[etrautmann]

Doctors are NOT to blame here. It's almost as inscrutable and impossible for them to understand the process as the patients. Doctors often times have to battle insurance companies on behalf of the patients to get them the drugs they need with coverage. My wife is a cancer physician and spends hours on the phone convincing insurance companies that patients actually need the treatments she's proscribed. It's an infuriating waste of time.

She also has little to no visibility into cost incurred by the patient, and often times there isn't a menu of options to pick from. She's not incentivized to perform extra testing/etc, and keeps patients costs in mind while providing care. I don't think that's rare among doctors. The whole system is frustrating, but yes mostly so for the patient.

[maxerickson]

Doctors could, to some approximation anyway, go on strike. They endorse the system we have by working in it (and have not been silent participants in building either).

[etrautmann]

It seems uncommon for one group to strike on behalf of another group. Pragmatically that seems very unlikely to happen even if theoretically possible. Policy level changes seem more likely to me.

[salawat]

That is by design. Look up the Taft-Hartley Act. Secondary striking is a forbidden labor practice in the United States. Any doctor's union that orchestrated one would be in hot water legally. It would essentially have to be a collective action orchestrated by distinct individuals with no legal entity providing any type of war chest.

To be clear, I believe at least that section of Taft-Hartley is arguably unconstitutional, and worthy of getting civil disobedienced hard. I just don't see it as likely to happen in such a way as to be effective in facilitating change. Add on top of that the onerous burden of medical school debt, and I don't exactly see many being willing to make that choice.

[maxerickson]

Okay, but the point is sort of that doctors are not in fact blameless for the system that they helped build and continue to participate in.

Like sure, they aren't solely to blame, and it would probably be hard for individual doctors to successfully push for systematic changes, but the flip side to that is that they don't get to say "Oopsie doopsie, it sure isn't great".

[etrautmann]

I disagree. Doctors did not build the insurance billing system that we have today, and are not implicated in creating the incredible complexity and challenge that exists for patients. They provide the care, and don't get to view the costs born by patients.

[TheNewsIsHere]

That particular deck is stacked against the favor of doctors and patients.

After all, a care facility can probably be reasonably confident that if a patient needs help, doctors will feel compelled to care for them.

Put another way, would you want to walk into a hospital/ER/your doctors office for something acute and get an apology that care is unavailable because the doctors are on strike?

[Gunnerhead]

I imagine he’s suggesting a strike where they do not fill out the necessary billing paperwork, like Japanese bus drivers didn’t collect fares or the Canadian customs officers didn’t collect tariffs during their strikes. Not sure if that’s possible, but that’s how I’d think they can strike.

[TheNewsIsHere]

This would absolutely work when the EHR/EMR is down. Otherwise, most of that stuff is automated and pulled directly from the medical/surgical records in the EHR/EMR.

[mindslight]

Providers are a full half of the problem! We live in a market economy, and it is doctors' responsibility to be able to answer straightforward questions about how much various treatments will cost, just as every other profession gives quotes and estimates. Pretending that money doesn't exist is doing a grave disservice to patients, for whom money most certainly is a concern.

In the short term, I know it's a tall ask for a provider to be able to tell a patient how much care from other providers might cost. But providers could certainly start by knowing the prices of services that they themselves perform. And if that's too hard because their billing departments have made it opaque with a whole slew of prices depending on who might be paying, then providers need to work on reforming their own houses before pointing fingers at the other half of the problem.