limoncello Posted June 18, 2011 Report Share Posted June 18, 2011 I cannot believe how judgmental some users on this forum are! As a physician, you job is to heal people! You have no right of judging them on their choice (or lack of) certain lifestyle. How many people actually follow a perfectly healthy lifestyle? To say that there is no point in signing up to be a donor since your organs will pretty much go to alcoholics, obese, careless drivers etc. is beyond ignorant!! Link to comment Share on other sites More sharing options...
Mourning Cloak Posted June 19, 2011 Report Share Posted June 19, 2011 To say that there is no point in signing up to be a donor since your organs will pretty much go to alcoholics, obese, careless drivers etc. is beyond ignorant!! It's someone trying to find an excuse - any excuse - to justify crab mentality. If you don't want to donate your organs from your corpse, just say that you'd rather rot with your bits and bites intact. It's your right to make that decision. But don't expect anyone to believe there's anything behind it other than pure egoism. Oh, yeah, and sign up for onematch - save some cute kid with leukemia! Link to comment Share on other sites More sharing options...
medguy5367 Posted June 19, 2011 Report Share Posted June 19, 2011 Wow... I think some people need to get off their high horse. You talk about being "non-judgmental", and then in the same breath you JUDGE those that do not wish to donate their organs. I can only hope that your level of maturity grows over time... Link to comment Share on other sites More sharing options...
FacelessMage Posted June 19, 2011 Report Share Posted June 19, 2011 I'm not an eligible blood donor (chronic anemia + immunosuppressants disqualifies me), so it probably would disqualify me from being a good organ donor as well. I would donate my organs if I could. Link to comment Share on other sites More sharing options...
aaronjw Posted June 19, 2011 Report Share Posted June 19, 2011 I can only hope that your level of maturity grows over time... Pot. Kettle. Black? Put on your big boy pants and calm down Link to comment Share on other sites More sharing options...
smile101 Posted June 19, 2011 Report Share Posted June 19, 2011 http://online.wsj.com/article/SB10001424052748703344704574609960519672346.html Link to comment Share on other sites More sharing options...
limoncello Posted June 19, 2011 Report Share Posted June 19, 2011 Wow... I think some people need to get off their high horse. You talk about being "non-judgmental", and then in the same breath you JUDGE those that do not wish to donate their organs. I can only hope that your level of maturity grows over time... I do not judge those who choose not to donate their organs. Rather what I was criticizing is the notion that: organ donations is pretty much "pointless" because those who need it are careless drunks, obese etc.. a view that is clearly ignorant to the reality of things. Link to comment Share on other sites More sharing options...
aaronjw Posted June 19, 2011 Report Share Posted June 19, 2011 I do not judge those who choose not to donate their organs. Rather what I was criticizing is the notion that: organ donations is pretty much "pointless" because those who need it are careless drunks, obese etc.. a view that is clearly ignorant to the reality of things. Agreed 10char Link to comment Share on other sites More sharing options...
estairella Posted June 21, 2011 Report Share Posted June 21, 2011 etc. You point out that the reason there is an opt-in list only, is because if you chose to opt-out and changed your mind, they might not know about it. That also holds true if you chose to opt-in and they might not know it, except in this case, there's no way to opt-out, you can remove yourself from opt-in but they will STILL ask your family when you're dead (unless you had a will which explicitly stated you were against organ donation). Fact - "Canada consistently has one of the worst organ donor rates of industrialized countries: about 13 donors per million people, compared with 20 per million in the U.S., and more than 31 per million in Spain." The proportion of Canadians who WANT to be organ donors is much much less than 50%, so to make that the easier/more convenient option is unethical, even if it benefits the majority. I mean, taxes benefit the majority. How would you feel if the government had an 'opt-in' list if you wanted all your assets to be given to the government as a tax when you died... there was no 'opt-out' list for you to give your assets to the rest of your family, and even if you didn't opt-in, the government would still beg your family members (while they're grieving your death) for the rest of your stuff? Link to comment Share on other sites More sharing options...
estairella Posted June 21, 2011 Report Share Posted June 21, 2011 Organ donors save lives. Therefore, organ donation is a good thing. One of the most naive statements I have ever heard. Please go to an internal medicine or ICU ward sometime. The amount it costs to "save" a life is often obscene and completely unjustified. I have been at codes for patients who have a 1% chance of making it out of hospital alive. You know what the cost per QALY for such a patient is? Over half a million dollars. I have seen patients who have been in hospital for months, are too stable to die and too unstable to go home or to rehab. Do you know how much it costs for a one-day stay in hospital? $2000-3000. But because people like you (and most of the general public) have this misconception that saving lives = good thing, patients like that end up as FULL CODE, and wasted money and effort goes down the drain. I can tell you about 100 homeless people die in Canada every winter due to hypothermia. It costs about $30-40/day at a hostel -> that's $360,000 - $440,000 to keep all of them in hostels for 4 months a year. So every time I start chest compressions on another 70-year old guy with CABGx4 and multiple past MIs, I'm condemning another homeless guy to a preventable death in the cold. Yes, you can call me a terrible person for being a future doctor and caring about costs. But one of the CanMEDs roles (i.e. one of the competencies to be a doctor in Canada) is being a manager, "optimizing decisions for individual patient care in the context of finite health care resources". Do you want to know the truth? The truth is, your mother's past kidney transplant was worth it (Cost per QALY of ~$30,000). Your girlfriend's future BMT probably won't be (Cost per QALY of $50,000-100,000). If that offends you, please don't get into healthcare, because naive idealists like you are going to make our healthcare system come tumbling down. Link to comment Share on other sites More sharing options...
hking03 Posted June 21, 2011 Report Share Posted June 21, 2011 One of the most naive statements I have ever heard. Please go to an internal medicine or ICU ward sometime. The amount it costs to "save" a life is often obscene and completely unjustified. I have been at codes for patients who have a 1% chance of making it out of hospital alive. You know what the cost per QALY for such a patient is? Over half a million dollars. I have seen patients who have been in hospital for months, are too stable to die and too unstable to go home or to rehab. Do you know how much it costs for a one-day stay in hospital? $2000-3000. But because people like you (and most of the general public) have this misconception that saving lives = good thing, patients like that end up as FULL CODE, and wasted money and effort goes down the drain. I can tell you about 100 homeless people die in Canada every winter due to hypothermia. It costs about $30-40/day at a hostel -> that's $360,000 - $440,000 to keep all of them in hostels for 4 months a year. So every time I start chest compressions on another 70-year old guy with CABGx4 and multiple past MIs, I'm condemning another homeless guy to a preventable death in the cold. Yes, you can call me a terrible person for being a future doctor and caring about costs. But one of the CanMEDs roles (i.e. one of the competencies to be a doctor in Canada) is being a manager, "optimizing decisions for individual patient care in the context of finite health care resources". Do you want to know the truth? The truth is, your mother's past kidney transplant was worth it (Cost per QALY of ~$30,000). Your girlfriend's future BMT probably won't be (Cost per QALY of $50,000-100,000). If that offends you, please don't get into healthcare, because naive idealists like you are going to make our healthcare system come tumbling down. I appreciate that you have first hand knowledge of what it costs to save a life. I have a fiancee who takes a medication that would cost us 30k per year to keep her alive. People in the US that are on the same medication have to make a decision as to whether or not they will buy food or meds... Here in canada, she doesn't have to worry about the cost. I have a mom who died of cancer, and she chose not to have any heroic measures taken. I have an aunt that raised me after my mom passed away, who was able to get a kidney transplant for free and save her from dialysis and a vastly shortened lifespan. So, I see the real life costs... maybe not the dollar figures, but I see what our healthcare system does, both good and bad. Jump down from your pedestal and stop with the insults. You cut my post down to two lines and go off on some tirade about how you've seen it, you've been there, you know what it really looks like. Good for you. I'll be there in about two years. I've also worked in the downtown east side for the last 3 years with kids with FASD, drug addicted parents who can't even kick their habit long enough to make an effort to see their kids. I grew up with an alcoholic father and two brothers that were so far off the rails that they were lucky to make it to adulthood. Have a good one and go save some lives on the wards- even if it costs the taxpayers a couple bucks. I'm pretty sure you'd want everything possible done for you if there was even a 1% chance of a survival. Link to comment Share on other sites More sharing options...
Leon Posted June 21, 2011 Report Share Posted June 21, 2011 I'm pretty sure you'd want everything possible done for you if there was even a 1% chance of a survival. This. !0c Link to comment Share on other sites More sharing options...
limoncello Posted June 21, 2011 Report Share Posted June 21, 2011 So, I see the real life costs... maybe not the dollar figures, but I see what our healthcare system does, both good and bad. Jump down from your pedestal and stop with the insults. You cut my post down to two lines and go off on some tirade about how you've seen it, you've been there, you know what it really looks like. Good for you. I'll be there in about two years. I've also worked in the downtown east side for the last 3 years with kids with FASD, drug addicted parents who can't even kick their habit long enough to make an effort to see their kids. I grew up with an alcoholic father and two brothers that were so far off the rails that they were lucky to make it to adulthood. Have a good one and go save some lives on the wards- even if it costs the taxpayers a couple bucks. I'm pretty sure you'd want everything possible done for you if there was even a 1% chance of a survival. I second this Link to comment Share on other sites More sharing options...
Cerena Posted June 21, 2011 Report Share Posted June 21, 2011 One of the most naive statements I have ever heard. Please go to an internal medicine or ICU ward sometime. The amount it costs to "save" a life is often obscene and completely unjustified. I have been at codes for patients who have a 1% chance of making it out of hospital alive. You know what the cost per QALY for such a patient is? Over half a million dollars. I have seen patients who have been in hospital for months, are too stable to die and too unstable to go home or to rehab. Do you know how much it costs for a one-day stay in hospital? $2000-3000. But because people like you (and most of the general public) have this misconception that saving lives = good thing, patients like that end up as FULL CODE, and wasted money and effort goes down the drain. I can tell you about 100 homeless people die in Canada every winter due to hypothermia. It costs about $30-40/day at a hostel -> that's $360,000 - $440,000 to keep all of them in hostels for 4 months a year. So every time I start chest compressions on another 70-year old guy with CABGx4 and multiple past MIs, I'm condemning another homeless guy to a preventable death in the cold. Yes, you can call me a terrible person for being a future doctor and caring about costs. But one of the CanMEDs roles (i.e. one of the competencies to be a doctor in Canada) is being a manager, "optimizing decisions for individual patient care in the context of finite health care resources". Do you want to know the truth? The truth is, your mother's past kidney transplant was worth it (Cost per QALY of ~$30,000). Your girlfriend's future BMT probably won't be (Cost per QALY of $50,000-100,000). If that offends you, please don't get into healthcare, because naive idealists like you are going to make our healthcare system come tumbling down. Calling out someone else's personal circumstances on a public forum and debating whether or not treatments for that member's loved one is 'worth it' is unnescessary and completely uncalled for. Cutting down others in a post, in such a distasteful way, for your own personal gain (i.e. 'strengthening' your argument) is not a welcomed course of action here. Let's all strive for civil conversations. Please. Link to comment Share on other sites More sharing options...
cnb88 Posted June 21, 2011 Report Share Posted June 21, 2011 One of the most naive statements I have ever heard. Please go to an internal medicine or ICU ward sometime. The amount it costs to "save" a life is often obscene and completely unjustified. I have been at codes for patients who have a 1% chance of making it out of hospital alive. You know what the cost per QALY for such a patient is? Over half a million dollars. I have seen patients who have been in hospital for months, are too stable to die and too unstable to go home or to rehab. Do you know how much it costs for a one-day stay in hospital? $2000-3000. But because people like you (and most of the general public) have this misconception that saving lives = good thing, patients like that end up as FULL CODE, and wasted money and effort goes down the drain. I can tell you about 100 homeless people die in Canada every winter due to hypothermia. It costs about $30-40/day at a hostel -> that's $360,000 - $440,000 to keep all of them in hostels for 4 months a year. So every time I start chest compressions on another 70-year old guy with CABGx4 and multiple past MIs, I'm condemning another homeless guy to a preventable death in the cold. Yes, you can call me a terrible person for being a future doctor and caring about costs. But one of the CanMEDs roles (i.e. one of the competencies to be a doctor in Canada) is being a manager, "optimizing decisions for individual patient care in the context of finite health care resources". Do you want to know the truth? The truth is, your mother's past kidney transplant was worth it (Cost per QALY of ~$30,000). Your girlfriend's future BMT probably won't be (Cost per QALY of $50,000-100,000). If that offends you, please don't get into healthcare, because naive idealists like you are going to make our healthcare system come tumbling down. Oddly enough, this is what you sound like (at around 30 seconds): By your logic, no hockey players (children, adults, or professionals) should be treated for concussions, shoulder separations, bone breaks etc. The amount of money they collectively cost the system in resources and time is ridiculous! They put themselves knowingly at risk! How dare we use valuable resources on them! Or what about people who run or swim? Knee injuries or shoulder injuries are their own fault. They know the risks. Their treatment costs us money too. Why should I have to pay for Michele's shoulder surgery/rehab?! She's a swimmer, she knows the risks! (Sorry to use you in my examples Michele!). Or what about me? As a skater I know that there's a greater risk in my adulthood of developing arthritis in my joints from repeated impact. So I shouldn't be given health care later on in life. I knowingly did something that will cost the health care system in the future. I'm sure it's not worth it to treat my eventual arthritis. How about you? Do you drive? If you get in an accident, then you must have a DNR in your file. After all, just think of the cost it would be to save you. Ambulance ride, nursing costs, doctor costs, hospital bed costs, drugs, equipment. May as well leave you to die painfully in your own blood and filth on the side of the road. Wouldn't want to "waste" precious taxpayer dollars! The cost to society to save your life is way more than your life is obviously worth. What about your family? Have ANY of them ever needed to go to the doctor? Been in the hospital? I don't want to pay for their expenses. I mean, using finite resources for someone who's pregnant? Come on! They can have it at home! Just like before the 1900s! So why have health care in the first place? It's not worth it to society to save and treat all these people that cost so much/aren't "worth" it. How about you get off your high horse, ditch the "holier than thou" f*cking attitude and open your eyes (and have a little compassion, or hell, sympathy/empathy for those around you). You cannot determine the value of a life. The fact is, most of these people are HUMAN BEINGS and need to be treated with respect and dignity- they don't need to be told that their wife/aunt/fiancee's transplant/treatment isn't worth it. What kind of doctor are you going to be?! "I'm sorry, Mr and Mrs Smith, but little Timmy has cancer. I could give him a BMT and it would save his life and possibly cure him, but it really isn't worth the health care cost. Sorry about your luck!"?! Come on! Give your head a shake! If you have a problem giving chest compressions to someone with several MIs, then FFS don't go into the health care field! As a final note to your ridiculous attitude about what in health care is "worth it", estairella, this is what I think of your "high horse/pedestal attitude" (and, without putting words in his mouth, probably essentially what hking was trying to get across): (please fast forward and listen to 40-46 seconds for optimal effect) /rant:mad: Link to comment Share on other sites More sharing options...
Pantaloons Posted June 21, 2011 Report Share Posted June 21, 2011 Okay, everyone. Stop with the name calling and the personal insults. Let's keep the tone respectable. What are we even talking about anymore? Maybe I'll close this thread soon. Link to comment Share on other sites More sharing options...
futuremedgirl Posted June 22, 2011 Report Share Posted June 22, 2011 Have a good one and go save some lives on the wards- even if it costs the taxpayers a couple bucks. I'm pretty sure you'd want everything possible done for you if there was even a 1% chance of a survival. Couldn't have said it better myself. After all, isn't that what your job at the end of the day is: to save lives, or the least, make them less painful and more bearable? Funding is always going to be a limitation, but then work around it whilst keeping the main goal of your profession in front of your eyes. Link to comment Share on other sites More sharing options...
Emma15 Posted June 22, 2011 Report Share Posted June 22, 2011 Yes, you can call me a terrible person for being a future doctor and caring about costs. But one of the CanMEDs roles (i.e. one of the competencies to be a doctor in Canada) is being a manager, "optimizing decisions for individual patient care in the context of finite health care resources". Do you want to know the truth? The truth is, your mother's past kidney transplant was worth it (Cost per QALY of ~$30,000). Your girlfriend's future BMT probably won't be (Cost per QALY of $50,000-100,000). If that offends you, please don't get into healthcare, because naive idealists like you are going to make our healthcare system come tumbling down. Distasteful, disrespectful, uncalled for, completely inappropriate, disappointing to hear from someone in the business of CARE and not entirely true! Not to downplay the inappropriateness of the enite comment but in terms of the "rationale" for the argument: QALY arguments won't hold for ESTABLISHED medical treatments. They are often used to assess new treatments and even then an unfavourable cost per QALY doesn't automatically mean that the treatment will be decided against. Also from CanMED: "Fundamentally, CanMEDS is an initiative to improve patient care." I am not arguing to justify futile efforts but this to me means more than penny counting at patient's bedside. Link to comment Share on other sites More sharing options...
mdDave Posted June 22, 2011 Report Share Posted June 22, 2011 Distasteful, disrespectful, uncalled for, completely inappropriate, disappointing to hear from someone in the business of CARE and not entirely true! Not to downplay the inappropriateness of the enite comment but in terms of the "rationale" for the argument: QALY arguments won't hold for ESTABLISHED medical treatments. They are often used to assess new treatments and even then an unfavourable cost per QALY doesn't automatically mean that the treatment will be decided against. Also from CanMED: "Fundamentally, CanMEDS is an initiative to improve patient care." I am not arguing to justify futile efforts but this to me means more than penny counting at patient's bedside. I'm thrilled that so many young premeds are all about saving lives no matter what the cost. But we're being naive you we believe the Canadian government isn't very much into penny counting. The day will come when some of you are docs and will be refusing to treat a patient because it would not be cost efficient. Not because it's your decision but simply because Canadian taxpayers will not pay for it. Link to comment Share on other sites More sharing options...
aaronjw Posted June 22, 2011 Report Share Posted June 22, 2011 I'm thrilled that so many young premeds are all about saving lives no matter what the cost. But we're being naive you we believe the Canadian government isn't very much into penny counting. The day will come when some of you are docs and will be refusing to treat a patient because it would not be cost efficient. Not because it's your decision but simply because Canadian taxpayers will not pay for it. I think when it comes to health care you'd be surprised that Canadian tax payers would support. The problem is all other programs which move funding away from items that the majority needs in favour of programs which benefit the minority. Link to comment Share on other sites More sharing options...
mdDave Posted June 22, 2011 Report Share Posted June 22, 2011 I think when it comes to health care you'd be surprised that Canadian tax payers would support. The problem is all other programs which move funding away from items that the majority needs in favour of programs which benefit the minority. The point is, people need to understand that there is a line somewhere, where saving a life is not worth it. Theoretically Canadians could pay sky high taxes and the government could spend it all on health care. Still, performing a heart transplant on a patient that is expected to die withing the next few days anyways WILL NOT HAPPEN. I think it's best that premeds learn early that money does indeed matter very much in health care and as doctors you will have the responsibility to not waste the taxpayers money on procedures that are useless in the long run. Link to comment Share on other sites More sharing options...
aaronjw Posted June 22, 2011 Report Share Posted June 22, 2011 The point is, people need to understand that there is a line somewhere, where saving a life is not worth it. Theoretically Canadians could pay sky high taxes and the government could spend it all on health care. Still, performing a heart transplant on a patient that is expected to die withing the next few days anyways WILL NOT HAPPEN. I think it's best that premeds learn early that money does indeed matter very much in health care and as doctors you will have the responsibility to not waste the taxpayers money on procedures that are useless in the long run. They wouldnt give said person a transplant to begin with. I agree though, we have finite resources and i think most people understand and accept the reality of the situation without it being rammed down our throats as one in this thread has done. Its a fine line. Link to comment Share on other sites More sharing options...
The Law Posted June 22, 2011 Report Share Posted June 22, 2011 I appreciate that you have first hand knowledge of what it costs to save a life. I have a fiancee who takes a medication that would cost us 30k per year to keep her alive. People in the US that are on the same medication have to make a decision as to whether or not they will buy food or meds... Here in canada, she doesn't have to worry about the cost. I have a mom who died of cancer, and she chose not to have any heroic measures taken. I have an aunt that raised me after my mom passed away, who was able to get a kidney transplant for free and save her from dialysis and a vastly shortened lifespan. So, I see the real life costs... maybe not the dollar figures, but I see what our healthcare system does, both good and bad. Jump down from your pedestal and stop with the insults. You cut my post down to two lines and go off on some tirade about how you've seen it, you've been there, you know what it really looks like. Good for you. I'll be there in about two years. I've also worked in the downtown east side for the last 3 years with kids with FASD, drug addicted parents who can't even kick their habit long enough to make an effort to see their kids. I grew up with an alcoholic father and two brothers that were so far off the rails that they were lucky to make it to adulthood. Have a good one and go save some lives on the wards- even if it costs the taxpayers a couple bucks. I'm pretty sure you'd want everything possible done for you if there was even a 1% chance of a survival. Summarizes my thoughts exactly. Good posting. Link to comment Share on other sites More sharing options...
zdh Posted June 22, 2011 Report Share Posted June 22, 2011 A doctor's top priority should never be anything other than to provide the best care they can to their patients. Hospitals have accountants to worry about how much everything costs. That being said, there is clearly a need to reform health care in Canada where it stays affordable, provides a high quality of care, and is sustainable into the future. There's a number of suggestions that come to mind; giving up on patients under your care is not one of them. Link to comment Share on other sites More sharing options...
aaronjw Posted June 22, 2011 Report Share Posted June 22, 2011 A doctor's top priority should never be anything other than to provide the best care they can to their patients. Hospitals have accountants to worry about how much everything costs. That being said, there is clearly a need to reform health care in Canada where it stays affordable, provides a high quality of care, and is sustainable into the future. There's a number of suggestions that come to mind; giving up on patients under your care is not one of them. Maybe time to start with some reform to salaries? Link to comment Share on other sites More sharing options...
Recommended Posts
Archived
This topic is now archived and is closed to further replies.