The next "one level up" might explore how much is because the community is quite morbid and unwell, because modern culture has displaced traditional home/self care with consumerized services, or because of other things.
There are people I know who are largely healthy and who consult paid medical services many times per year for everyday disturbances, and others who take decades to overcome procrastination to even get a physical. The demand for commercialized health services is very much a cultural thing, especially for everyday wellness, and that culture has been evolving quite dramatically.
Meanwhile, there's no ignoring that obesity and sedentary living are rampant, that a recent pandemic spooked people about infectious disease and its possible consequences, etc.
You're thinking about the pocketbook economics, here, but looking at it through these other lenses might provide further perspective too.
Not sure what you mean by this? If I have a broken bone, I'm not going to set it myself at home and take a few aspirin. Same if I'm puking my guts out.
If you just mean getting exercise and eating healthy then I fully agree with you. But, when you're actually sick, and need to see a professional, that is the right time for "consumerized services".
You're welcome to take it as foolish pre-modern ignorance if it strikes you that way, but actually yes: many people do not think to go to a doctor for minor bone injuries or vomiting, and many more than that wouldn't think to do so for more common everyday illnesses like a familiar sore throat, rash, nosebleed, fever, etc
For some, this is rooted in a confidence in their own personal-community care, for others its an insight into what few actions a doctor might take themselves for these issues, etc
There's lots of ways to explain it, and certainly many of them can be easily criticized by people who see professionalized medicine differently, but you may as well let go of the idea that everybody out there approaches it in the same way that you do. It's probably not even all that consistent among your own circle of family, friends, and acquaintences.
We're still only in the beginning of what seems to be a sweeping cultural transformation around how people see health and medicine and the perspectives people bring are still quite diverse.
At the same time, the overall direction in recent decades is definitely towards seeking commercial medical care for more concerns as well asserting that this is an entitlement that all people should have access to.
I haven’t heard of some of this and it raises a whole lot of questions. Can you tell us more? What is a “minor bone injury?” What sort of alternative healthcare do they use instead to treat it?
Maybe give us an example of some people who do this?
Well, to make an example that doesn't stretch into ethnic traditions and stays within the contemporary and modern experience that you and I probably share:
Consider two non-professional runners who develop a stress fracture. It's a fairly common injury for distance runners who push themselves too far. It presents as a certain kind of pain and that pain becomes aggravated under certain conditions. It's generally easy to self-diagnosis, and more serious fractures are generally evident because they're far more disabling and intensely painful.
One goes to a doctor, who quickly has a strong guess as to the problem. Nonetheless, they send the runner for an x-ray to confirm, then take another appointment to review the results and prescribe a treatment. That treatment will amount to rest and patience, and (with some doctors) some prescription for the pain. Total cost billed to someone is probably on the order of $1000.
The other is pretty confident in their self-diagnosis and can't fathom the time demands, financial cost, and social resource consumption of bringing in a industrial apparatus just to confirm that diagnosis and be told to take it easy on their affected leg for a few months.
Both examples play out everyday, and there's essentially no difference in health outcome for the vastly most common case. It's true that the latter is at higher risk of missing a more serious complication, but it's also true that the former invites costs, consequences, and risks of their own.
I kicked a table and am 90% sure I broke my pinky toe which turned black and doubled in size. I didn’t go to doctor because I knew they wouldn’t do anything. A month later it’s back to normal.
A friend did the same but got a doctor scan; they confirmed it was broke but did nothing else.
So, I don't agree with GP, but my grandmothers (on both side of the family weirdly) had IV bags for the longest time for when people were 'puking their guts out'. I even was the lucky recipient of one when I came back _extremely_ hangover from a party at ~19yo. Both had nurse training (one because she was one, the other because she was trained by the church to work at a mission before she met my grandfather)
I suppose I’m guilty of the demand for immediate care too. Not because I go to the doctor immediately after I get a symptom, but because I try to get better on my own until I reach a point where I think I need help, and at that point, I no longer want to wait.
I cannot just schedule an appointment for 3 days ahead because “late” cancellation costs $$ too.
It's a shame that we have not preserved more local, "community medicine" that you mention. Unfortunately, the reason is that we have destroyed the community by moving to a model where advanced technology is our primary aid instead of other human beings.
The next "one level up" might explore how much is because the community is quite morbid and unwell, because modern culture has displaced traditional home/self care with consumerized services, or because of other things.
There are people I know who are largely healthy and who consult paid medical services many times per year for everyday disturbances, and others who take decades to overcome procrastination to even get a physical. The demand for commercialized health services is very much a cultural thing, especially for everyday wellness, and that culture has been evolving quite dramatically.
Meanwhile, there's no ignoring that obesity and sedentary living are rampant, that a recent pandemic spooked people about infectious disease and its possible consequences, etc.
You're thinking about the pocketbook economics, here, but looking at it through these other lenses might provide further perspective too.