30 Days of US Healthcare: Ortho peer to peer

Day 8. Thanks for watching!
Here is the 30 Days of US Healthcare playlist: • 30 Days of US Healthcare
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[@josecordova32]

Ortho bro being upset is a first.... breaks my heart!

[@lennierofthethirdfaneofchu7286]

He's upset because his patient is being harmed.

[@namantherockstar]

Glau inspires me.. My parents said if i get 50K followers They'd buy me a professional camera for recording..begging u guys , literally Begging...

[@LexYeen]

​@@lennierofthethirdfaneofchu7286He took an oath to not do that, and here insurance bro is _forcing_ him to do that. No wonder he's upset.

[@jimwormmaster]

There was the one where he said the admin wasn't admin bro, just admin...that one cut deep.

[@captainmalin3541]

You’re standing up for your patients. You Win Ortho Bro!

[@LexYeen]

Thanks for helping me get my blood pressure up to operational levels this morning, Dr. G.

[@HisameArtwork]

ikr. we lived 5 years in USA so glad to be out, but here in romania we copied so much american bullshit. ideally we'd be normal europeans like the dutch and sweeds or at least at french and german levels of normalcy...instead we're at greece and italy levels sigh... at least we're not hungary or uk. it can always be worse.

[@crains8087]

this

[@souldancersbyjennifer]

🤣🤣🤣

[@Richdragon4]

​@@HisameArtworkHungary has no future. It has history though. A lot of it.

[@DrEsky914]

I know UK gets a lot of flak but they cured my uncle (a farmer with minimal income) from skin cancer 5 years ago, treated his subsequent DVT, treated his parkinsons with excellent equipment including motorized wheel chair and provided round the clock assistance to his wife in his last days of life so he could STAY AT HOME!! at no cost to the family. (I never see that in the US). And this was just this past spring so not long ago.

[@oneminuteofmyday]

The orthopedic surgeon I went to told me straight up: “I have to send you to physical therapy before I can treat you with what you actually need. Physical therapy isn’t going to help, but insurance insists on paying for that first before they will pay for what will actually help you. They _love_ to pay for physical therapy.”

[@NigelTolley]

Just weird. I'm also certain that a torn tendon heals better if fixed now, and not after another 6 weeks of pain and (mis)healing.

[@ankavoskuilen1725]

That is very strange. I thought they didn't want to pay for treatments ever. Now they pay twice. First the treatment that doesn't work, then the treatment that will work. Seems like a waist of money to me.

[@LeadTrumpet1]

@@ankavoskuilen1725It’s mostly a tactic to get patients and doctors to give up trying.

[@kaspianepps7946]

@@ankavoskuilen1725 I think the idea is that some people will end up not getting the surgery because they can't afford the part they have to pay for on top of what they paid for the failed treatment.

[@ser0992]

​​@@kaspianepps7946 It could also be that for some people for whom would be prescribed surgery physical therapy is just enough, so, on a large scale, they save money by paying for less surgery (more costly) but more P.T. (less costly). Then again that could imply malpractice by lots of doctors, as they didn't prescribe the right treatment, soo ¯⁠\⁠(⁠°⁠_⁠o⁠)⁠/⁠¯ Anyway I think there is a good financial reason (not ethical, cause who cares about that when money), else they would have already stopped.

[@CanyonALynn]

If ortho bro is mad about this, I can't wait to see the absolute takedown neurology is going to give to UHC. 😂

[@DGlaucomflecken]

Coming up in about a week 😂

[@CanyonALynn]

@DGlaucomflecken Oh I can't wait to see them get demolished! Thanks, Dr. Glaucomflecken! 🍿🫡

[@webbowser8834]

@@DGlaucomflecken Great, now I'm giddy with anticipation. Does United Health Care cover giddyness-induced hyperventilation?

[@viniciuslima9430]

@@DGlaucomfleckenthanks doc…now my anxiety kicks in 😂😂😂😂😂

[@samisososo]

I want this like I want *air*

[@wziqian]

The high dose Ancef almost got him 🤣, but ortho bro stayed strong 💪💪🔨

[@Xandros999]

Not falling for that this time!

[@MurseSamson]

He was soooo close!! 🤣 🤌🫰🫰 📏

[@nicolesanchez4954]

Hi dose ancef made me 😂😂😂

[@RadPuppies]

United Healthcare called us the other day, wanting to know if we would consider offering their employee health plans, and because of your videos, I turned them down flat. The VA provides better health care coverage than them.

[@stephaniehowe0973]

That is sad. The VA isn't that great

[@xxMurmaiderxx]

God damn, I can’t stand when we get VA orders

[@huasohvac]

Those that don't know the VA is so bad guys have killed themselves in their parking lots and gone unnoticed for days. Even their option for a civilian doctor sucks as the one I got said he couldn't help me.

[@shawnycoffman]

And that is absolutely saying something.

[@YM-co1iy]

Holy shit. It's a real company?? I figured he just used a generic name. 😲

[@Megan-bo7oe]

My stepmom was required to do 6 weeks of PT before they would approve an MRI for severe neck pain. The PT didnt help, so they finally ordered an MRI. Turns out she had a very rare cancer, sinonasal undifferentiated carcinoma, that had spread to her spine and liver. She passed away 5 months later. She was only 51 years old. Had they done an MRI initially, they would have caught it earlier and maybe she would have had a different outcome. Still makes me so angry

[@souldancersbyjennifer]

Horrid horrid people... I wonder if any of them could sleep at night or answer to their conscience... Let's see how things are like when they're on their death beds... Or just hospital beds themselves...

[@vsrump]

I was so sorry to read your post -it’s unconscionable - AND insurance co shareholders are to blame . They are raking in $$$$$ while allowing patients like your step Mom to suffer … maybe we can start taking them to court ?

[@amandamiller6995]

My deepest condolences on your loss. Nothing can bring back the precious time that you could have spent together with each other. AND I'm sure you miss her every day even now. In science and medicine, we are taught to look for the horses, not the zebras. So, it's the most usual diagnosis which is typically coming to our minds at first. However, your post proves that it cannot be ruled out that it's required that all patients must be evaluated carefully before a complete diagnosis is rendered. Even if the furthest probability is unlikely. Word to the wise.

[@WakeupAmerica777]

@@souldancersbyjenniferThe CEO’s and all of the people at the top I’m sure sleep like babies. The rest of us who take the calls daily can’t sleep and want desperately to get everything approved because we have a soul.

[@TheWhanos]

@@souldancersbyjennifer bold of you to assume they have ever had a conscience

[@spideyphd]

I have a buddy who is a recent graduate from Physical Therapy school. Lots of growing pains. I remember how baffled and frustrated he was about the percentage of patients which were there just to prove that physical therapy was ineffective.

[@rlight7334]

And they end up spending so much more money in the end by treating worsened conditions! The bean counters only know how to looks at monthly costs, or some narrowly focused costs, vs overall costs.

[@Oksanallex]

​@@rlight7334I don't think they would do that if they really lost money on this. They definitely get something out of it, we just don't know what.

[@adamcarman5330]

Yeah it sucks. PT works great for many people but there are clear cases where people NEED surgery. Now most PTs worth their salt will turn it into a prehab opportunity to set the patient up for better/quicker rehab after surgery is successful

[@LexYeen]

​@@adamcarman5330I'm damn lucky the PT I saw before my scoliosis surgery was a sure thing treated me like that. Ain't no way a 50+ degree curve that folded my right shoulder inward was gonna be solved by physical therapy and a brace, and he knew that from taking one look at me.

[@benjaminbaumgardner7620]

Yea it pisses us off. And sometime we actually can help but the doc set them up for failure by giving negative expectations

[@TR-wm3sg]

Oh my gosh, this whole series is just brutal. Laughing and sobbing at the same time.

[@LinusBerglund]

As someone from a more civilized country the previous ambulance clip was an eye opener. I knew it was bad over there of course, but that is really a next level disregard for your fellow humans. But then again, if you are still thinking about whether you can afford emergency care maybe you aren't sick enough. In any event, it is a great way to make sure poor people wait longer before calling an ambulance.

[@anonnymousperson]

unfortunately I'm just left sobbing, and I don't even live in the US.

[@nancylindsay4255]

@@anonnymousperson Thank you for your sympathy.

[@matttrump9455]

I’m surprised he can actually get someone on the phone. I’m waiting for the video address the endless automated system loop that connects you to different people who each transfers you to a different department. All in an effort to get you to give up.

[@jamesburton1050]

Agreed!!

[@katiekeaton9063]

Dr G know how to avoid that. Angry secretaries who get to humans BEFORE handing the phone to the doc. (Me, I’m the angry secretary. I also did the with that got denied, probably)

[@SeeToTheLemson]

Outpatient PT here. You left out the best part! The patient only gets so many visits per year for PT. If (read: when) the patient is forced to do conservative PT FOR A COMPLETELY TORN LIGAMENT, they do not receive additional approved visits for their post-op therapy that will actually be medically relevant and necessary. They get boned on both ends. Pun, and crippling medical debt, intended!

[@veverich222]

As an occupational therapist, I can confirm that the last patient I ever want to see is someone who actually needs surgery (or even just a freaking MRI) but has to do their mandatory 6 weeks.

[@Madamchief]

MRI?! Too expensive! Try an X-ray 😂👍 hahahaha

[@iyaayas]

Have you considered faking it or would that be considered insurance fraud/medical malpractice? Or somebody reporting you for faking it?

[@vickiepatterson1748]

You really don't want to "fake it" or do anything they would consider insurance fraud! Receiving the wrath of an insurance company is worse than 100 denials or alternate treatments. They can fine you, imprison you and make your life a living hell. And if you ever got insurance coverage again, it would be the highest premium you ever saw and you would have to jump through hoops just to have a simple procedure. Insurance companies take insurance fraud very serious.

[@veverich222]

@@MadamchiefYes! X-ray then therapy then MRI to confirm the need for surgery and then return to therapy for rehab. The circle of life!

[@BigbyOShaunessy]

I’m wondering whether patients just set up six appointments and no-show just to avoid the PITA of travelling for nothing? Sure, it’s fraud. But so is United Healthcare. So it’s even.

[@mamabear3327]

I had uterine cancer and my doctor told me that my insurance wouldn't approve the surgery to remove it unless I tried chemo first. I had to call my insurance and force them to approve the surgery by telling them that without surgery to stop it before it spread they were risking a much more expensive treatment plan later on because of genetic inclinations for chemo to cause worse cancers to develop in my family.

[@r.harishkarthick8671]

Well the primary treatment is upfront surgery

[@LexYeen]

"look assholes, either way you're paying, your choice is how much you want to gamble on the price." 😂 Sucks you had to take that tactic to get your healthcare paid for, but good job making them cough up the cash all the same.

[@rlight7334]

I’m actually surprised that worked, based on working with insurance companies.

[@scotts918]

Pay X amount now, or pay XXXX amount later, your choice...

[@raphaelledesma9393]

I mean… if I recall correctly surgery works out cheaper in the long run especially when combined with some chemo depending on stage. Scenario 1: Chemo alone will take multiple sessions with an increased chance of recurrence and EVEN MORE CHEMO Scenario 2: Surgery alone does risk recurrence of cancer but if low stage enough can be curative. Scenario 3: Surgery with chemo has lower risk of recurrence which means less chance of the company paying for more chemo in future. The option that actually cures it is cheaper in the long run unless it’s Stage 4 and incurable.

[@partyjams]

you know you messed up when ortho gets mad.

[@shadeofsound23]

"He has to fail something before we can try something that works." Can we just start saying it how it is? The insurance company is hoping you'll die before they pay out on your health insurance, and they're doing everything they can to make that sure that happens. Honestly, it should be treated as the attempted homicide that it is, and the very least should be combated with malpractice suits.

[@TheNinthGeneration1]

Exactly, their goal is denying as many claims as possible while collecting as much premium, deductible and copayments as they possibly can. They didn’t get into the insurance industry to be an insurance company.

[@michellebobier4471]

Sadly, I believe this is true. Back in the 80s I did volunteer work with people with AIDS; this was when AIDS was a death sentence. People got diagnosed, and six months later they were dead. The guys I worked with constantly got the runaround from their health insurance companies. They had to submit claims again and again and again. I finally decided that the insurance companies were just waiting them out, hoping they would die before they reached the end of the bureaucratic runaround. The whole thing is heartless and criminal.

[@safaiaryu12]

​@@michellebobier4471That is disgusting. I'm so sorry they had to deal with that, and you had to witness it repeatedly. How awful.

[@safaiaryu12]

Malpractice is a damn good idea. They're basically practicing medicine; they should be treated as such.

[@tjwortho]

Ortho bro irl here - This one hits different -lol. Love this series. Should be shown to every member of Congress.

[@riorio982]

I'm not a doctor or nurse (I'm a insurance auth specialist), but I usually pull out the "they've tried immobilization, icing, heat, no improvement", "Patient has significant interference with daily functions", or finally "I'll suggest to the patient to call you all directly to discuss this."

[@erinnorwood6124]

Thank you

[@vdinh143]

You're one of the good ones. We all gotta make money to live but we don't have to sell our souls for riches.

[@melissaroberts2299]

I’m an auth specialist also. I need to try this next time

[@MaryCumbersnatch]

I remember working MSK prior authorization. "According to the medical guidelines we use to review, the patient has to first fail a trial of conservative care such as PT, OT, chiro, NSAIDS, or acupuncture before surgery can be approved," was typically my go-to line. I did also explain how important it was for the prior authorization request's clinical notes to document why the patient couldn't tolerate conservative care, if that was the case.

[@clmagnet]

I love Ortho bro, he repaired both of my labrums and now, still years later, I have minimal pain and some if not most of my range of motion back in my shoulders. Let the real experts do their jobs!

[@CaTastrophy427]

Let's not forget that in some cases they don't treat anaphylaxis as a failure. If you're allergic to the entire family of drugs they want you to fail before trying a different drug family/treatment method, you might be hosed eternally. Source: friend with eczema, went through a clinical trial of a drug that worked, insurance wouldn't approve continuing it until he'd finished a trial of one of a few other meds, all of which he was allergic to, two had caused him to go to the ER with anaphylaxis, the other ones he either didn't try bc it's in the same family as the ones he abruptly stopped at the suggestion of the ER docs, or he'd tried a much lower dose of and still reacted badly to them, cementing the idea that he's not allergic to the specific drug but the whole family. So there's like 8 or 9 drugs across two families they want him to fail three or more of, he's counted as failing 0 of them despite having tried 5 and reacting badly to all 5, including two ER visits. He's paying out of pocket for the one drug that worked (since he'd been trying to find one that worked for now 9 years and never found one that did besides that one) while fighting insurance on this moronic policy.

[@BigbyOShaunessy]

I hope your friend prepared himself by taking the prescriptions in the ER.

[@alexanderelderhorst2107]

The drug killed you? Oh well at least it cured you... through death. Like shoving cheap peanuts down the throat of someone with an allergy to cure their hunger before trying the loaf of bread that's a couple bucks more expensive.

[@CaTastrophy427]

@@BigbyOShaunessy After the first in each family caused problems when tried at home, the smaller dosage tests of the related drugs were administered in-office, yes.

[@dkmd9227]

I called an insurance company a few years ago and asked to speak to the actual person who was adjudicating a claim for a peds trauma patient of mine… I was told there were no phones in the room where the adjudicator was located😂. She hung up on me when I offered to mail them a phone.

[@ChanceNP]

Was told I had to email a completed form vs. faxing it because the “fax machine is in the room next to us.”

[@TheFlutterer]

ortho was tempted by the ancef 😂😂

[@KittenTheB]

I'm with you bone-bro! Stand firm ✊

[@mattsoukup1789]

I'm just thrilled to hear such a specific and accurate ultimate frisbee setup for the injury, to be honest 😅

[@johnderewianka6989]

Scrolled through the comments looking for this.

[@bemusedalligator]

imagine running a vert stack when you could do literally anything else instead though...

[@benjaminbaumgardner7620]

Same! Playing men’s sections tomorrow

[@SomeDudeSomewhereOverThere]

Ortho's 3 year old "No" tantrum 😅

[@susantumanoff938]

This is the best one yet; been there, done that when I had endometriosis. Took years before they would approve my hysterectomy and I wasn't even having to deal United Health Care. I am a RN and UHC is considered a bad word at our hospital. Their Medicare plans suck people in with a couple of good benefits but they are the worst when it comes to covering large dollar health care.

[@ladymurasaki26]

There's a worse bad word now... OSCAR

[@waffles3629]

Ugh, my insurance denied a hysterectomy because I hadn't tried a medication....that I had tried after they finally approved it after two appeals. I got my hysterectomy. My doc was furious.

[@iloveamerica3917]

All managed Medicare plans suck major ass. United is the by far better than other companies managed Medicare plans. Humana MC is awful.

[@turtlrunr]

​@@ladymurasaki26 LoL 😅

[@safaiaryu12]

I am FINALLY at the stage where my doctors are considering a hysterectomy... the fight with my insurance is gonna freaking suck. I'm so excited to be done with the worst of the endometriosis but I'm sure they're gonna make it hell along the way.

[@nathanpetty560]

Great video, of course. But the patients really do suffer when physical therapy is "required" before surgery is approved (spinal ruptured disks come to mind) when there is no chance PT is going to help in any meaningful way. A friend of mine is going through months of needless agony because of these "policies".

[@LexYeen]

They expected my scoliotic spine to un-twist itself with a brace and physical therapy. UHC needs to _cease._

[@goliathcleric]

They also usually create worse health outcomes and more expensive surgeries. Typically, the sooner surgery is done for something like that the better the outcome.

[@DGlaucomflecken]

Fail first policy is a terrible thing

[@ada5851]

It's literally prescribed torture that just causes more damage

[@omnomzofchainsaws4278]

​@@ada5851my father is going through this right now, and he failed out of PT. But the PT didn't send the "correct" forms to send over to Ortho, so it's been an additional 2 weeks to get the right paperwork just to submit, and then an additional month waiting for approval while he can barely even move.

[@johnmccrossan9376]

Why doesn't ortho bro prescribe something like sitting in the surgery waiting room for half an hour then when ultimate Frisbee bro fails that ortho can operate

[@williamgibbs18]

I did 8 years in private practice as a prosthetist in NY. I have so many United Healthcare horror stories.

[@gagaplex]

That was actually one of the reasons I wanted to become an ortho/trauma surgeon for a while: They fix things. Mechanically. Stuff works afterwards. Very rewarding.

[@distalradius8146]

I agree, one of my surgeons referred to it as "The carpentry of medicine". He isn't wrong. He actually did very nice carpentry in his off time. Said it was nice to work on something inanimate without all the pressure. He also liked to say " Son, you just can't nail cottage cheese to the wall."

[@mixiearmadillo7452]

I could not love Ortho any harder

[@Debbie338]

This was spot-on for when I destroyed my ACL windsurfing. I hobbled around on NSAIDS and crutches until the PA for UF’s superstar ortho guy brought his dog in for a check-up and asked me what happened. I went into surgery less than a week later, and I thank that PA every single day of my life. It’s been twenty-five years and my ACL has never been better.

[@rachelsimon1437]

"I DON'T FAIL I WIN" what a baller

[@nab-rk4ob]

The marker mike is priceless. This is the first time I've seen Ortho Bro upset

[@MsMaureen1975]

I'm glad you're doing this, it's a great way to educate people about the horrendous state of our healthcare system. You always make me laugh, even these videos, but this series also makes me very sad.😞

[@Madamchief]

Unrelated to Ortho but still a horror story: LabCorp just bought out the clinical lab at my hospital and now ships all routine labs out of state so providers are ordering everything STAT for same-day results (which charges the patient extra)🤦‍♀️ when everything is stat nothing is stat

[@kimrespess6580]

It is a shame that you have to keep your guard up for things like you describe. I have found that it is better to use a lab of my own choosing based on my insurance. You have the right to insist on this arrangement.

[@jenniferwintz2514]

Several of my family members (my young adult children among them) lost health insurance and are using a local concierge medical office. Trained doctors and other staff, PHENOMENAL care, relatively low cost. They have an in house pharmacy and can dispense many common low cost meds in house. They perform many low cost labs in house. They have provided a level of care I haven't seen since my early rural childhood with an old country doctor. And a modern holistic approach. Such an eye opener. We deserve better.

[@falconerd343]

I've had a concierge Dr before. Definitely a fantastic experience. I wish they were more common!

[@jerrimartin6947]

I am an ortho nurse and had to attempt to ask for precert for these kind of surgeries. This definitely represents what goes on in getting insurance to pay for a patients surgery. Right on! This stuff would take hours of my time.

[@friendlyporkchop]

as someone who had an ACL replacement surgery earlier this year, this one hits hard. especially because a reinjury/retear of the ACL is more likely the longer you wait to get surgery after the initial injury. PLUS additional injury to the meniscus and surrounding ligaments (leading to arthritis down the line) is more likely the longer the surgery is put off. you can't just mess around for 6 weeks without it risking the long term health of the patient. justice for ultimate frisbee bro and everyone else caught in the nightmare that is the US healthcare system

[@MegaMech]

Does failing at walking it off count?

[@LexYeen]

Depends on which retired grade school coach UHC hired.

[@dimitri4457]

Starting the day by nearly throwing my phone across the room. Great start.

[@ftd888]

UH Agent: How about acupuncture therapy? He could fail that. Ortho: No. UH Agent: It’s all the rage these days. It can do amazing things. Ortho: No … wait, do you even cover acupuncture therapy? UH Agent: Hahahaha, of course not.

[@safaiaryu12]

That's what I was wondering...

[@milan1200]

Same here. “You need an mri so I’ll order an X-ray first.”

[@jenniferwintz2514]

So relatable. I worked 20 years for a major insurance company in various roles. I've heard ALL of this. 😵‍💫

[@longforgotten4823]

Time we as American taxpayers eliminate this threat to our survival. Time for universal healthcare for all.

[@lohphat]

Citizen's United blocks any reform. Congress is mostly bought and paid for by industry "donations". Their constituents are not their primary concern.

[@Nickwritespoetry]

Damn right! I'm sick of this insurance BS. The best way to improve the well-being of all Americans is to actually provide them the care they need. Here, here for universal healthcare! We gotta vote in progressive politicians who can get the job done.

[@waffles3629]

And it would be better for the economy too. Win win

[@iloveamerica3917]

Universal healthcare free for all isn't a buffet either though. It would have medical necessity rules and there'd be competing opinions on what is medically necessary. And increased access to care would mean longer wait times. It's not all rainbows.

[@fbbWaddell]

No. That's just gonna be Universal Healthcare denying a treatment because the govt doesn't want to pay for it. Pay attention.

[@alexhunt3028]

This is what literally happened to me for hip surgery!! Insurance denied it 3 times before finally approving it. All because I hadn’t tried an injection that would supposedly help my 1/3 torn labrum and keep my hip from dislocating. Maybe fine for someone who sits at a desk all day, but not for someone who’s career is as a professional contemporary/ballet dancer… we have Cigna and if my mom didn’t work for them, not sure how we would have known how to get them to approve it (she works in mental health and hates the current insurance system in the US)

[@souldancersbyjennifer]

Horrible... Glad you had a leeway. Hope you've recovered now

[@sashaa911]

I had to fail several injections and PT for my hip labrums . It's so stupid insurance decides when the doctor knows what the patient needs

[@Omnicloud7strife]

Ortho's "No" is exceptional here. I can't wait to see how United Health reacts to Johnathan.

[@efusco]

The serious consideration of high-dose ancef is gold!

[@thegoshdarnedbatman5257]

I’m recovering from a foot surgery in Australia right now. Universal healthcare paid for it. I’m shuddering at what I would have had to go thru in the USA

[@Mexican00b]

Everytime see shorts about how people who probably barely finished highschool, it just blows my mind That politicians can be legally bribed is amazing!!!

[@clearlyconsistent1728]

Thanks for illuminating why i have had to undergo agony so many times just to prove something does not work!!!

[@Nightowl80]

The great ancestors dramatic pause😂

[@iyar220]

I don't even live in America and i still feel bad

[@gmg9010]

I love hearing when surgeons and doctors go against healthcare in these situations and just give their patients what they actually need.

[@meesisatonmai]

I love the Ultimate Frisbee details!

[@gemstorm16]

I adore Ortho Bro being hardline on this. ❤

[@Tech10x10]

He failled to win an ultimate frizbee game. That enough for you?

[@ashleydozar1387]

This one has to be my favorite ever! I'm begging for a part 2!😂

[@LadyAnuB]

This is what my roommate has gone through under work comp. Doc said knee replacment was needed but other stuff first due to their cheap ass selves. Now she she's had 2 years of work comp while the knee replacement and, subsequent, rehab has been delayed by at least a year.

[@MissZXC16]

The way ortho bro barks out "nnnNNO!" was the best

[@anamandic4540]

I don’t generally “like” KZbin videos because I just can’t be bothered but I’ve started intentionally “liking” these 30 Days of US Healthcare ones to try to boost their reach. Every time I have to interact with the US healthcare system, I’m just more and more extreme in my opinions about how to reform it. At this point, I want top-down, heavy-handed, systematic banning and dismantling of the private health insurance industry altogether, losses be damned.

[@cubandarknez]

bro... freaking feel this. Always get the freaking 6 weeks phys therapy requirement whenever I have to move to a new insurance and want to continue my previous treatments. Waste of my time and money.

[@carols-corner]

And it really makes no sense because then the insurance has to help pay for both the ineffective treatments and the inevitable surgery. The only reasonable explanation for this is that insurance hopes the patient and/or doctor will give up fighting and either live with their pain or die. And THAT, my friends, is MESSED UP. Can we prosecute them for inflicting torture/cruelty/accessory manslaughter? 🤔

[@MurseSamson]

"Maybe you can fix it with high dose Ancef?" - 😂 you almost got him! 🧠🤔🤔🤔🤨 🤣

[@SifuPaladin]

Speaking as an acupuncturist, acupuncture can be great to reduce postoperative recovery time, reduce pain, and improve overall outcomes when used along side surgery, but in this case it's not a replacement for surgery. If a patient comes in with an ACL tear I'm not going to waste 6 weeks of the patient's time before getting them the care they need. Meanwhile that same insurance company insistiting that the patient try acupuncture first probably won't even cover the acupuncture that they are insisting on.

[@kevinklassen4328]

ICU doctor here. I wonder if I could avoid starting levophed in some of my patients if I just got them to watch some of these videos instead.

[@leshommesdupilly]

One time, our orthopedic surgeon had no pants scrubs to put on, so he just operated pantless lmao Yes, ortho prefers bones over pants, a thousand times

[@Madamchief]

That's a HIPPA violation 😂 hahaha

[@jennaandparkerstaggs1113]

My favorite of this series so far!

[@sashaa911]

Thank goodness for my Ortho bro who fights for me against my insurance denying things. Appeals, Peer to peer, he eventually gets it through to them. I have Ehlers Danlos and sometimes getting them to approve even imaging is a battle. A good ortho is a lifesaver for an EDS patient. So thankful for my Ortho Bro doc. Prepping for my third surgery under his care.

[@chrishuntley8369]

“Maybe you can fix it with high dose Ancef?” “Maybe... No, that’s not going to work this time.” OMG! I might have been a close party to a conversation like this. 🤣

[@sciencebunny]

Ortho bro even pulled out the big words to fight for his patient

[@blessedwhitney]

Meanwhile, in Workers Comp land, the law office is flipping out to try to get a fusion. The claimant's paralegal runs down the hall with the paperwork, "I GOT IT APPROVED!" and the attorneys chant "fusion fusion fusion fusion!" for the 80 year old lady who may or may not survive.

[@Chpow01]

I walked around on a torn meniscus for 3 months, inside of my ended up looking like a car wreck, but the fact I waited so long to go in, that I refuse painkillers and have gone months to years between steroid shots in my spine seems to make the insurance company cover my procedures, but I still have to pay the $500 co-pay for an MRI... So there is that.

[@chanticleer0714]

I'm surprised Ortho Bro called him "bro"! Sadly, I have too many friends who relate to this on a personal level. 😢

[@alainpbat3903]

The fish eye effect of the phone bro threatening ortho is cinematic genius

[@sargentlalo6712]

Until now, UHC is the only character that made ortho bro mad. He's just a happy bro, why would you mess with him

[@chrisanderson2368]

Ortho's stern voiced NO very much implies 'do Not shit on the carpet'.

[@fisher15g]

Sounds just like the TriCare model... especially the 6 weeks of PT before actually addressing the problem

[@JokesInBase13]

Well you have to have 6 weeks of PT first so your body has a chance to start healing with the bone and ligaments aligned wrong. That way, when you actually DO get the approval to go in surgically, it becomes more complex and painful to repair.

[@brunettekoala]

I dread to think what the farming community will resort to when Rural medicine tries to get approval for something serious…

[@jtkane317]

I now do xrays, start PT, try either injected if right size joint or oral steroid and refer for ortho in 7-10 days for many significant soft tissue injuries from urgent care. Clears up the xray hoop and PT hoop so patient can get mri within 2 weeks of ortho seeing them without having to delay and they will have had 2 or 3 attempts to treat from conservative care, to presceiption med, to PT. The only things that seem to get covered asap for a handful of common plans in my area are high school and college athlete injuries, legitimate trauma induced injury that never shouldve walked through my door, and carpal tunnel. Though some plans have a preference for EMG testing and proof of splinting treatment failure for at least 4 weeks. EMGs are torture sessions as someone who has had one done.

[@ChanceNP]

I profusely apologize when I have to send a patient for an EMG.

[@janisedenton4242]

Their PCP could do this too (I've been UC doc and PCP), but they don't seem to do it, in my experience. (Aside...my 2 EMGs weren't bad, weird and very fleetingly shocking, but painful...no.) TG

[@amandamiller6995]

Speaking as someone who has had bilateral EMGs performed for the evaluation of carpal tunnel syndrome, it was uncomfortable, yes BUT necessary for the surgical procedures to happen. When I went back in for my follow up visit with my Orthopedic doctor, there was a VERY clear, big, red "S" on the front page of the report. Indicative of the fact THAT I was in need of surgery. At least for 1 wrist! So, while the discomfort certainly was not pleasant. I was enduring much WORSE symptoms from the carpal tunnel effects in my daily life. Ergo, when these things become so burdensome, a patient must seek out the services of a physician. Who then MUST base their decisions on whether to operate on the testing from such things as EMG data. I completely understand this. No regrets about it.

[@jtkane317]

@amandamiller6995 I understand it but carpal tunnel is a clinical diagnosis. The need for EMG arises from insurance balking at coverage of a surgery than anything else. My EMG showed almost no conductive problems and yet I had CTS. Surgery fixed it.

[@amandamiller6995]

@@jtkane317 I'm really glad that worked out for you! I ended up having both of my wrists done as well TOO. I've had quite a lot of really painful procedures done to me over the years so I completely understand that it's necessary for the physicians to do whatever is necessary in order to get the results they need. I am required to cooperate with whatever protocol is required to the best of my abilities. It's a total teamwork between us!

[@lndhmsh1608]

My authorisation for a procedure was rejected even after 6 weeks of failed physical therapy and they recommended I get literally any other procedure except the one that my doctor recommended.

[@janisedenton4242]

But they insist that they are not practicing medicine! Baloney!

[@pamyuhnke8143]

I just exploded my ankle. Wondering if Kaiser suggested PT before trimalleolar fracture surgery 😂 PSA- always make sure youre in deep water when paddle boarding and not in 6inches of water. You’re welcome!

[@glevDPT]

As a physical therapist.... this sketch hits deep

[@physicistatlarge]

Ortho Bro's back!

[@JoeTheImpaler]

I’m not sure if I’m laughing because it’s funny or if I’m trying to not cry because it’s true 🤣

[@TalesStahl]

that sounded a bit like the guy from United Healthcare tried to give him a tip how to play the system... "we both know he needs surgery but i cant approve it until he fails something so let him fail something quick so that i can approve the surgery"

[@kellennani748]

I can’t tell who the closeted ultimate frisbee player is: Ortho bro or Dr. G.

[@DGlaucomflecken]

I have been playing competitively for 20 years!

[@kellennani748]

I had a feeling! So awesome, I love ultimate! Thanks as always for the top notch content :))

[@terpkristin]

This is why I’m almost out of PT visits allowed this year, even though I’m not halfway back following my ankle surgery. Alas. I’m “fortunate” that I can pay out of pocket to ensure I get back to where I need to be 🤦🏻‍♀️

[@louiseah7662]

Ortho Bro is my fave!! (After rural Jonathon) 😊

[@laukinath194]

Someone get Ortho bro a hug, stat!

[@grsm4456]

Omg going through this right now 😂 need to fail PT in order to get an MRI ordered.

[@Kygeis27]

I'm legit wondering if he can try the high dose ancef for like 24 hours and consider it a failed treatment just to tick the box? Might be easier to work the system?

[@ayarel01]

“…No!” 😂

[@sophiathore3538]

If failure was a prerequisite for money, I'd be rich af

[@Liriq]

Do not anger ortho 😡😡 Bone bro radiates chill and good vibes, and we all need that

[@micahphilson]

"Ah weird, the tiny needles didn't heal my torn ligament. Can I have actual treatment now?

[@intelxio]

I love ur videos man they make my day ❤❤❤

[@rossholbrook3231]

Just got done doing an anesthesia rotation at an outpatient orthopedic center. The hesitation on the high dose ancef was spot on.

[@JokesInBase13]

I have a good friend who is a licensed, went-to-school-for-4-years acupuncturist/chinese herbalist and even he would tell you that patient is a job for OrthoBro and no one else.

[@Ganurath]

Is wishing really hard a treatment? Quick, cheap, hypothetically viable while consistently ineffective...

[@PCayMan]

Is this real? I’m genuinely shocked at this