When I first started my internal medicine rotation at the latter end of med school, I was quietly scandalized by how many diagnoses I caught that other doctors missed. These weren’t clever diagnoses to be proud of - given time and careful thought, the worst med student in the country could have done the same. I caught one diagnosis that had been missed by three other EDs in the past week, and just required asking the patient two questions beyond their chief complaint.

The doctors I was working under weren’t bad. They were, however, forced to run ragged all day without a break for a shit, allowed no more than a few minutes per patient. They didn’t like it any: they’d openly say “don’t emulate this,” while running to the next room.

The funny thing is, surgeries and pharmaceuticals and medical equipment are expensive. A doctor’s time? If he’s not a top renowned specialist, not much. But people have gotten so used to insurers playing the middleman retailer (buying healthcare services cheaply and reselling them to patients at a premium...), they’ve forgotten they can just -pay for the doctors time-.

It doesn’t require playing amateur medical sleuth. It just requires admitting that a highly skilled worker that had to train for a decade to do the job costs more than 20$.