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I am curious what some of you think. I do not think that is the case.
I have experience with this, at least how things have gone.
I lived in LA and had to go to Cedars Sinai for appendicitis; the health care and doctors and nurses were all A+.
I had great doctors when I lived in LA....but I have great ones here, too.
My spine surgeon I saw today just got back from teaching a seminar in Rockefeller Center. Obviously he is an excellent physician. Very impressed, without any of this I would still grade him A+. The guy is like 35 years old. I would grade my GP, skin doctor, and one or two others A or A+ as well. (I don't see skin doc or specialists often, but when I do) Nothing below excellent. Not exaggerating, I love all of my doctors. If there's ever a problem they're right there and will call me at the end of the day.
I do not think the stereotype is true that you need a big big city to access excellent health care.
Knoxville is a solid medium-sized city. But not a big city.
Basically, I believe that the best hospitals tend to be in large cities, and the best specialists tend to be near those hospitals. Google "medicare 5-star hospitals" for a list. A short answer is:
1. . . . for complicated care and for cancer care you should be near a large city, where the latest technology and know-how are available.
2. . . . if you want to be in a competent hospital within 1/2 hr (or so) of the onset of a heart attack, you should be near a large city
3. . . . if you want to be in a top-rated stroke center within 1 hr (or so) of the onset of a stroke, you should be near a large city
But if you want routine care, you could probably be anywhere. There are plenty of community hospitals with wonderful people for that purpose. Of course, there are exceptions to all these statements, so there's no need to flood me with anecdotes that illustrate those exceptions, but in the main I believe the above is true.
Basically, I believe that the best hospitals tend to be in large cities, and the best specialists tend to be near those hospitals. Google "medicare 5-star hospitals" for a list. A short answer is:
1. . . . for complicated care and for cancer care you should be near a large city, where the latest technology and know-how are available.
2. . . . if you want to be in a competent hospital within 1/2 hr (or so) of the onset of a heart attack, you should be near a large city
3. . . . if you want to be in a top-rated stroke center within 1 hr (or so) of the onset of a stroke, you should be near a large city
But if you want routine care, you could probably be anywhere. There are plenty of community hospitals with wonderful people for that purpose. Of course, there are exceptions to all these statements, so there's no need to flood me with anecdotes that illustrate those exceptions, but in the main I believe the above is true.
This is true, regarding emergency hospitals, specialized hospitals, and such. Rural areas just aren't able to offer that level of ER care or specialized surgical care, certainly not in all fields of surgery. And these days, so may small town hospitals are understaffed; you may get great care during regular daytime hours, but the evening and night shifts can involve waiting for hours, because there's only one ER doctor on staff.
Does one need a "top-rated" stroke center, when having a stroke, or an average-rated stroke center do? I've always heard, that the important thing with a stroke, is to get to the ER ASAP. Proximity matters. IDK about how high the ratings would have to be.
This is true, regarding emergency hospitals, specialized hospitals, and such. Rural areas just aren't able to offer that level of ER care or specialized surgical care, certainly not in all fields of surgery. And these days, so may small town hospitals are understaffed; you may get great care during regular daytime hours, but the evening and night shifts can involve waiting for hours, because there's only one ER doctor on staff.
Does one need a "top-rated" stroke center, when having a stroke, or an average-rated stroke center do? I've always heard, that the important thing with a stroke, is to get to the ER ASAP. Proximity matters. IDK about how high the ratings would have to be.
I wasn't talking about rural. Rural have hospitals that can easily handle the basics.
Just my own experience, there are excellent doctors, surgeons, and specialists here in Knoxville, and Knoxville isn't really a "big city". Pretty much all the worst in East TN gets sent to UT medical here.
Basically, I believe that the best hospitals tend to be in large cities, and the best specialists tend to be near those hospitals. Google "medicare 5-star hospitals" for a list. A short answer is:
1. . . . for complicated care and for cancer care you should be near a large city, where the latest technology and know-how are available.
2. . . . if you want to be in a competent hospital within 1/2 hr (or so) of the onset of a heart attack, you should be near a large city
3. . . . if you want to be in a top-rated stroke center within 1 hr (or so) of the onset of a stroke, you should be near a large city
.
Yes yours was a retirement thread. I agree with you. I'm so close to a good hospital I wouldn't call 911, I would rush the person there if able. I'm nowhere near retirement age, but I need a good ER nearby for peace of mind.
I am curious what some of you think. I do not think that is the case.
I do not think the stereotype is true that you need a big big city to access excellent health care.
Size counts because the comparable high quality medical schools associated with the best hospitals,
present in some smaller cities too, ... 'care' is much harder to manage without the business volume of the bigger cities.
An objective measure I was once told about is distance to a Level One Shock-Trauma Center. LINK
Wherever that is you should find everything else you need too.
Last edited by MrRational; 12-13-2021 at 01:51 PM..
I am curious what some of you think. I do not think that is the case.
I have experience with this, at least how things have gone.
I lived in LA and had to go to Cedars Sinai for appendicitis; the health care and doctors and nurses were all A+.
I had great doctors when I lived in LA....but I have great ones here, too.
My spine surgeon I saw today just got back from teaching a seminar in Rockefeller Center. Obviously he is an excellent physician. Very impressed, without any of this I would still grade him A+. The guy is like 35 years old. I would grade my GP, skin doctor, and one or two others A or A+ as well. (I don't see skin doc or specialists often, but when I do) Nothing below excellent. Not exaggerating, I love all of my doctors. If there's ever a problem they're right there and will call me at the end of the day.
I do not think the stereotype is true that you need a big big city to access excellent health care.
Knoxville is a solid medium-sized city. But not a big city.
I believe that medicine can be delivered anywhere, but the options in dense population areas make it more marketable resulting in the best medicine providers fighting for patients. Also, research programs nee patients, so they go to the larger hospitals in cities. But for the most part, you can get good care anywhere.
I believe that medicine can be delivered anywhere, but the options in dense population areas make it more marketable resulting in the best medicine providers fighting for patients. Also, research programs nee patients, so they go to the larger hospitals in cities. But for the most part, you can get good care anywhere.
True.
We have excellent care here in NE Mississippi. Part of the reason for that is, the hospital here serves a large area. 750 beds; $3B in revenue in a town of 36,000.
But medicine is compartmentalized. If I need an eye specialist for example, we have them here, but the best clinics are elsewhere. But open heart surgery, routine spinal surgery, joint replacement, and that sort of thing I don't feel I need some nationally ranked doctor. Most people, in fact, never do. And those who do are referred to some other facility - Jackson, Birmingham ... wherever.
I had successful heart surgery. The people were nice, the surgeon explained everything, the follow up and care was good as far as I could see, and I lived. Last year they did their 300th trans catheter aortic valve replacement. I am able to complete my 1-hour gym workout three times a week. What more could I ask for?
True.
We have excellent care here in NE Mississippi. Part of the reason for that is, the hospital here serves a large area. 750 beds; $3B in revenue in a town of 36,000.
But medicine is compartmentalized. If I need an eye specialist for example, we have them here, but the best clinics are elsewhere. But open heart surgery, routine spinal surgery, joint replacement, and that sort of thing I don't feel I need some nationally ranked doctor. Most people, in fact, never do. And those who do are referred to some other facility - Jackson, Birmingham ... wherever.
I had successful heart surgery. The people were nice, the surgeon explained everything, the follow up and care was good as far as I could see, and I lived. Last year they did their 300th trans catheter aortic valve replacement. I am able to complete my 1-hour gym workout three times a week. What more could I ask for?
Thanks for sharing. I'm stuck recovering from a back surgery the long way, ugh (complications). But my doctor I would rate A+. I have his cell phone number, I have texted him before when it was really bad. He got right back to me. Doctors let alone surgeons don't usually give their personal phone numbers out to patients.
I just was super impressed today when he saw I was wearing a NY shirt (spouse's) and he mentioned he was teaching a class at Rockefeller Center a week or two back. Yeah, that's a good doctor lol. From Knoxville, going to NYC to teach. You'd think it would be the other way around.
Basically, I believe that the best hospitals tend to be in large cities, and the best specialists tend to be near those hospitals. Google "medicare 5-star hospitals" for a list. A short answer is:
1. . . . for complicated care and for cancer care you should be near a large city, where the latest technology and know-how are available.
2. . . . if you want to be in a competent hospital within 1/2 hr (or so) of the onset of a heart attack, you should be near a large city
3. . . . if you want to be in a top-rated stroke center within 1 hr (or so) of the onset of a stroke, you should be near a large city
My brother had colon cancer, age 47ish at diagnosis. He died at age 49. Was going to Boston for his care.
My stepdad was diagnosed with it here about a year ago, Upstate of South Carolina. Age 64. He's finished his chemo, radiation and surgery and.. He flat out asked them.. They said he had about an 80% chance of being cancer free. Time will tell.
Treatments were almost polar opposites.
Brother was diagnosed after the tumor grew and blocked his colon. They went in and did the surgery to remove the tumor, then ran him through chemo. After about a year, it came back. They did a procedure where they opened him back up, removed what they could find, and poured chemo chemicals in him and let them stay in there for a while when he was on the table, then did chemo again. 3 months later, it was back, 8 months later, he was dead. No radiation was ever done.
Stepdad.. While things aren't settled here yet.. They diagnosed him and started him on chemo, followed by radiation. About 6 months later, they did surgery to remove the tumor. This was just last month. He had a few more complications. During the chemo, the tumor blocked his colon, so they did the 'disconnect' and he had a bag until the surgery to remove the tumor. They didn't want to remove it before he finished chemo/radiation to minimize the possibility of spread. He had several infections during his treatment and just got out of the hospital today because he had another infection and a very low potassium that caused an apparent seizure. But, his cancer markers are all at basic undetectable levels.
Were they the same cancers? Who knows. One could have been far worse than the other and my stepdad certainly isn't out of the woods yet. If he survives where my brother didn't.. If my brother had the same course of treatment, would it have changed his outcome? You can't really say.
Every case is unique. And there aren't really areas where doctors aren't familiar with cancer and up to date on the latest treatments. We're a wired world nowadays, after all. There may be some oddball cancers out there where there are specialists on them.. But I don't really think there are too many areas in the US now where you can't get specific treatments. Maybe some of the larger cities get more clinical trials, but..
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