Ringing in the ears aarrrrghhh!!!

[Laurence Stein DDS]

Hi Doc Paul,

In my book you're a real doc ( an RD). The med students used to give the dental students alot of **** about not being a real doctor. Either they had inflated egos or we had deflated ones...who cares.

I do hope Louie has seen the ENT. I have the same reservations as you. Contiuning to self treat is going to be counter-productive and even dangerous.

Unfortunately, if there has been an inner ear injury, it is probably permanent. Hopefully, however it's nothing but earwax but an ear doctor should make the call.

My question about the fresh water came to mind because for one of my certifications, we did most of the dives in a freshwater lake. I never experienced any ear infections but my ears felt full following every freshwater dive. I've rarely experienced this in the ocean.

Finally, call me dense, but what is NHS? PM me if it can't be written.

Cheers,

Larry Stein

 

[The Iceni]

Laurence Stein DDS once bubbled...
Finally, call me dense, but what is NHS? PM me if it can't be written.

Larry Stein

It is our wonderful National Health Service!

Now you've blown it!

I undertstand you have HMO's over the pond. Well the NHS is a compulsory HMO paid for out of generalised taxation rather than insurance. It is what has been left over from Anerin Bevan's post war socialist idea that if enough government money was made available to treat all illness, the health of the nation would be greatly improved and therefore the overall long-term costs of treatment would be reduced.

In 1948 all the hospitals were nationalised and all GPs agreed to be contacted to the NHS. "He stuffed their mouths with gold."

Sadly they did not allow for chronic disease, cancers opr indeed the motor car. In addition, of course we have since had considerable demographic change, an aging population with fewer in work to pay for their care. In fact the idea of a system free at the point of use lasted only as long as the following budget, when prescription charges were introduced.

I was brought up to believe the NHS was the envy of the world. Few now believe that communist tripe!

Sadly the NHS has all but destroyed medicine in the UK. From my own perspective it seems all patients can now have everything they need as long as NHS managers (ever obedient to their political masters) agree they need it. We are treated worse than serfs (which of course are, being her majesty's loyal subjects).

It is worse than being the inmate of an internment camp as there is no escape! If you have ever read David Copperfiield by Charles Dickens, you will know what I mean; The beadle and The Workhouse.

The thing that annoys me most is that we GPs are required to undergo nine years of "training" but are not allowed to mix NHS and private practice to put that training to good use. Many therefore now go untreated, wait years for it or pay consultants' extortionate fees for simple procedures.

We now even have obedient "nurse consultants" only too ready to dish the dirt on those more highly qualified than themselves.

(The system is totally corrupt particularly at the top.)

It is a sorry mess and worsening by the day. :boom:

Sadly no adequate solution appears to be on the horizon.:fury:

Well, Larry. You did ask!!! :loopy:

 

[Laurence Stein DDS]

Dr. Paul,

Geez, I'm sorry I asked, sounds like you're always having a bad day. I understand what you're talking about though. HMOs here are the nearest thing to what you describe. Even regular insurance has, and I use this word with a bit of irony, consultant doctors.

They check the treatment recommended against what insurance allows. Somehow, they manage to get around the ethical stipulation that requires a doctor to personally examine a patient before rendering a diagnosis and treatment.

As I am sure your system must have, all treatments have either diagnostic codes or treatment codes. For reasons that escape me, a consultant or even more likely, an unlicensed lacky, is able to change my code to another, return the form to me and then sends a letter to the patient telling them the fee is too much. It never even mentions that they have changed the code.

It's called down coding. In the event I "upcode" a procedure, I can be brought up on fraud charges.

So now the patient is pi**ed at me because they think they are being charged too much for a procedure that I haven't recommended.

This correspondence is supposed to take no more than 30 days. I can't tell you how many times I have received a letter dated on the 30th day containing all the information and x-rays sent for their review. Also included in the envelope is a form letter asking for all the information contained within that envelope so they can proceed to process the claim. So we send it back for review again and wait another 30 days.

It's the insurance companies who have the corporate jets...and your plumber can make more than you for a procedure.

Perhaps what is the most frustrating is that medical/dental ethics is totally at odds with business ethics. Ours is driven by what is best for the patient (customer). Theirs, is driven by market pressure, reduced overhead, maximized profit. These are mutually exclusive goals.

Regards,

Larry Stein

 

[The Iceni]

I've corrected the post.

(Still up dealing with my emails after a good day's diving. Work never stops!)

 

[Laurence Stein DDS]

Dr. Paul, Man, you gotta get some sleep. That diving will wear you out! And then there are those babies.

BTW, I wasn't correction you on HMO. We have DMSO's and MSO's--they are sort of corporate owned group practices. The have a doctor front. Non-professionals are not allowed to "own" a medical or dental practice. They pool their resources--often centralizing to reduce staff and use one billing service and one salary and human resources company.

Within these organizations, the doctors are free to choose HMO, PPO, Indemnity insurance or fee for service.

I just hope the US goverment stays out of this. Are you hearing me Hillary?

Some good may eventually come out of this. There is a lawsuit pending. Patients have been excluded because under the "rules", since their insurance is part of their "benefits package" and since such packages may have a link to their pensions, HMO have been immune to assaults by the employees. However, in the last two weeks, physicians HAVE been allowed to join the suit. Their bais is fraud on the part of the insurance companies. This ought take about 100 years!

Larry

 

[Louie]

I confess I've got BUPA (private health insurance). It was all those six month waits to see a specialist everytime I had a sport injury that just made me lose patience with the NHS.
I used to work as a social policy researcher and yes, the Health Service is one long story of decline and the consequences for patients has been very unfortunate. I'll stop here.

By the way, on the ears, I saw a doctor specialising in dive medicine (private) and he prescribed Gentisome (antibiotic and steroid eardrops). I've been using them for a week now and most of the horrid swishing sound is gone.

 

[The Iceni]

Louie once bubbled...
. . . I saw a doctor specialising in dive medicine (private) and he prescribed Gentisome (antibiotic and steroid eardrops). I've been using them for a week now and most of the horrid swishing sound is gone.

Did your own doctor even look in your ears?

I wonder just how much the specialist was paid for that!

(I despair, Louie. I really do!)

 

[Laurence Stein DDS]

Hi Louie,

Glad you went in to the doctor. It was the right move and the smart move.

I don't treat ears but sometimes I can't believe how long people will put up with a problem and treat themselves. Then they come in and additional expenses, treatment and even permanent damage that an earlier visit may have mitigated.

Doc Paul, you mean that a NHS doc wouldn't look in the ear and you have to pay a specialist to come up with a "gimme". Amazing.

Having seen one other post by another very patient patient, who had to wait for 6 months for dental surgery that had to be hurting the entire time, this NHS seems nuts and how you all put up with it is a mystery!

Get well Louie. Buy an otoscope Doc. Paul and begin checking ears as a specialty!

Best to both of you.

Larry Stein