51,000 dead of coronavirus

Page 7 - Seeking answers? Join the AnandTech community: where nearly half-a-million members share solutions and discuss the latest tech.

Jhhnn

IN MEMORIAM
Nov 11, 1999
62,365
14,681
136

amrnuke

Golden Member
Apr 24, 2019
1,181
1,772
136
Thanks for the detail on this. Is this for a private practice? I was talking about a hospital setting. I assume compensation is diffrent when you are contracted with a hospital. Specific to the alleged scheme I did not think doctors would benefit financially in that scenario. With no financial incentive It becomes way less then probable that this covid death inflation is going on. Same train of thought for the folks in the lab processing test results. The two being in cahoots seems even more unrealistic.
In general, you're either a hospital/system employee or private practice (or a private practice with a "foundation" agreement with a hospital system, etc, same thing). No matter the employment model, a physician is either paid a salary, is RVU based (you get paid on your work done regardless of collections), or is collections based (you get paid what insurance/patient gives you), or some mix, generally.

With respect to caring for COVID patients:
- If you're salaried, you see no pay difference no matter how many people you see. Seeing 10 COVID patients intubated and dying you will not see a dollar more unless they provide hazard pay or something which I've never heard of for physicians.
- If you're RVU based, you see more pay the more work/procedures you do, regardless of whether patient has good insurance, poor insurance, or no insurance. So if we have more COVID patients admitted you might see more money, but it's not like a COVID patient has some special quality that is a goldmine or anything. They're just sick people. Same thing happens every fall with the flu. The downside being that your outpatient procedures and office volume are way down during a pandemic so your pay drops, and not by a small amount. Most private practice folks are in the red right now even with the gov't assistance because they can't do elective procedures and patients don't want to come to clinic.
- If you're collections-based, you see more pay the more work-procedures you do, but get paid nothing for uninsured patients for instance. Same as for RVU based otherwise.

In general you would not get more money for taking care of COVID patients, instead of say an intubated flu patient or a critically ill cardiac patient - no matter how you're paid. In fact, during this pandemic anyone who gets paid based on work done / collections is seeing far less income.
 
May 13, 2009
12,333
612
126
To be fair, Germany's numbers are unusually good. It's not just the US they are doing better than, the contrast with, say, Belgium, is startling. When this is over, will be very interesting, even critical, to see why that is (assuming it's not a statistical artifact).

Even though the stats are really unreliable, and comparisons tough, it seems as if the US and UK and Belgium are doing particularly badly, and Germany and South Korea and Taiwan and Singapore have done relatively well. For all Sweden's "different approach" they don't seem to be doing much better than the major European countries, especially if you account for their demographic advantages over Italy or France, and are doing notably worse than other parts of Scandinavia with similar demographics. Germany is the real outlier.
Trump or anyone else can only do as much as the people will allow them to do. We are a country full of arrogant douchebags. Too tough or cool to social distance. Too ignorant to understand the greater good. Trump deserves a good bit of blame as well. Not saying he doesn't. But the American people deserve some too.
 
  • Haha
Reactions: brycejones

interchange

Diamond Member
Oct 10, 1999
8,022
2,872
136
In general, you're either a hospital/system employee or private practice (or a private practice with a "foundation" agreement with a hospital system, etc, same thing). No matter the employment model, a physician is either paid a salary, is RVU based (you get paid on your work done regardless of collections), or is collections based (you get paid what insurance/patient gives you), or some mix, generally.

With respect to caring for COVID patients:
- If you're salaried, you see no pay difference no matter how many people you see. Seeing 10 COVID patients intubated and dying you will not see a dollar more unless they provide hazard pay or something which I've never heard of for physicians.
- If you're RVU based, you see more pay the more work/procedures you do, regardless of whether patient has good insurance, poor insurance, or no insurance. So if we have more COVID patients admitted you might see more money, but it's not like a COVID patient has some special quality that is a goldmine or anything. They're just sick people. Same thing happens every fall with the flu. The downside being that your outpatient procedures and office volume are way down during a pandemic so your pay drops, and not by a small amount. Most private practice folks are in the red right now even with the gov't assistance because they can't do elective procedures and patients don't want to come to clinic.
- If you're collections-based, you see more pay the more work-procedures you do, but get paid nothing for uninsured patients for instance. Same as for RVU based otherwise.

In general you would not get more money for taking care of COVID patients, instead of say an intubated flu patient or a critically ill cardiac patient - no matter how you're paid. In fact, during this pandemic anyone who gets paid based on work done / collections is seeing far less income.

To be fair, the question would be for hospital systems and not physicians directly. It's one I don't know the answer to.

But the idea is ludicrous. To suppose that it's happening means falsifying medical records which are seen by dozens of people who would know better. And since nearly every chart is electronic, there really is no way to do that without modification being immediately apparent to anyone who looked at the record. So basically the only way would be to have every doctor, nurse, tech, respiratory therapist, etc. etc. wholesale in on the conspiracy. The idea that you could pull it off for one patient seems highly implausible to me, much less on any scale to matter for the argument at stake. And, as you point out, physicians would not get any of the financial take under their reimbursement model. Pretty much everyone else would be in the same boat. So you'd have to pay off quite a lot of people to even try to get away with it. I think whatever this possibly not even real increased revenue would be, you'd be very far in the red trying to profit by paying employees to commit fraud. I was hoping @Batmeat would have replied with some bounds on his assertion, also, because basic math could likely easily defeat it. Unless of course, they are making up the existence of patients altogether and finding someone to pay for said imaginary patient? Things get really funny if you try to work out how you could actually succeed in this conspiracy.

Another way of looking at this: medical fraud is real, and if you wanted to do it, there are far easier ways to succeed.
 

amrnuke

Golden Member
Apr 24, 2019
1,181
1,772
136
To be fair, the question would be for hospital systems and not physicians directly. It's one I don't know the answer to.

But the idea is ludicrous. To suppose that it's happening means falsifying medical records which are seen by dozens of people who would know better. And since nearly every chart is electronic, there really is no way to do that without modification being immediately apparent to anyone who looked at the record. So basically the only way would be to have every doctor, nurse, tech, respiratory therapist, etc. etc. wholesale in on the conspiracy. The idea that you could pull it off for one patient seems highly implausible to me, much less on any scale to matter for the argument at stake. And, as you point out, physicians would not get any of the financial take under their reimbursement model. Pretty much everyone else would be in the same boat. So you'd have to pay off quite a lot of people to even try to get away with it. I think whatever this possibly not even real increased revenue would be, you'd be very far in the red trying to profit by paying employees to commit fraud. I was hoping @Batmeat would have replied with some bounds on his assertion, also, because basic math could likely easily defeat it. Unless of course, they are making up the existence of patients altogether and finding someone to pay for said imaginary patient? Things get really funny if you try to work out how you could actually succeed in this conspiracy.

Another way of looking at this: medical fraud is real, and if you wanted to do it, there are far easier ways to succeed.
Exactly.

They are just making it up.
 

TheVrolok

Lifer
Dec 11, 2000
24,254
4,090
136
To be fair, the question would be for hospital systems and not physicians directly. It's one I don't know the answer to.

But the idea is ludicrous. To suppose that it's happening means falsifying medical records which are seen by dozens of people who would know better. And since nearly every chart is electronic, there really is no way to do that without modification being immediately apparent to anyone who looked at the record. So basically the only way would be to have every doctor, nurse, tech, respiratory therapist, etc. etc. wholesale in on the conspiracy. The idea that you could pull it off for one patient seems highly implausible to me, much less on any scale to matter for the argument at stake. And, as you point out, physicians would not get any of the financial take under their reimbursement model. Pretty much everyone else would be in the same boat. So you'd have to pay off quite a lot of people to even try to get away with it. I think whatever this possibly not even real increased revenue would be, you'd be very far in the red trying to profit by paying employees to commit fraud. I was hoping @Batmeat would have replied with some bounds on his assertion, also, because basic math could likely easily defeat it. Unless of course, they are making up the existence of patients altogether and finding someone to pay for said imaginary patient? Things get really funny if you try to work out how you could actually succeed in this conspiracy.

Another way of looking at this: medical fraud is real, and if you wanted to do it, there are far easier ways to succeed.

Absolutely.

Batmeat has demonstrated extensively that he's batshit (crazy).

No reason to take anything he says seriously moving forward.
 

ShookKnight

Senior member
Dec 12, 2019
646
658
96
And Obama was expected to be placed in prison for the 12,000 that died due to H1N1.

These same people will go after Trump, yes? Oh, that's right; Orange Man Good.
 
  • Like
Reactions: jman19

UNCjigga

Lifer
Dec 12, 2000
24,929
9,208
136

TheVrolok

Lifer
Dec 11, 2000
24,254
4,090
136
I have 3 ER docs in my family—LA, here in Durham and NY. All have told me that during the COVID surge, they saw declines in people coming in for “typical” ER stuff (traffic accidents, industrial/work accidents etc.) So keep in mind, that surge in deaths is even after being offset by declines in other causes too.
Our hospital has been a ghost town.
 

sportage

Lifer
Feb 1, 2008
11,492
3,161
136
I still believe the virus is more so killing older people, right? And again... exactly how old is Donald Trump? Just doing the math. ✌
 

amrnuke

Golden Member
Apr 24, 2019
1,181
1,772
136
Our hospital has been a ghost town.
One of the hospitals I was at was at 50% capacity. Then one weekend they had 6 COVID patients on vents and an entire unit filled with positive cases.

Another of the hospitals I work at was the same. They have now had 4 COVID deaths, an entire unit of positive cases, another unit of pending cases, and severe patients on the brink of death with pending results, happened over the course of about 3-4 days.

It's been a hell of a ride.
 
  • Like
Reactions: Lanyap

Lanyap

Elite Member
Dec 23, 2000
8,184
2,224
136
Our hospital has been a ghost town.


That’s really anecdotal. What are the demographics of your county, parish, providence? I live in a county that’s considered rural and the confirmed cases are in the 80’s with 3 deaths. I’m sure that our ERs are a ghost town.
 

fskimospy

Elite Member
Mar 10, 2006
85,581
50,768
136
One of the hospitals I was at was at 50% capacity. Then one weekend they had 6 COVID patients on vents and an entire unit filled with positive cases.

Another of the hospitals I work at was the same. They have now had 4 COVID deaths, an entire unit of positive cases, another unit of pending cases, and severe patients on the brink of death with pending results, happened over the course of about 3-4 days.

It's been a hell of a ride.
It seems that this virus is extremely contagious so that areas which see relatively few infections could be rapidly overwhelmed.
 

Jhhnn

IN MEMORIAM
Nov 11, 1999
62,365
14,681
136
Our hospital has been a ghost town.

Don't expect it to last. Covid-19 will be coming around everywhere rather shortly, I expect. Just the way it is. A whole shitpile of Americans will die. We're just giving the system some time to be ready to help everybody in danger of dying to avoid it. I just hope it works that way. Probably not, given our freedumb loving natures.

Trump is still trying to bullshit his way around that, offering false hope it won't be that way. He's had a lot of help from the usual right wing talking heads, too. Remember when i was totally contained? Now it's Chloroquinine, UV light, disinfectants & Blah, blah, blah. A mini campaign rally every day there on the TV. Great ratings. Meanwhile, he just uses it to amplify the usual corrosive right wing agenda, xenophobic bullshit & blame shifting away from his utter ineptitude. Throw in a crime against humanity in defunding WHO during a lethal global pandemic.
 

TheVrolok

Lifer
Dec 11, 2000
24,254
4,090
136
That’s really anecdotal. What are the demographics of your county, parish, providence? I live in a county that’s considered rural and the confirmed cases are in the 80’s with 3 deaths. I’m sure that our ERs are a ghost town.
Of course it is. I'm speaking to the point that the "regular stuff" is "staying out." We have over 160 cases in house, which is currently over half our census which is still remarkably low for us. The point is that even though the covid volume is pretty high, the volume for the everything else is so low that, overall, the census has been really really low. We usually have a hundred or so folks in the ED at a time, we've been averaging in the 30s-50s.
 
  • Like
Reactions: Lanyap

TheVrolok

Lifer
Dec 11, 2000
24,254
4,090
136
Don't expect it to last. Covid-19 will be coming around everywhere rather shortly, I expect. Just the way it is. A whole shitpile of Americans will die. We're just giving the system some time to be ready to help everybody in danger of dying to avoid it. I just hope it works that way. Probably not, given our freedumb loving natures.

Trump is still trying to bullshit his way around that, offering false hope it won't be that way. He's had a lot of help from the usual right wing talking heads, too. Remember when i was totally contained? Now it's Chloroquinine, UV light, disinfectants & Blah, blah, blah. A mini campaign rally every day there on the TV. Great ratings. Meanwhile, he just uses it to amplify the usual corrosive right wing agenda, xenophobic bullshit & blame shifting away from his utter ineptitude. Throw in a crime against humanity in defunding WHO during a lethal global pandemic.
We've, fortunately it seems, flattened the curve in our area. Our models predict peak by May 5th and that it shouldn't "over tax" our resources. Let's hope that's true. We've certainly been treating Covid for weeks, but we've been incredibly lucky compared to our not so distant neighbors in NYC.
 

esquared

Forum Director & Omnipotent Overlord
Forum Director
Oct 8, 2000
23,967
5,112
146
Just in from CNN interview.
Dr Chris Murray of University of Washington
just said that his newest model shows 74,000 deaths in the country.

This is an increase in his number from 10 days ago, based on changes that are being made as some states reopen, as well as the cases in some areas not dropping.
 

Mai72

Lifer
Sep 12, 2012
11,562
1,741
126
You have to wonder why our numbers are so low. Yes, I know this isn't over yet. But, in the beginning scientist were stating millions dead in the US alone. Fauci had stated hundreds of thousands dead by the end of April. Well, it looks like that isn't going to happen. My question is why haven't we seen a HUGE surge in fatalities? Was it due to social distancing, or did we overestimate this virus? Was it worth putting our economy thru this? We are looking at a very nasty recession because of the lockdown. Just curious to what other people think about this.
 

SmCaudata

Senior member
Oct 8, 2006
969
1,532
136
You have to wonder why our numbers are so low. Yes, I know this isn't over yet. But, in the beginning scientist were stating millions dead in the US alone. Fauci had stated hundreds of thousands dead by the end of April. Well, it looks like that isn't going to happen. My question is why haven't we seen a HUGE surge in fatalities? Was it due to social distancing, or did we overestimate this virus? Was it worth putting our economy thru this? We are looking at a very nasty recession because of the lockdown. Just curious to what other people think about this.
Well the initial numbers were 100k - 200k before all the social distancing. We saw how hard it was hitting Europe (Italy and Spain). This report triggered a lot of the distancing orders and many states were more aggressive than anyone expected. States with some low numbers shut down surprisingly fast. So in summary, we maybe overestimated, but the aggressive responses at the state level saved many lives.

Sent from my SM-G975U using Tapatalk
 

brycejones

Lifer
Oct 18, 2005
27,579
26,670
136
You have to wonder why our numbers are so low. Yes, I know this isn't over yet. But, in the beginning scientist were stating millions dead in the US alone. Fauci had stated hundreds of thousands dead by the end of April. Well, it looks like that isn't going to happen. My question is why haven't we seen a HUGE surge in fatalities? Was it due to social distancing, or did we overestimate this virus? Was it worth putting our economy thru this? We are looking at a very nasty recession because of the lockdown. Just curious to what other people think about this.
If we did nothing we would have seen those numbers. Our lower numbers are the result of the measures we've taken.