A comprehensive guide to choosing the best, quickest, most cost-effective care: PCP, Urgent Care, Telehealth, ER, Freestanding ER and—my favorite—Home.
It's interesting to compare England's NHS to what we experienced in California.
Over there, I always got seen for anything (serious or not) in less than a day or two. Over here, I can never get an appointment in less than three weeks — except that one time when I called to say I was experiencing phantom smells. "That sound serious", they said. "Can you come in tomorrow morning?" I went for an MRI the next day and I got the result an hour later. It's frustrating when the wait is three weeks (or months and months for minor surgery) but there's something about that that makes sense. I had one doctor who coordinated everything and everything was free.
When my wife was sick in California, she was admitted and seen by like 5 different doctors who each sent a bill for 10s of thousands and they didn't talk to each other. They all seemed to have their own motivation which usually involved invoices. Her heart doctor asked "Why are you seeing a pulmonologist? There's nothing wrong with your lungs!". "I dunno, he just keeps telling me to make appointments." The care she received over there was amazing and they saved her life but the admin is totally bewildering and the bills never seem to stop coming.
The NHS seems almost broken now but they still do a fantastic job when a fantastic job is needed. I'm back to 8 week waits for MRI results now. Must be fine, right?
There's much worse coverage and access to preventative care and basic health needs in the US, but much shorter overall wait times when seeking care for potentially life threatening or life-altering diagnoses (cancer, autoimmune, etc.) Did you find that to be true? When Jake first had osteosarcoma of the skull he was living in England and the wait for a CT would have been months, and a friend of mine in Canada are seeking cancer care in the US right now because the wait to see an oncologist for his blood cancer is months, and by then, well, I don't have to tell you. Did you find that it was easy to get appointments for serious symptoms in the UK? I've heard that if you live long enough to get the care, it's good care, but that's a big if.
I got seen immediately when I reported my symptoms in the UK. I know other brain cancer patients who have had craniotomies within a couple of days of seeing a doctor.
I think of it as a ruthless triaging system. If it’s super urgent they’ll see you immediately. If it’s only slightly urgent, you might have to wait weeks. It's broken for sure.
I always had good health policies in the USA and was always seen quickly. I’m not sure how long it takes for uninsured people to be seen.
I’m glad you included ‘Home’ as an option. It boggles the mind how many people immediately think they HAVE to see a doctor when staying in bed a day or two would be sufficient.
We fail to teach basic health literacy, and I think people get overwhelmed. I have “guides to supportive care” that I print out for patients explaining what over the counter meds they can take and how to take care of themselves depending on the illness. I used to think this information was common knowledge and people would be insulted, but mostly the handouts all come from questions patients have asked. I want to find ways to fill those gaps. Who really wants a 2k ER bill for the sniffles? If only I could convince people I’m not hiding a magic cure (I tell them if I’d invented the cure for a cold do they think I’d be working a shift and not island hopping somewhere off the coast of Greece I. My yacht? That usually convinces).
It's interesting to compare England's NHS to what we experienced in California.
Over there, I always got seen for anything (serious or not) in less than a day or two. Over here, I can never get an appointment in less than three weeks — except that one time when I called to say I was experiencing phantom smells. "That sound serious", they said. "Can you come in tomorrow morning?" I went for an MRI the next day and I got the result an hour later. It's frustrating when the wait is three weeks (or months and months for minor surgery) but there's something about that that makes sense. I had one doctor who coordinated everything and everything was free.
When my wife was sick in California, she was admitted and seen by like 5 different doctors who each sent a bill for 10s of thousands and they didn't talk to each other. They all seemed to have their own motivation which usually involved invoices. Her heart doctor asked "Why are you seeing a pulmonologist? There's nothing wrong with your lungs!". "I dunno, he just keeps telling me to make appointments." The care she received over there was amazing and they saved her life but the admin is totally bewildering and the bills never seem to stop coming.
The NHS seems almost broken now but they still do a fantastic job when a fantastic job is needed. I'm back to 8 week waits for MRI results now. Must be fine, right?
There's much worse coverage and access to preventative care and basic health needs in the US, but much shorter overall wait times when seeking care for potentially life threatening or life-altering diagnoses (cancer, autoimmune, etc.) Did you find that to be true? When Jake first had osteosarcoma of the skull he was living in England and the wait for a CT would have been months, and a friend of mine in Canada are seeking cancer care in the US right now because the wait to see an oncologist for his blood cancer is months, and by then, well, I don't have to tell you. Did you find that it was easy to get appointments for serious symptoms in the UK? I've heard that if you live long enough to get the care, it's good care, but that's a big if.
I got seen immediately when I reported my symptoms in the UK. I know other brain cancer patients who have had craniotomies within a couple of days of seeing a doctor.
I think of it as a ruthless triaging system. If it’s super urgent they’ll see you immediately. If it’s only slightly urgent, you might have to wait weeks. It's broken for sure.
I always had good health policies in the USA and was always seen quickly. I’m not sure how long it takes for uninsured people to be seen.
I’m glad you included ‘Home’ as an option. It boggles the mind how many people immediately think they HAVE to see a doctor when staying in bed a day or two would be sufficient.
We fail to teach basic health literacy, and I think people get overwhelmed. I have “guides to supportive care” that I print out for patients explaining what over the counter meds they can take and how to take care of themselves depending on the illness. I used to think this information was common knowledge and people would be insulted, but mostly the handouts all come from questions patients have asked. I want to find ways to fill those gaps. Who really wants a 2k ER bill for the sniffles? If only I could convince people I’m not hiding a magic cure (I tell them if I’d invented the cure for a cold do they think I’d be working a shift and not island hopping somewhere off the coast of Greece I. My yacht? That usually convinces).