Home surgery? You have to be kidding........

The monopoly of the established medical profession? Give all people the right to prescribe? Ok, I will take 100 valium so I can read the home surgery posts with an even keel.

Anyone who thinks that home surgery is an option is looking for trouble. Cutting off skin cancers, draining abscesses etc should be done by a trained professional. Yes, yes, before modern medicine the average joe would do theses things, many times with reasonable results.

What does the laymen know of the possibilities? Take skin cancer, do you know the type? What margins do you take with the lesion? Lymph nodes, why are they important? How about abscesses, just a big zit right? Nope, what bacteria is growing in your festering boil? Why is it important? What if you don't drain it appropriately?

Picking up a Merck manual, reading a few online pages, and an old surgery text book is no substitute for a trained surgeon. Many procedures look easy, and many treatments appear straight forward, but you are asking for trouble if you think a bit of casual research will do the trick.

I am with the mods on this one, go see your doctor. Unless of course you stayed in an Holiday Inn Express last night, break open the beer and scalpels, there is surgery to be done.............:evilgrin:

Last time I was in the hospital I picked up an infection that damn near killed me.

Lots of bugs, but staying out of the hospital is no assurance that you will be free of infection. One particularly bad bug is MRSA, which stands for Methacillin Resistant Staph Aureus, a bad bug because it is resistant of penicillin based drugs, and tends to be aggressive. Yet, I see community acquired MRSA infections all the time.

Hospitals are like big petri dishes, full of bugs, avoid them if possible. However, if you need surgical intervention the hospital is where you need to be. Infection is a risk with every surgery. Granted, some facilities have been shown to be negligent in infectious disease control. I think it is better for the the patient to research the facility in question, ask about infection rates, and outcomes, rather than take matters in their own hands.............

thanks to the insurance companies' insistence that surgeries be drive through, if possible, and stays restricted to the shortest duration if not. The shortening of hospital stays, while ignoring the very real need for convalescence and some rehab and a lot of teaching that used to be done, has had quite an effect on the number of serious postop infections. That's the one thing the bloodsucking HMOs and insurance giants did right, IMO, although there should be follow up visits at the patient's home to do the teaching and rehab instruction.

Most of the postop infections I saw after hospital stays were curtailed were either in diabetics, who run a tremendous risk of infection postop or not, and in people who had suffered other complications after surgery and had their stays prolonged. I saw very few infections in people with normal blood sugar whose postoperative course was uneventful. In fact, I can't remember any in those folks over 12 years on a cardiothoracic and vascular surgery unit.

The infections that do occur, though, are getting much nastier. The bugs are fighting back, and there are no new antibiotics in the drug approval pipeline. Scary.

Do you have any data to support the claim that decreasing hospital stays after surgery has lead to a decrease in infection rates? Not that I am disagreeing with you, I am just curious and too tired to go to medline to look it up.

It appears to give medical advice, and I thought that was against DU's policy.

Emphasis added by me:


Your paragraph of questions appear to break DU's rules as stated by Moderator's above quoted and linked post. Also, two consecutive questions might be construed as medical advice, certainly, one question you asked is answered in the next question: I suppose that if you are a licensed physician or surgeon, then it doesn't appear that you break the above stated and quoted rules, but how do we as readers verify your credentials in that case?

If the answer to the question of your professional licensing is affirmative, then why did you omit that disclosure on your first post?

It also begs one other question, how does one break a perceived monopoly, if one isn't allowed to talk about it? How does one talk about the issue of national health care, if some people's ideas of adding competition to the "medical monopoly" are "off the table" and discussion is prohibited about some ways that may be effective, albeit, inherently dangerous?

I believe it was my Econ101 class years ago that gave me the impression that competition is nearly the only effective price lowering process in capitalism. Cooperation could work, but doesn't seem to in practice. Medical corporatists could cooperatively decide to make their services affordable to the poorest minimum wage worker, even welfare recipients, but they don't.

How does one decrease the compensation of college-trained professionals as a group, if one is prohibited from talking about all anti-competitive issues that might exist within that group?

The mod's recommend "For sound medical advice please seek the advice of a trained medical professional." The OP is saying the same thing, and that's the only substantive advice in the post.

but I will admit not understanding why it's okay for someone to say "For sound medical advice please seek the advice of a trained medical professional", for that itself is clearly "medical advice."

Perhaps there's a law somewhere specifically stating that phrase isn't medical advice?

No, just common sense.

Disclosure of professional licensing? Not required, I am not offering professional medical advice, again, just common sense.

Competition? Airline pilots have a monopoly, so do nuclear scientists. Dammit, I want to fly and fiddle with nuclear reactors, lets band together and break the evil monopoly.

"Make their services affordable to the poorest minimum wage worker, even welfare recipients, but they don't." Bullshit, if you are sick and present to an emergency room you will be treated. I have treated two Mexican nationals this week alone, no insurance, no payment, just sick people in need. It is the law.

However, you are right on one point. The working poor, those which do not receive medical benefits from their jobs, cannot afford coverage, and do not qualify for state assistance, are screwed by the system. Universal health care in some form should be a goal of our government, far too many people are falling through the cracks.

Decrease compensation of college-trained professionals? What, in favor of uneducated, untrained individuals? Sorry, compensation has been cut and what I have witnessed in the profession is an influx of new docs which are less willing to work 100+ hours a week, take on difficult patients, expose themselves to high risk endeavors. How does that affect the patient? If you are a high risk OB patient, hand injury patient, or neuro trauma patient you may be out of luck in finding a specialist in your area. Transport to a specialist may get you a dead baby, gimp hand or injured brain, just to cite a few areas I have personally witnessed.

No. To bring financial wage equity to relative time (that was) spent in a classroom seat.
Quickly, this is to what I refer:
-->Raising the minimum wage to about $21 per hour does so.
-->Lowering the wages of professionals to about 1/4 (IIRC) of what they were in 1993 does so.
-->Graduating from high school at about halfway through the 5th grade also does so.

(based upon 1993 data and assumes about 75% of people lack college degrees. I'm going from memory, so the figures may be slightly or somewhat off, but anyone can calculate them, formula is average pay of class group divided by number of years typically spent in education.
http://www.census.gov/population/socdemo/education/p70-51/table02.txt )

A different way of stating the problem: Since a dentist has about 166% (5/3) more educational time invested, their increased earning capacity should be about 166% of earnings as measured against those of high-school learning level, instead of 400% that they did earn on average in 1993.

Any single one of the above ("-->" bullets) makes our current system of specialized education much more equitable for all citizens, and it eliminates the inequities of a capitalistic financial system that parasitizes the least educated member of society for their entire lives including their school years. A combination approach of the three above attenuates the suggested figures toward their current figures. My taking the middle one of the three above simply was using one of them. Would you have objected less strenuously had I chosen the first one instead? My view is they are closely interrelated; practically identical; mirror images of the same phenomenon of (L)earning inequity.



How much a typical citizen will owe corporate for such treatment, you don't say. Further, an emergency room visit is not primary care. It is not whether you will be treated for a health emergency, but how much one goes into debt as a result, and whether that debt lands you, ultimately, considering the new bankruptcy laws, in some kind of "kinder and gentler" debtor prison. I'm stating health care today is about the masses of citizens being financially preyed upon to an extreme and unreasonable degree given the masses average income and the relative number of years spent in education.



Regarding your word choice of "common": others may consider another word that's less self-complimentary. Some others in this "home surgery" thread, and in some of the other threads that were locked, seem to have a different "common sense" regarding health treatments than your view.

How does promoting the agenda of doctors help progressive democrats when about 75% of the American Medical Association's contributions have been to Republicans, a ratio that so far is holding for the 2006 cycle, according to opensecrets.org? Currently, more of your money paid in doctors' fees is recycled to the republican machine. (I'm sure there are some democrat doctors that aren't AMA members, where's that list?)



One way I like to think of these things is how they might impact others. Self-surgery by non-professionals? Likely none or little impact to other parties. Running a nuclear facility? Seems like a lot of others in the surrounding community might be impacted if someone there is incompetent and there's an emergency. So too, an airliner being flown by someone unqualified. If it's a small plane and is empty of passengers, there's still the danger the plane might crash and kill others on the ground. These objections don't seem to apply for self-surgery, effects would seem limited to the individual making any such decision.

Also, where does one draw the line? Is needling a splinter out of a finger self-surgery like a poster below asks? How about cutting a mildly ingrown toenail that's weeping pus? What if one's in the middle of the ocean, sailing around the world alone, the radio has been damaged, and acute appendicitis presents? (I know it's extreme, but was reported on TV to have happened once and resulted in a successful self-apendectomy)

One curious thing about our current civilization, society, or social-political-economic system, is how we are being protected from ourselves by those who claim to have our best interests in mind, but those same entities simultaneously profit from a sales pitch of what is essentially dependence upon a "professional" class who preys on us financially at every turn. I believe we can thank the corporatists for driving the wedge.

Those entities seem to directly impact other individuals' "liberty" and "pursuit of happiness" clauses of the Declaration of Independence partly through a matured religion of consumerism.

Keeping non-scheduled drugs on the Rx prescription list is just another financial boon that serves to keep citizens dependent upon doctors. Spend <10 minutes, write a script, tell patient, "call me if you don't feel better in a few days," charge patient a C-note (insurance companies and subscribers get a significant discount on the charge). Another creative term for that is highway robbery when the patient is lucky to have a job and to be earning minimum wage! (wage disparities are inherently relative)

Codifying a living wage goes a long way towards attenuating the pay-disparity issue, and so too would a free college education to remove the college-loan payback rationale for relatively high professional pay which may have a convergence effect on future wage disparity and creep. But so too does limiting the pay of professionals (especially including CEOs) preying on average Joe/Jane.

:hi:

Having just got off call, worked about 36 hours, 8 operations, 1 death, and greeted with a plea to cut my wages by 1/4 1993 dollars, I am less than enthusiastic. You seem to want to completely revamp society, an admirable goal, but unlikely to occur. Some of the things you post, I agree with, a living wage for example. I could debate the non-scheduled drug issue, and I have issues with big Pharma as well, and I am just too tired right now.

You contend that self-surgery would not affect a large portion of the population. However, the issue is not simply self surgery, the real issue to taking more control over your own health care. Surgery is the extreme, taking out your own appendix is ludicrous, but taking responsibility for your diabetes, heart disease etc is not. An interesting article I read today about the topic...
http://news.yahoo.com/s/nm/20060130/hl_nm/usa_dc

As for the compensation issue, pay in proportion to amount of time in the classroom? An interesting notion, which I do not agree with. Unrestrained capitalism leads to exploitation, the opposite, communism or socialism breeds resentment and does not foster an environment for greater achievement. Meritocracy must be part of the equation. Just my opinion.

Would I be a doctor if the pay was not good? If everyone else was earning about the same, and you took away the fear of lawsuits and the cost of education, yes. But that is not reality, if you cut my pay, as you suggest, you will be taking out your own gallbladder.

I will read your post again when I am less tired..........

bring logic and reason into this forum?:spank:

You're just part of the medical mafia.
:rofl:

Why, oh why did I come here...........

I'm not a big fan of doctors, I can count the number of good ones I've seen on one hand, not counting the thumb.

But I'm not stupid enough to think I can diagnose and treat anything other than allergies or muscle strains myself.

When I do visit a doc, I go armed with knowledge, I do my homework.

If I don't like what he/she says or does, and he won't listen to my concerns, I see someone else.

The biggest enemy of bad doctors are informed patients.

Not people pushing snake oil or telling us not to trust medical professionals.

The alties are trying to make a living too, by gaining customers through maligning science based medicine.

Good docs aren't scared of alternative medicine, all of the ones I've known weren't.

They're willing to discuss other options but intelligent enough to know the difference between anecdotes and evidence.

The first thing I tell patients is research the issue. Do not take my word for it, look it up on the internet, go to the library etc. An uninformed patient is more likely to have anger and resentment if something does not go ideally. Most of what I do is not rocket science, a few diagrams here and there and some data to back up why I do things is all that is needed. I spend a lot of time teaching patients the reasons behind medical practice. The doc that says 'just trust me, this is what you need' is an asshole.

I prefer to have patients say "Yes, that is true, I researched the topic and what you are saying is consistent with my research." Most people research buying a car more than they research a medical decision.

As for not being a big fan of docs, I would have to agree. Most are republican...........:evilgrin:

The first doctor I saw after moving here was a twitchy homophobe with four ex-wives.

When he found out I moved here from Vermont, he automatically assumed that I left my home state because of civil unions.(I find most bigots assume everyone else thinks like they do)

He launched into a long winded diatribe about homosexuals and how he didn't have anything against them as long as they didn't adopt kids. (you gotta love that qualifier they all use: "as long as..." )

When I was through telling him to pull his head out of his ass, among other things, he asked me if I was a lesbian.

:wow:

I told him it was the first time I can remember ever wishing I was. :mad:

abortions, not to the ditziness of Botox parties, but underground procedures nonetheless as women will refuse to return to back alleys.

was finally passed. There's gonna be one hell of an underground womens movement for assisted early abortions if they overturn it.

Home surgery is certainly not in the best interest of the patient, however, with the confirmation of Alito it is only a matter of time before Roe is dead, as death awaits thousands of scared, desperate young women seeking an abortion at the hands of questionably trained individuals.

I agree with the tenor of your post, I hope an underground movement does occur with trained professionals offering illegal abortions to those in need. Fuck Alito and GWB, taking society back into the dark ages..........

and the procedure is called a "menstrual extraction," and is best performed within 1-2 days on either side of an expected menstrual period, although it can be done as much as a week or so after the due date.

I remember reading about these groups about 5 years ago, so I hope they're ongoing. They may be needed.

And I'll join one again.

We have to, we can't go back.

people should not be surprised - to see people interested in what they can do for themselves.

The choice might be a "do it yourself" or it doesn't get done.

Some people might think that removing a splinter with a sterilized needle is "surgery" that people should go to the DR. for. I would think that is crazy.


I was watching the Travel Channel where the "Shaman" was doing circumcisions on boys. Supposedly he is the only one who knows how. (Seems like they need a back-up person - what will happen when he is gone?). He made "knives" out of bamboo. Kind of makes you think about what people have always done for themselves - without ever going to a hospital.

Around here there has been much debate about midwives. Should they be licensed or should they be prosecuted?


I expect there is more people could do themselves. If people can do it for themselves - I don't know that it should necessarily be "outlawed". On the other hand - if the insurance companies decided that people could do it themselves or for far less than the hospitals do - (home births might be more like $1500 instead of $20,000) they might DEMAND that people go the cheap route. That sort of happened with hospital stays after births. For awhile - it was seen a choice to go home fairly soon after a birth - then it got to be a demand.

I got some cherry angiomas--oh I hate those buggers. My dad used to have them and they drove me bonkers. So when I asked the dermatologist, oh those won't hurt you. Those are COSMETIC. You guys know what that means. No insurance!!! So when insurance doesn't cover do you know what it costs? Ok, Dad was also a doctor and he pierced my ears at home using ice...................I'm tough.

So, from Ebay for under five bucks I order a soldering iron (seriously!!). Then I dip it in some boiling water for a while, brace myself, and zap zap zap.

HOME SURGERY!! Now the mods will probably deep six this thread.

Now there is a limit to what I can do, but for less than ten bucks I probably accomplished what it would have taken a dermatologist sans insurance funds about a thousand bucks to do. All it took was an Ebay bid. This is not medical advice but merely an anecdote.

By the way, do you know that home births have the same complication rate as hospital births? I would have to look for a reference for that but so help me there is one!! I saw it.