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Posted on 04/04/2012 11:22:18 AM PDT by ColdOne
WASHINGTON — Old checklist for doctors: order that test, write that prescription. New checklist for doctors: first ask yourself if the patient really needs it.
Nine medical societies, including the American Society of Clinical Oncology and the American College of Cardiology, representing nearly 375,000 physicians are challenging the widely held perception that more health care is better, releasing lists Wednesday of tests and treatments their members should no longer automatically order.
The 45 items listed include:
* Don't repeat colonoscopies within 10 years of a first such test * Don't perform early imaging for most back pain * Don't do brain scans for patients who fainted but didn't have seizures * Don't prescribe antibiotics for mild- to-moderate sinusitis unless symptoms last for seven or more days or worsen * Don’t perform stress cardiac imaging or advanced non-invasive imaging in the initial evaluation of patients without cardiac symptoms unless high-risk markers are present * Don't perform PAP smears on women younger than 21 or who have had a hysterectomy for a non-cancer disease * No advanced imaging or bone scans in patients with early-stage breast or low-grade prostate cancer * Don’t done bone scan screening for osteoporosis in women younger than 65 or men younger than 70 with no risk factors * Don't perform routine cancer screening on dialysis patients with limited life expectancies * No chemotherapy for sickest cancer patients
(Excerpt) Read more at msnbc.msn.com ...
Funny, they said this wasn’t going to happen.
I would most certainly be dead today if, four years ago, my doctors had followed these “rules.”
I do find it interesting that they seem to be singling out some of the most prevalently occurring cancers (breast and prostate) to make treatment cut backs for. They can argue all they want about how these cut backs are scientifically motivated. However, it looks more like cost-cutting to me.
Oh but I thought it was the Republicans who “want you to die” according to that nutcase Florida ex-congressman.
Hmmm so how do we find the cancer down there since PSA tests are not that reliable? Then again by that point I have already past my most productive years so I should find an ice flow and not be a burden on society.
The truth is that doctors began over-testing and over-treating patients when the lawyers started suing them over alleged failure to properly treat their patients.
Over-testing and over-treating became a defensive option that became a habit and then was discovered to be a profit center, especially when physicians began to own/lease expensive diagnostic machines like Cat-scans, sometimes at the inducement of the machine salesmen.
In every case, in every decision both the attorneys and the physicians can justify what they do as being in the interest of their clients/patients.
And after all, it was free. Either the insurance companies or Medicare/Medicaid paid for all the tests and treatments and we all know those payments came from some free cloud in the sky, not from policyholders premiums or taxpayers.
I look forward to seeing the AMA, etc. Explain this to the Liability Attorneys.
This should be fun.
Mr. Doctor, under the old rules, would Mr. Claimants terminal cancer have been detected early enough for treatment?
I rest my case, your honor. $100 Million Dollars, please!
Should begin with tort reform, so that Doc’s aren’t motivated to order unnecessary tests to protect themselves from lawsuits.
I personally feel we have way, way overdone it with testing and medical procedures, and a lot of what they’ve been doing is unnecessary.
That being said, the choice should be between you and your doctor. Not government’s.
The list, Ping
Let me know if you would like to be on or off the ping list
Before we do a knee-jerk and attack Doctors.....
Having family in the medical profession, I can tell you this is happening largely because Doctors are being told what to charge, even if they lose money on it. An example is the cost of a recent MRI that I had cost $1650. My provider paid $890, leaving $760, of which the Doctor can only charge me $350 as dictated by the provider and the powers that be. The Doctors loss is $450. My family is in Dentistry and they lose money on certain procedures in the same way, but in a smaller scale. So why continue procedures that you lose money on? That is also why cash is still king at the Doctors office.
Are our esteemed members of Congress, cabinet members, upper level government employess, including Barry, his family, and his mother-in-law , going to be denied these tests?
I’ll have what they’re having.
The fact is, the sooner you die, the less of the money you paid into health care they have to pay back.
The Rats turned the lawyers loose on the medical profession to provide vast income to a major constituency and to begin the process of destroying healthcare so they could take it over. Significant tort reform would accomplish the same goal. But, of course, the Rats would not think of it. It does not serve their evil purposes.
I despise ObamaCare but this I agree with. If everyone had a health savings account & had to buy their own designed policy, allowing across state lines provisions with just a few mandates & these lawyers were constrained premiums could be cut probably 40% with some significant co-pays & deductibles.
I agree with you completely-years of nanny government means too many people have forgotten how to manage their own lives, and that leaves the door open to those who take unfair advantage, not to mention malpractice attorneys-none of those people give a damn about anyone as anything but a combination lab rat and cash cow...
Absolutely right.
I’ve heard of hospitals offering free or low-cost cardiac imaging stress tests to high school athletes who have no symptoms. Tell me this is being driven by medical, rather than legal, concerns.
I see no one asked the malpractice attorneys.
How to fool people.
1) Make a long list with some extra reasonable things that are easy to understand in it and some very unreasonable things that are complex or difficult for ordinary people to understand.
2) Publish a “summary” of the list with just the reasonable things on it. Add a few under-defined unreasonable things.
Example: Physicians should not do the following:
1) Nail their patients feet to the floor.
2) Attempt to cure warts with toads during a full moon.
3) Retroperitoneum laparotomy.
The entire health care field is in utter chaos, run by foreign doctors and foreign staff. It’s not only a major rip off, but extremely dangerous due to the lack of competence and communication. Of course they’ll blame the big insurance mobsters for the extreme costs, and the insurance mobsters will tell ya from their 125 story skyscrapers, they hardly make any money at all.
PSA tests.....don’t have much to do with scoping the colon.
Amen, Bro..........
I see you tell tall tells everywhere......
.
Insurance companies require that physicians obtain diagnostic tests to justify procedures and medical treatment. Otherwise, the treatment will not be covered. In fact, the insurance companies require more tests than are needed in many cases. So the obvious solution is to disallow diagnostic tests so that the procedures and treatments are not indicated.
If you don’t look for something, you won’t find the answer, so I guess ignorance is bliss.
Hey, are you not the person who defends violent unprovoked criminal beat downs perpetrated by African Americans?
I’ll post the link if want!
Doctors are also ordering too many tests because insurance companies require them for patients qualify for treatment coverage. If you don’t have your ‘ducks in a row’ with respect to your diagnostic workup, the insurance company will not authorize, deny payment, or worse, the Medicare auditors will find you and fine you.
Ooops.
“That being said, the choice should be between you and your doctor. Not government’s.”
If you are paying, then I agree with you 100%. If taxpayers are paying then you’re kidding yourself if you think you are going to get anything you want.
The doctor is not "losing" $450. MRIs are vastly overpriced on a routine basis. If you had to pay the whole $1650 instead of $350 you would shop around. Then you would discover that you could get the same MRI for a fraction of the cost.
The entire health care field is in utter chaos, run by foreign doctors and foreign staff.
Ummmmmm, yes you are.
It explains a lot to me......
Would you like me to explain it to you?
Here, lemmme post it for you again:
The entire health care field is in utter chaos, run by foreign doctors and foreign staff. It’s not only a major rip off, but extremely dangerous due to the lack of competence and communication. Of course they’ll blame the big insurance mobsters for the extreme costs, and the insurance mobsters will tell ya from their 125 story skyscrapers, they hardly make any money at all.
So...you own that. Exposed for all to see.
Take care.......
That means we’d just follow the British NHS example, where they take Pakistani and Indian doctors working for half what British doctors would take.
You bet!
•Repeat colonoscopies within 10 years of a first test
Hmmm so how do we find the cancer down there since PSA tests are not that reliable? Then again by that point I have already past my most productive years so I should find an ice flow and not be a burden on society.
First of all, colonoscopies and PSA have nothing to do with each other. A colonoscopy is used to find problems in the colon; PSA is used as an indicator that Prostate Cancer may be present.
Having said that...as a long-time radiological technologist specializing in Nuclear Medicine, I can assure you that at least 75% of the scans that I do are done ONLY to keep the lawyers off of the doctor’s back.
In fact, a look at what took place in Texas a few years ago is all the proof you need of that. Texas was SIEVING doctors because of lawsuits, and finally passed a Tort Reform law a few years ago. The first year after it was passed, diagnostic scanning went down 56%. That is an AMAZING number.
Remember when Obama was trying to pass ObamaCare and Howard Dean got up in front of a microphone and said (screeched?), “Tort reform? We have ENOUGH problems trying to pass this bill; we’re certainly not going to try to piss off the lawyers (who are the largest contributors to the Democratic Party) in the process, are we?”
I have been listening to Cavuto this afternoon. This is a way they are going to ration. It isn’t just tests they are going to ration, it is also treatments.
It is rotten and people are going to die when they should get good medical care.
This is shameful.
I will be voting Obama out. He must go.
This angers me to no end.
The thing the political Dems have forgotten is that when all healthcare is run by the government one of their largest contributor groups—the tort lawyers— will be out in the cold because they won’t be able to sue the sovereign.
They might lose their support unless they can figure another target for them to sue with government support. Maybe non-green industries that don’t cater to man-made global warming.
I don’t think the ABA tort lawyers have snapped to this yet either. Aren’t they still supporting Obama and his plan to make health care a government enterprise.
Let's assess how the original charge is arrived at, shall we?
Cost of scanner: 1.5 - 2 million $
Place to put scanner (facility build out, rental, compliance with reams of regulations): 500K
Tech to run scanner + benefits: 150K.
Nurse to start IVs and sedate claustrophobic pt + benefits: 200K
Service contract to maintain scanner: 50-100k/yr
Clerical staff+ benefits: 100K
IT infrastructure for interpretation and reporting: 200K
Malpractice/liability insurance: 100K/yr
Radiologist salary: $300K/yr
Housekeeping services: 50K/yr
Utility charges: 10k/yr (?)
You might want to rethink your original statement.
I know of no nurse making $200k a year....doing what you have described.
Return to a consumer-based free market system. People can pick on their own, health companies compete for the consumer and costs for tests come down.
Benefits cost alot. Radiology nurses are expensive. Depends also on the state - CA very expensive. Also, if imaging center runs 365 days a year, it adds up even more.
This is step one toward the death panels.
Stay healthy or die...everyone’s future.
Those are listed in the article. Sound like the death panel recommendations the American public was warned about...
Don't perform:
*Routine cancer screening on dialysis patients with limited life expectancies
*Chemotherapy for sickest cancer patients
Again....I’m in the “business”...and I know of zero nurses making $200k a year...doing what you have described.
Medical malpractice liability doesn’t arise from bad outcomes alone, but from bad outcomes caused by failing to follow professional standards. Plaintiffs won’t be allowed to reach a jury on claims based on violating outdated standards.
200,000/365 = $550/day
550/10hr/day = $55/hr (remember this INCLUDES the benefits!)
So I had a hysterectomy from hemoraging fibroids... so let me guess. Insurance company will now have valid reason to deny pap? My mom had a hysterectomy and ended up with ovarian cancer!
If the mandate holds, the doctors can still be sued.
Doctors that don’t want to work for the government will move on to something else. They might set up in another country not too far from here that wants to make money, or they will just move on to something else.
We are going to end up with 3rd world doctors and crappy care.
I guess that is the point. Kill people and the problems are solved.
Maybe that is why all those caskets are kept in storage.
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