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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by alexandra_k on November 6, 2018, at 15:30:32
so... most of the teaching the allied health people exposure i've had... it was all about the customer service. i mean, it was about seeing allied health professions not as professions with knowledge, but about seeing allied health professions as professions that are customer service focused. like... personal training. like... beautician. that kind of thing.
so... given that... it's pretty freaking surprising just how non customer focused allied health professionals are, in the wild.
i mean, from gym trainers who think their purpose in life is to boss people about in the gym to...
my latest is optometry.
i went in to book an appointment to see an optometrist for an eye exam... and i very nearly walked out. they sat me down and asked me a million questions (in front of a room full of people). i mean, no paper forms, they wanted me to speak the answer loudly and clearly (for the camera?). name, age, address, phone number... you know, all the 'security' information that Work and Income and other agencies ask you to speak into your phone when you want to know stuff like... tax information or pay information or... all that kind of security information, spoken with your very own voice...
it was starting to feel like a data collection exercise.
then i get a text reminder about my optometry appointment. i do not believe i asked for or authorised text reminder.
so i texted back that i cancel the appointment.
so today (the next day) i get a 'your text message was not sent' from my phone company.
they don't even seem to manage the *pretense* of optometry as being something where i get to consult with a clinician about the state of my eyes so i can make an informed decision about what (if anything) needs to be done.
it's just *other people* collecting up information. and then it is dubious that i will actually get access to any of that information (pretty sure i've never recieved a paper printout even of the results of an eye exam).
so they can reach into their santa sack of glasses and get me to try a pair on and 'better or worse or much the same'. i won't even ask how much the government chose to spend on having people walk around with end of supply chain glasses... we don't believe in astigmatism because it's 'normal'. yeah, it's totally normal for people to drive into motorcycles because they don't see them...
yeah.
Posted by alexandra_k on November 6, 2018, at 15:35:51
In reply to customer service, posted by alexandra_k on November 6, 2018, at 15:30:32
it is interesting that the UMAT study text says specifically that you should inform people about treatments that might help them, even when their insurance company (for example) is not funding the treatment for them.
i quite agree.
they may decide that the treatment is important enough to them for them to see about how to get the funds together. that is not a call you get to make on their behalf.
i really do not think that this would be considered the ethical stance, in this country, though. i am fairly sure (almost certain) that the sentiment would be that it would be cruel to inform people about things they cannot have.
they cannot have
they cannot have
that's what it is to be doctor - see? to make those calls.
say the people who got spat back out. sigh.
Posted by alexandra_k on November 6, 2018, at 15:53:36
In reply to Re: customer service, posted by alexandra_k on November 6, 2018, at 15:35:51
actually, i wonder if that is why American is renowned for having a particularly exhorbatant cost of health care.
when people decide 'I want everything that can possibly be done to be done', I mean.
i went to a talk and the guy was lamenting that people mostly chose for that to happen. even when he thought (in his expert opinion) that it was unnecessary.
interestingly (to my mind) he didn't say he thought it would do more harm than good. He didn't say that the best medical decision was to (for example) not have that scan because of the radiation from the scan that would likely do more harm than any good that would come from finding abnormality on the scan.
I guess he doesn't want people starting to resist hospitals and the like wanting to take multiple x-rays of their kids...
but he did say that people were of the opinion (often) that if their health insurance funded it: they wanted it.
it's not a very... sustainable... attitude. i quite agree.
i wonder how much the UK is differnet with respect to information. i mean, I wonder if they try and manage demand for services they don't want to provide by way of limiting people's knowledge about treatments / treatment options.
i know our government surely does that. it would be harder to do that in Europe... people travel to France and the like and they see what people have access to over there...
I will have to see about optometry at some point... It's about seeing whether I can make an appointment without handing over all my data. I really shouldn't need to have an appointment with admin first while I watch them feed it all into a 'health database' ... into my healthone file... So other people can know all that's wrong with me (but I won't be told because timely treatment is simply not an option for all those people in the control group). We must observe the natural history...
We have prominent academics arguing for no intervention (e.g., don't prescribe antibiotics because that's creating treatment resistent) and also don't do screening programs. I'm actually abvilane tabout screening programs. Mostly because we won't intervene to help people when people are bothered by signs and symptoms. When people want intervention in a timely fashion (e.g., to stop them goign blind) we will not intervene to help them. Instead.. We think it's a better idea to take bio samples from a bunch of people who have no signs or symptoms so we can find something wrong with them... At which point we pop them on a waiting list and they are likely to die from lack of treatment.
It is like 'only treat the involuntary'.
Yeah.
It's just bullies being bullies.
Sigh.
Posted by alexandra_k on November 6, 2018, at 18:36:41
In reply to Re: customer service, posted by alexandra_k on November 6, 2018, at 15:53:36
I do, of course, understand that these live-in STEP courses are... Refugee camps. For people who are not allowed to study wherever they came from. People whose own country would not allow them a sufficiently quiet environment in which they could focus for the work. People whose own country would not teach them the clinical (or other) skills to practice Medicine.
I also understand that your STEP one score it supposed to help you decide which specialities you will pursue matching to... To help give people some time to come to terms with whatever has been... Uh.... Previously alloted. I understand that people probably choose which Med school to go to on the basis of the STEP one score averages the school manages to produce...
The refugee thing is designed for people who are in danger of failing. In other words.. The jobs they are having trouble finding anyone to fill.
A lot of people train med and never practice. I guess because they don't match to anything...
I guess you try and and see what differnet countries will offer you.
NZ has made it clear as they possibly can to me that they would prefer me to live as a nameless slave babysitting everyone elses kid... Just giving it away... Whatever the bullies want whenever the bullies want... Keep the bullies eyes on me. So good for OTHER people. They see more value in that than in allowing me to be... Egalitarian we just are not. I don't think we ever will be.
I am cross about the technology thing, here.
I strongly suspect that obtaining a quiet testing centre is about paying additional for the 'practice test' and during that I can say to the people that I am concerned about noise. That's not... Bribery... Extortion... I can't think what else to call it... That's just the ... Uh... Processing fee. Yeah right.
Posted by alexandra_k on November 6, 2018, at 19:11:20
In reply to Re: customer service, posted by alexandra_k on November 6, 2018, at 18:36:41
I maybe shouldn't be too hard on the Consumer people. It is hard to know... On the one hand, this country has progressed to being the 'easiest country in the world in which to do business' not just because of the lack of laws protecting the people but also because of the presence of laws that prioritise corporate interests over the people. And this happened... Under their watch.
So... They haven't been doing a very good job of it. Worst job of it in the world, in fact. Couldn't have done a worse job of it.
On the other hand... Some of their information is good.
Confirms what I already suspected, a lot of the time. And some information that might enable better choices... Only... Now I am suspicious. Why should I trust them or their information?
One of the things was cleaning products. They tested some (some I never would buy) but anyway... They found that some actually leave things dirtier than they were to start with. That's what I suspected. It's a great way to sell things, you see. People put a little cleaning product on... Put a little more cleaning product on... Use the whole jar of cleaning product then go out to buy some more...
And of course it's not just cleaning products. It's... All the chemicals. Shampoos and conditioners and handsoaps... It's all just disposing of chemical wastes and selling products.
It's all probably just one corporation, really. Or a couple who decided to collude. Lots of... Temporary brands. You only see them and then when you go to buy next time a bunch have gone and there are a bunch of 'new' ones. And it's all just the same crap repackaged with a different smell of... Candy. Typically. So freshly washed hands smell like sticky lollies.
But, hey, it's not like the people wash their hands anyway - right?
It's becoming harder and harder to find actual stuff. Actual food. Actual cleaning supplies.
Things are progressively worse, here.
Posted by alexandra_k on November 6, 2018, at 19:21:09
In reply to Re: customer service, posted by alexandra_k on November 6, 2018, at 19:11:20
and the smartest, hardest working kids are supposed to get to do it -- right? each country is supposed to pick their smartest and hardest working kids and give them a shot at doing it. for the good of us all. that's the idea, right? so that a greater proportion of people have access to good medical care.
and some people aren't the smartest or the hardest working... but they can contribute money to the cause. and that money can be spent on things that do help the genuine cause so... if people want to buy the chance then even though the chance doesn't seem good... well... let them have a go. i do see the sense in that.
but corruption is when people don't let the smartest hardest working kids do it because they want to make their own kids or whoever look good. look better than they are. look like the best that this country could produce. corruption is when people want bully kids to do it because they think it'll be okay because they have control of the bully kids (only that won't always be true so i don't really understand why...)
it's really f*ck*ng tedious that i've been treated like a stupid child since returning here.
just let me f*ck*ng do it, already. i'm not learning to love this country any more the longer i spend here. i am only coming to despise it. it isn't fair that we only have 2 universities where i can do med because each country is supposed to look after their own with respect to making it possible for their hardest working and brightest to be able to earn government subsidised / government made feasible for people who aren't rich... places. Australia doesn't let us apply so there are only 2 universities. And they prioritise Australians over our own people. What a f*ck*ng joke.
The only reason why people are resistant to 'New Zealanders' catching on as a peoples or an ethnic group is because then instead of all the infighting squabbling we're currently preoccupied with... We might actually pull together against foreign corporations who have an interest in keeping us dumber and dumber and dumber than we already are...
Help. Somebody...
Control your bully people.
Posted by alexandra_k on November 6, 2018, at 19:25:40
In reply to Re: customer service, posted by alexandra_k on November 6, 2018, at 19:21:09
you see i'm not very trusting since they 'lost' my application to enrol... then they took longer than their standard time (longer than 6 weeks)... then they said they wouldn't let me start until May (that I had to throw away 2 months worth of work I did in good faith)... then when I posted my submitted documents (via track and trace) they started trying to pretend I needed to physically submit them in person and postal delivery wasn't good enough for that to count as being submitted...
this is the state of university.
apparently it's not corruption it's 'miscommunications' and the like.
yeah, right.
just give me my f*ck*ng degree, already.
Posted by alexandra_k on November 6, 2018, at 20:45:37
In reply to Re: customer service, posted by alexandra_k on November 6, 2018, at 19:25:40
even swimming...
people complain that they get sick of swimming, because they get sick of following the black line.
i don't get to follow the black line very much. partly, because it is hard to follow the black line. mostly, because as soon as someone sees a lane with a breaststroker they want to dangle their feet around the turning target for a while (to try and make you stick left) and then lane share so you need to alter your kick or stop whenever you touch them and be all like 'ooooooooooh i'm soooooooooo sorry. is it okay with you if i swim? i mean, really, are you sure? you sure you wouldn't prefer it if i did something else? oh, you want me to swim your stroke at your pace. huh'.
that'll make the aquajoggers (who do it for years and years and years with no appreciable progress) feel better about their yak yak yak yak yak exercise plan.
for reals.
Posted by alexandra_k on November 6, 2018, at 20:55:26
In reply to Re: customer service, posted by alexandra_k on November 6, 2018, at 20:45:37
Oh.
So, I suspect it has to do with the end of supply chain medications, too.
Probably a lot of the cheap generic medication we have is stuff that was manufactured under trade mark... But the medication has fallen out of fashion for, uh, scientific reasons. So it gets repackaged as generic and shipped off here, because there isn't the demand for it, that there was predicted to be, or whatever, from the developed world.
For example, those bone growing medications. Where the problem was that they cause bone to grow indiscriminately and without functional strength. So you end up with bony deformation and still with people having fractures. Bone density scanning is something that they like to do, in these parts, and prescribe that bone growing medication.
And thus the exercise prescription is for aquajogging.
Maybe a little cycling (at very low intensity).
I guess they don't want people to do anything that might actually improve functional bone mass... Even functional bone strength (e.g., like swimming with intensity will actually do).
And they probably don't want these people seeing hip mobility. Hip mobility progressions and theh like...
Take your med.
Be an experimental subject for whatever implant device the device reps send to do the operation...Tis a nasty business...
Posted by sigismund on November 26, 2018, at 18:35:53
In reply to customer service, posted by alexandra_k on November 6, 2018, at 15:30:32
Dunno why, but the idea of service died as that of customer came in.
We know your time is valuable. Your call has been placed in a queue. Your call may be recorded for quality and training purposes. If you would not like your call to be recorded, please press 2. Otherwise a consultant will be with you shortly.
>so they can reach into their santa sack of glasses and get me to try a pair on and 'better or worse or much the same'. i won't even ask how much the government chose to spend on having people walk around with end of supply chain glasses
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Posted by alexandra_k on November 26, 2018, at 22:17:04
In reply to Re: customer service, posted by sigismund on November 26, 2018, at 18:35:53
I've been meaning to change banks for a while. Mine is awful to me, honestly. I don't see why. I have a steady stream of money going in... And out... Whatever... It's no skin off their nose...
There was a time when I was upset about how Work and Income treats people, here, because banks have security but (I said) my bank didn't treat me half as bad as Work and Income did. Just talking to you like you are garbage. Trying to bar you at the door. Bully you about. Only... Now it is like they have decided to prove me wrong in that and the standard of my banks service has dropped immensely.
You enter in and... Once they have assertained you are a student they proceed to treat you as thought you are absolute garbage.
Privacy is one aspect. That is THE aspect when it comes to here, I think. Whether you are offered a (at least partial illusion of) privacy in a consulation with a person who works in the bank... Or whether you are asked personal information out there on the floor with however many random strangers wofting about within earshot (probably mostly employees).
If I say anything about this... About the unprofessionalism... About... Would they speak to me like that or expect me to be forthcoming about that information in a public space... If I was applying for a mortgage? Or if I was wanting to speak with someone about longer term investment options...
The standard sort of response is 'we think you are being confrontational and we are thinking of calling security to have you removed'.
Just... Wow.
Yeah.
Things really are that bad, here.
I got through part of an interview (to borrow a small sum of money because a reimbursement that was meant to come back to me took longer to process than expected and short notice flights were considerably more expensive...)
And realised...
They are modifying standard personal loan contracts / overdraft facilities for students. They are loaning up to $2,000 to 18 year olds fresh out of High School when they aren't receiving enough of a government benefit (or enough of a government loan) to be able to afford their power bill or eat properly...
They are allowing them to borrow for their personal living expenses because they are students and 'it's only temporary' -- right? Then, when they aren't students anymore the standard overdraft / loan interest rates kick in...
They are setting people up to be forever slaves to the bank.
When they come out with massive student loans to the government also.
When they come out with degrees that won't get them employment, most likely. At least one year of frictional unemployment (I bet the way that works is enough frictional unemployment until you are desperate at which point they offer you... Whatever it is you are 'forced' to end up taking)
And this is a supposedly reputable lending agency.
Why would I want to leave my money in that bank when that's what they choose to do with their money?
It's just...
Awful.
You just gotta get away from the nasty, here.
Back to the whole... Criminalisation thing. Just mentioning that I want to be treated as a person and not garbage is grounds for people to threaten to call security.
How much longer will it take before people are imprisoned for the suggestion?
Things really are getting that bad, here.
Westpac New Zealand.
Australians teaching Kiwis to be second class citizens, again...
I was thinking...
When I was in the US I was there on an 'exchange' visa. But what did the US get out of Australia in exchange for taking me for a year and giving me teaching work (and pay) for a year? There were at least 2 students before me who also went from Australia... And what did the US get back from Australia in return?
The year I went was a year when the US economy really took a hit. I remember that they were talking about needing to lay off support staff... Permenent staff on the highest pay bands collectively agreed to take a pay cut so that support staff would not be required to be laid off.
That year... Was the last year they took a student from Australia. THe Department Chair said 'we are having trouble getting our students jobs in the job market after they finish up their PhD's. The US economy has taken a down-turn and the first to get hit is the Arts... US departments aren't hiring so much'.
This was a time when the Australian dollar overtook the Canadian. This was a time when Australia had a lot of post-doctoral fellowships (1 or 2 or 3 year post-PhD research positions).
This was a time when the US University sent a couple of their promising students out to Australia... And I remember specifically that the department was actually sociall pretty f*ck*ng mean to one of them (getting her really drunk and later on laughing at her for stupid sh*t she did -- when they could have made equal mockery of their own but chose not to). Just really f*ck*ng mean.
I see that now... They aren't taking students from Australia for a year anymore. But I see that they are offering a New Zealand undergraduate an entire funded scholarship to do a degree in anything they like. Just... Wow. That was my whole thing when I was there... I wanted to be doing cognitive neuroscience (well, the neuroanatomy that the med students do, really) and I wanted to be doing science (they wouldn't let me audit graduate science classes only arts classes)...
Maybe it's Australia that hasn't been doing so well with the fair trade thing...
Things are particularly oppressive, here.
This is the end of the thread.
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