Is This Normal/Standard Practice?
Comments
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ScansRon Silver said:
My impression for the noMy impression for the no scan "rule" is due to the insurance company. No other reason. I had this discussion with both the radiologist and oncologist. The radiologist simply lied and made reference to how we "found things" prior to scans and implied that there was no benefit. The oncologist pointed the finger at the insurance companies.
Doctors, radiologists, the whole lot of them are dishonest pond scum. It is all about the dollars.
If you read my first post in this thread, anyone with even a smidgen worth of knowledge in this area could see how some type of scan schedule would be beneficial.
Well, a panel of experts agreed. However, the insurance compainies have not. And our "friends" in the medical profession who treat us, routinely lie to us. Scum.
http://www.mayoclinic.org/diseases-conditions/lung-cancer/in-depth/lung-ct-scan/art-20044852
I could not disagree with you more Ron, I thank God every day for the skills, expertise and caring given to me throughout my long campaign by my doctors. Your view though is very typical of the mood created by our government officails that anyone that makes a very good living is a bloodsucker and needs to be chopped down to size. Guzzle, I too am British, I am an old rock and roll musician that moved over here in 1974. I never got to ise the NHS much when I was living in the UK, young and invincible right, but I do have family there and visit quite often. I am aware of the privatization moves there. The funding for the NHS is, as you said, mainly from taxes but quite a bit comes from the national insurance stamps which is supposed to fund both the NHS and the pension system. The taxation levels, as in income tax, are not that greatly apart although the top tax bracket in the UK is much higher than here. The taxation differences betwen the US and UK are mainly in taxes on consumer products, VAT, petrol etc. Germany has a great system that I wish was the standard for here.
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Hi mate. You are right theydenistd said:Scans
I could not disagree with you more Ron, I thank God every day for the skills, expertise and caring given to me throughout my long campaign by my doctors. Your view though is very typical of the mood created by our government officails that anyone that makes a very good living is a bloodsucker and needs to be chopped down to size. Guzzle, I too am British, I am an old rock and roll musician that moved over here in 1974. I never got to ise the NHS much when I was living in the UK, young and invincible right, but I do have family there and visit quite often. I am aware of the privatization moves there. The funding for the NHS is, as you said, mainly from taxes but quite a bit comes from the national insurance stamps which is supposed to fund both the NHS and the pension system. The taxation levels, as in income tax, are not that greatly apart although the top tax bracket in the UK is much higher than here. The taxation differences betwen the US and UK are mainly in taxes on consumer products, VAT, petrol etc. Germany has a great system that I wish was the standard for here.
Hi mate. You are right they are trying to introduce some lean outsourcing. PET scans are done by a private company which is contracted to NHS. I suppose looking at best practise from countries like Germany. I have to day though when people are really ill NHS are usually very good. I have gone from consultation through scans, FNAs and am under the knife on Monday in under 3 weeks. Bit of a whirlwind. In in Liverpool which as you know is a very musical city so let me know if you have any tunes to download whilst in at a loose end.
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NHSGuzzle said:Hi mate. You are right they
Hi mate. You are right they are trying to introduce some lean outsourcing. PET scans are done by a private company which is contracted to NHS. I suppose looking at best practise from countries like Germany. I have to day though when people are really ill NHS are usually very good. I have gone from consultation through scans, FNAs and am under the knife on Monday in under 3 weeks. Bit of a whirlwind. In in Liverpool which as you know is a very musical city so let me know if you have any tunes to download whilst in at a loose end.
Oh forgot to say if needed oncologist physio etc all on hand at same site which is 4 miles from my house. RT etc delivered on same site. The other funding stream for NHS is charity especially for research. Ive done a lot of events for Clatterbridge over the years. If I have neck dissection and RTI will fight to get fit enough to do more. Ron I just hope you get the treatment you deserve mate.
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NHSGuzzle said:NHS
Oh forgot to say if needed oncologist physio etc all on hand at same site which is 4 miles from my house. RT etc delivered on same site. The other funding stream for NHS is charity especially for research. Ive done a lot of events for Clatterbridge over the years. If I have neck dissection and RTI will fight to get fit enough to do more. Ron I just hope you get the treatment you deserve mate.
Yes Guzzle, Know Liverpool well, played with some scousers in bands back in the sixties and seventies, have a bunch of tunes on you tube as well as other sites. What was the main cinema in Liverpool, played it a couple of times as well as the old Cavern and Iron Horse. I have a niece in the UK that is going through breast cancer, they have been magnificent to her, make sure you involve the McMillan people they will go miles to make your life comfortable. I hope the NHS does not deteriorate. I did have issues with it when my mother was ill in 2008, she was old and did not get the immediate attention that would have occurred here. The Obamacare thing will crash and burn but I am confident that a phoenix will rise up that will be the right thing for all people. Go to my facebook page, Denis R. Thompson and you can give me your e-mail address for some tunes. Denis
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nhsdenistd said:NHS
Yes Guzzle, Know Liverpool well, played with some scousers in bands back in the sixties and seventies, have a bunch of tunes on you tube as well as other sites. What was the main cinema in Liverpool, played it a couple of times as well as the old Cavern and Iron Horse. I have a niece in the UK that is going through breast cancer, they have been magnificent to her, make sure you involve the McMillan people they will go miles to make your life comfortable. I hope the NHS does not deteriorate. I did have issues with it when my mother was ill in 2008, she was old and did not get the immediate attention that would have occurred here. The Obamacare thing will crash and burn but I am confident that a phoenix will rise up that will be the right thing for all people. Go to my facebook page, Denis R. Thompson and you can give me your e-mail address for some tunes. Denis
Sorry to hear about your mum and hope it gos well for your neice Denis. Will have a look on fb and send message over. Let me know if you need anything sending to your neice mate.
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you have your opinionRon Silver said:
My impression for the noMy impression for the no scan "rule" is due to the insurance company. No other reason. I had this discussion with both the radiologist and oncologist. The radiologist simply lied and made reference to how we "found things" prior to scans and implied that there was no benefit. The oncologist pointed the finger at the insurance companies.
Doctors, radiologists, the whole lot of them are dishonest pond scum. It is all about the dollars.
If you read my first post in this thread, anyone with even a smidgen worth of knowledge in this area could see how some type of scan schedule would be beneficial.
Well, a panel of experts agreed. However, the insurance compainies have not. And our "friends" in the medical profession who treat us, routinely lie to us. Scum.
http://www.mayoclinic.org/diseases-conditions/lung-cancer/in-depth/lung-ct-scan/art-20044852
The radiologist simply lied
If that were true then he would be up for a malpractice suit as well as ethics charges. If true, it seems a rare event.
Doctors, radiologists, the whole lot of them are dishonest pond scum. It is all about the dollars.
First, most doctors pursue medicine primarily to help people, not make a pile of $$. These are very smart, dedicated, and focused people who could make a pile more money pursuing other professions if that was their goal.
These folks are service providers, just a link in a chain of money flow. Because they are stuck and sandwiched between insurance companies and payers such as Medicare (CMS) and private companies does not make them dishonest pond scum. In fact, they are squeezed in many unfair ways and have very little control being the pawn in this big mess.
Honestly, I am surprised more have not just thrown in the towel already. Maybe they do care about helping more and accept all the $$ BS so they can help.
Finally and btw - you seem to be typing away here just fine; did not the "dishonest pond scum" save your damn life? geeez
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Are you kidding? These
Are you kidding? These "medical professionals" by and large do what their handlers (hospitals that employ them and the insurance companies that essentially employ them both). The view I express is held by many in the profession (many silently, some not so silently). The only thing, ONLY thing, that keeps this whole medical/industrial complex in check IS the malpractice suits. It all a cost benefit analysis. Yes, by and large, our medical profession has become the whores of the insurance companies. But, I do appreciate the honest ones who will say "Yes, periodic scans would clearly benefit, but right now your insurance company will not approve and pay. In contrast to the pond scum who lie and say it would not be beneficial.
"Saved my life...." Interesting comment. The mechanic who properly installs your brake pads saves your life etc. The furnance tech who properly installs your furnance saves your life.
We have long had a problem in this country with insurance companies dictating what treatment we receive. By the way, the issue raised in the links (CT scans) will now be approved by under the Affordable Care Act. Oh, wait, these scans were not necessary and ill advised UNTIL medicare and insurance companies have to pay for them, ONLY then did they become necessary and good medicine. What about the poor souls who would have benefited from these scans and died prematurely while waiting for the insurance companies to finally agree with the experts and the government to finally require payment for the scans.
Again I read your replies and wonder. This is a classic example of the insurance companies dictating what is and what is not "good medicine." These medical professionals who sit back and let the insurance companies dictate to them what is and what is not "good medicine" and lie to their patients and/or not inform them are indeed pond scum. What we need is the medical professionals to be up front and honest and simply say "This is advised but insurance will not pay." Instead of not telling you and if confronted simply lie and say such treatment/procedure would not be beneficial.
The USPSTF drew up the recommendation and published it online in the "ANNALS OF INTERNAL MEDICINE" in December of 2013. Is there a radiologist or oncologist who was not aware of this? One month, two months, three months later? Really.
What excuse if there for not practicing good medicine and recommending/scheduling these CT recommended scans AFTER USPSTF published its recommendations? Do we only inform the patients AFTER insurance agrees to pay? How, can anyone, anywhere, defend a radiologist/oncologist not at least informing their patients that the "practice of good medicine" would involve such CT scans? It is the practice not to not discuss these matters with patients until AFTER insurance will pay.
Go ahead, if you fall into the segment who are advised to have these scans, confront your provider and ask why they were not scheduled or at least why you were not informed about the USPSTF recommendations regardless of whether your insurance would pay.
The individuals on this forum are the most well read and informed group on this planet. I know you understand my POINT of all of this -----medical professionals should not limit the information (including lying by ommission/deception) they provide to the patient regarding treatment simply because insurance will or will not pay for it. No, the answer-why tell the patient about it if insurance will not pay, doesn't pass the pond scum test.
Well, the process is in place and soon insurance will pay (because they are being forced to).
http://www.modernhealthcare.com/article/20131230/NEWS/301019813#
http://www.towerurology.com/insurance-companies-dictating-medical-decisions-bad-precedent/
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If you took the time to readRon Silver said:Are you kidding? These
Are you kidding? These "medical professionals" by and large do what their handlers (hospitals that employ them and the insurance companies that essentially employ them both). The view I express is held by many in the profession (many silently, some not so silently). The only thing, ONLY thing, that keeps this whole medical/industrial complex in check IS the malpractice suits. It all a cost benefit analysis. Yes, by and large, our medical profession has become the whores of the insurance companies. But, I do appreciate the honest ones who will say "Yes, periodic scans would clearly benefit, but right now your insurance company will not approve and pay. In contrast to the pond scum who lie and say it would not be beneficial.
"Saved my life...." Interesting comment. The mechanic who properly installs your brake pads saves your life etc. The furnance tech who properly installs your furnance saves your life.
We have long had a problem in this country with insurance companies dictating what treatment we receive. By the way, the issue raised in the links (CT scans) will now be approved by under the Affordable Care Act. Oh, wait, these scans were not necessary and ill advised UNTIL medicare and insurance companies have to pay for them, ONLY then did they become necessary and good medicine. What about the poor souls who would have benefited from these scans and died prematurely while waiting for the insurance companies to finally agree with the experts and the government to finally require payment for the scans.
Again I read your replies and wonder. This is a classic example of the insurance companies dictating what is and what is not "good medicine." These medical professionals who sit back and let the insurance companies dictate to them what is and what is not "good medicine" and lie to their patients and/or not inform them are indeed pond scum. What we need is the medical professionals to be up front and honest and simply say "This is advised but insurance will not pay." Instead of not telling you and if confronted simply lie and say such treatment/procedure would not be beneficial.
The USPSTF drew up the recommendation and published it online in the "ANNALS OF INTERNAL MEDICINE" in December of 2013. Is there a radiologist or oncologist who was not aware of this? One month, two months, three months later? Really.
What excuse if there for not practicing good medicine and recommending/scheduling these CT recommended scans AFTER USPSTF published its recommendations? Do we only inform the patients AFTER insurance agrees to pay? How, can anyone, anywhere, defend a radiologist/oncologist not at least informing their patients that the "practice of good medicine" would involve such CT scans? It is the practice not to not discuss these matters with patients until AFTER insurance will pay.
Go ahead, if you fall into the segment who are advised to have these scans, confront your provider and ask why they were not scheduled or at least why you were not informed about the USPSTF recommendations regardless of whether your insurance would pay.
The individuals on this forum are the most well read and informed group on this planet. I know you understand my POINT of all of this -----medical professionals should not limit the information (including lying by ommission/deception) they provide to the patient regarding treatment simply because insurance will or will not pay for it. No, the answer-why tell the patient about it if insurance will not pay, doesn't pass the pond scum test.
Well, the process is in place and soon insurance will pay (because they are being forced to).
http://www.modernhealthcare.com/article/20131230/NEWS/301019813#
http://www.towerurology.com/insurance-companies-dictating-medical-decisions-bad-precedent/
If you took the time to read the post above, now I will give you the counter argument. Why should I inform or even discuss with a patient going through this often horrific process (treatment of cancer) procedures such as these CT scans until after the "dust has settled" i.e., the process of whether it will be paid for by medicare or private insurance. Do I say "my dear patient, the most recent research indicates that a yearly CT scan would be advised but because your insurance will not approve you can't have one." Or do I say "my dear patient, I will see you every two months and we will take a real close look and if I see anything that warrants further investigation I will schedule a scan." Do "ethics" require the former or is the latter the best practice. What do you think??
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Pond scum
It is very unfortunate that any of us had or have this terrible disease, and, by the way, did I not say that all of my scans were had every 6 months, that my insurance company never questioned any procedures, they even paid to have my teeth removed because my "pond scum" guy wrote them a letter saying that removal was to prevent degradation of my jaw. If you treat your medical providers the same way you talk about them, I am not surprised they do not tell you much. And, as a matter of information, health insurance companies make less net income than than most COMMERCIAL businesses, They net about 5%.
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I wish denistd and all of youdenistd said:Pond scum
It is very unfortunate that any of us had or have this terrible disease, and, by the way, did I not say that all of my scans were had every 6 months, that my insurance company never questioned any procedures, they even paid to have my teeth removed because my "pond scum" guy wrote them a letter saying that removal was to prevent degradation of my jaw. If you treat your medical providers the same way you talk about them, I am not surprised they do not tell you much. And, as a matter of information, health insurance companies make less net income than than most COMMERCIAL businesses, They net about 5%.
I wish denistd and all of you well. Pond scum is a very mild word to describe the daily routine activities of many of the medical professionals who treat cancer patients. Not all. Many. Well meaning individuals who find themselves in a system controlled by for-profit corporations that dictate how they practice medicine. Cancer treatment is THE big health care profit center. It dwarfs all other areas-it has swallowed them. By and large they walk a very narrow path, a path wholly dictated, in essence, by what medicare and insurance will pay.
denistd, answer the question:
Do I say "my dear patient, the most recent research indicates that a yearly CT scan would be advised but because your insurance will not approve you can't have one." Or do I say "my dear patient, I will see you every two months and we will take a real close look and if I see anything that warrants further investigation I will schedule a scan." Do "ethics" require the former or is the latter the best practice.
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The ethical way to proceedRon Silver said:I wish denistd and all of you
I wish denistd and all of you well. Pond scum is a very mild word to describe the daily routine activities of many of the medical professionals who treat cancer patients. Not all. Many. Well meaning individuals who find themselves in a system controlled by for-profit corporations that dictate how they practice medicine. Cancer treatment is THE big health care profit center. It dwarfs all other areas-it has swallowed them. By and large they walk a very narrow path, a path wholly dictated, in essence, by what medicare and insurance will pay.
denistd, answer the question:
Do I say "my dear patient, the most recent research indicates that a yearly CT scan would be advised but because your insurance will not approve you can't have one." Or do I say "my dear patient, I will see you every two months and we will take a real close look and if I see anything that warrants further investigation I will schedule a scan." Do "ethics" require the former or is the latter the best practice.
would be for the physician to say "my dear patient the most recent research indicates that a yearly CT or PET scan would be the best course of action, but your insurance may not approve this." I will attempt to justify one for you via MD to MD, but they may deny it in which case you may choose to appeal their decision and/or pay for one privately if the appeals fail." "I am sorry you have to bear this extra burden at a time when you are fighting cancer, but know I am doing my best to advocate for your care." Honesty is best here. Also most humane approach.
Not Denistd,
PJ
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Scans made a difference for mePJ47 said:The ethical way to proceed
would be for the physician to say "my dear patient the most recent research indicates that a yearly CT or PET scan would be the best course of action, but your insurance may not approve this." I will attempt to justify one for you via MD to MD, but they may deny it in which case you may choose to appeal their decision and/or pay for one privately if the appeals fail." "I am sorry you have to bear this extra burden at a time when you are fighting cancer, but know I am doing my best to advocate for your care." Honesty is best here. Also most humane approach.
Not Denistd,
PJ
Following tx, I had a PET followed up every 3 mos. with a CT w/contrast. My ONC then went to every 4 months for the scans. At 15 months, a tumor around my carotid was detected. (Hindsight, it was on prior scan but not detected). Anyway, I was feeling really good and had no idea anything was wrong nor did my doctors. It never could not be felt because of it's position. So, if not for the routine scan, it would have remained undetected and untreated. My insurance carrier never questioned the routine scans and I am thankful for that.
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NHShwt said:Scans made a difference for me
Following tx, I had a PET followed up every 3 mos. with a CT w/contrast. My ONC then went to every 4 months for the scans. At 15 months, a tumor around my carotid was detected. (Hindsight, it was on prior scan but not detected). Anyway, I was feeling really good and had no idea anything was wrong nor did my doctors. It never could not be felt because of it's position. So, if not for the routine scan, it would have remained undetected and untreated. My insurance carrier never questioned the routine scans and I am thankful for that.
The NHS surgeon who performed my dissection today was superb. Like many he could earn more in private medicine but chooses to stay with NHS who trained him. I just don't believe that ill people should have the stress of horse trading with insurers. If any of you were on UK visiting and became ill you would be treated at no cost. I am happy for my taxes to be spent this way. My wife is a Sister in Alder Hey paediatric hospital ICU. It made me think. Do all kids have insurance? Imagine not being able to get you
child care. I cant believe I have no neck or shoulder stiffness at all. My surgeon is a Wizard and he is available to all. What the US system does appear to have is more choice.
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forcing the cost curve to bend...Ron Silver said:I wish denistd and all of you
I wish denistd and all of you well. Pond scum is a very mild word to describe the daily routine activities of many of the medical professionals who treat cancer patients. Not all. Many. Well meaning individuals who find themselves in a system controlled by for-profit corporations that dictate how they practice medicine. Cancer treatment is THE big health care profit center. It dwarfs all other areas-it has swallowed them. By and large they walk a very narrow path, a path wholly dictated, in essence, by what medicare and insurance will pay.
denistd, answer the question:
Do I say "my dear patient, the most recent research indicates that a yearly CT scan would be advised but because your insurance will not approve you can't have one." Or do I say "my dear patient, I will see you every two months and we will take a real close look and if I see anything that warrants further investigation I will schedule a scan." Do "ethics" require the former or is the latter the best practice.
Here is an article that is a perfect example of what my premise is in getting health care costs in line. Basically, the article points out that insurance companies may be squeezed out as more heath care provider organizations deliver care directly to customers and cut out the insurance middleman. This is a way to cut much cost and inefficiencies and allow for higher value medical care directly to consumers.
Painful, yes. Some lose, yes. Consumers ultimately benefit, yes.
http://www.thefiscaltimes.com/Articles/2014/03/27/Hospitals-Plot-End-Insurance-Companies
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