I got complaints I wasn't teaching
      If you want the specialist guaranteed to do the case u have to b private

  • How many hours do you work a week? I'm curious what he surgical hours are like.

    • +1

      I'm on call about 100 hours a week but at work about 60 hours, variable
      You need an understanding family.
      If you have a weak partner it won't last. X7 divorce rate vs average

      • How do you cope with the odd hours?/ long hours?

        Any supplements you take i.e caffeine tablets etc..?

        • +6

          I found I couldn't keep my workload unless I got fitter so have an elliptical bike to work out on.
          I drink coffee but have always done with little sleep although I don't bounce back as well these days
          The family can do it tough. If I have a complication with a patient. Eg return to theatre for haemorrhage, I perhaps will be grumpy with the kids , short fuse etc for a week or two.
          Some doctors definitely don't feel their patients pain but I would say most notable Normal ones do
          The pressure can be insane, most surgeons will deal with death every year.
          When I feel the heat I think of the TAG ad "don't crack under pressure " and my dad telling me when I was about 9 "I've noticed nothing makes you scared "
          I would only want my kids to do it they are nuts on it
          The money is good but if you aren't right for it - you will be miserable

  • +1

    This might be obvious, but I found bulk billing doctors at medical centres really bad… Dr google is better IMO (was told to wait a week for it to "get better" with a ruptured ACL).

    In my case, going to emergency was the only thing that got the process moving (and you really want to get on waiting lists ASAP).

    Other than that - the quality of care through the public system was quick and very good. I didn't get to see the surgeon beforehand however.

    I think if you do everything possible to make yourself a good candidate for surgery it helps though.

    • +2

      Fair point
      The system is variable , for years our services were lacking due to being a safe seat
      Now we swing things are improving
      Again I agree gps cannot survive on bulk billing so it creates poor practice

      The Medicare fee has not been properly updated from the 1970s so the AMA fee is what it would have been if it had been kept up with inflation when they chose to stop doing that
      That's what AMA rates are , if you ever see surgeons saying they charge that

      I would recommend seeing a good busy non bulk billing GP. They will guide you properly.
      I see a lot of people trying to do the right thing but skipping that vital part and being badly messed up.
      Start right.

    • +1

      100% agree i found out that lesson the hard way!
      Bulk billing for scrips and expensive doctor for anything serious. You get what you pay for

      • +1

        There are some amazing doctors at bulk billings practices. I found one who not only diagnosed me correctly and quickly both times I saw him, but also got me in to see an oncology specialist who I knew had a fantastic reputation (treated a relative) the same day he got my test results.

        I understand it's hit and miss but I wouldn't write them all off as lazy.

        • I think there is a big conflict when medical care is run on a high volume low margin basis. As fewer and fewer doctors bulk bill these days - you really have no choice unless you have the capacity to pony up (or travel a long distance to the rare good one).

          Another problem is that you never know if the referral you are getting is purely for the kickbacks (same with scans - this place sends you off for a ultrasound at the drop of a hat).

          Working in such a place would be a bit demoralizing really.

          At the hospital I had complete confidence in whatever they would do and whoever they would refer me to.

        • @gringo: The referral ends up costing you more than if you paid to see a doctor in the first place.

  • -1

    why don't doctors know anything about nutrition?

    • +1

      i wonder about that too.

      • +1

        i think dieticians will be in demand very much in the future

  • You've got a few grammatical errors - I assume English isn't your first language? (or you're not really a surgeon :)

    • Was typing on ipad.

  • I avoid medical people nowadays. I have found they are either incompetent, ignore you, treat you like rubbish, dont want to do any actual work or like the money too much. Finding a good doctor is like finding a needle in a haystack and unfortunately I'm done with going in circles and dealing with dud after dud trying to find someone decent. So avoidance is best.

  • it's great. Feeling much more confident when I go to the doctor, which I am sure, because it's advised by real people, possibly the ones you know)

  • +1

    I have to have my thyroid removed and found out today that the hospital cover I have with NIB doesn't cover it :(

    Options now are to:
    get on public list and have a junior do it (and potentially give me a crappy scar)
    upgrade NIB cover and wait 12 months
    pay for private entirely out of pocket just so the surgeon does it himself (I didn't even get a price quote so if anyone has any ideas please share)

    Please advise!
    (also I love your username TheCutter hehehe)

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