tag:blogger.com,1999:blog-18943510.post4924911166183738279..comments2023-08-21T02:57:37.362-05:00Comments on Dr. Wes: When Doctors Are Excluded From the PlaybookDrWeshttp://www.blogger.com/profile/17438019699222125477noreply@blogger.comBlogger15125tag:blogger.com,1999:blog-18943510.post-13360760811041891522011-10-05T08:25:00.068-05:002011-10-05T08:25:00.068-05:00Dr. Bowdish,
Is there any evidence that omalizumb...Dr. Bowdish,<br /><br />Is there any evidence that omalizumb saves lives?...good evidence, randomized trials?Robert C.,MDnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-4381395761488749182011-10-01T22:15:24.249-05:002011-10-01T22:15:24.249-05:00Anonymous said, "My ticker isn't too heal...Anonymous said, "My ticker isn't too healthy and I can't afford that operation my doc thinks would be best."<br />Lack of cerebral blood flow is often contemporaneous with delusions.Tim Hulsey, MDnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-20937191266937758792011-09-28T19:09:16.838-05:002011-09-28T19:09:16.838-05:00Dr. Hulsey,
Of course. Neither technology nor mi...Dr. Hulsey,<br /><br />Of course. Neither technology nor miracle drugs nor marketing nor "the" market have anything to do with health costs, notwithstanding Dr. Wes' argument regarding the reason for the cost of new drug he wishes to prescribe.<br /><br />And I am intrigued by your "floating prices higher artifically", but why argue? I have just proclaimed an absolutely Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-76462365142255185402011-09-28T18:15:17.558-05:002011-09-28T18:15:17.558-05:00Keith said, "but the insurer is not saying yo...Keith said, "but the insurer is not saying you can't use the medication; just that they will not pay for it."<br />In reality the insurance company <b>has</b>, <i>de facto</i>, made the patients decision for him! Wes can explain to them the reasons for using the drug for this patient, but the insurance company has <b>RULES</b>! Stroke patients can live for decades in a vegetative Tim Hulsey, MDnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-81398890067960572732011-09-28T12:27:07.289-05:002011-09-28T12:27:07.289-05:00Anony 02:09 -
If the "number needed to trea...Anony 02:09 - <br /><br /><i>If the "number needed to treat to prevent one (nonhemorrhagic) stroke with dabigatran (150 mg twice daily) is 357" is this therapy appropriate for many patients? <br /><br />How do you control skyrocketing costs, a few $ per month v $350 (approx) if the payback is really that low?</i><br /><br />Don't forget to factor in the costs of INR's, lost timeDrWeshttps://www.blogger.com/profile/17438019699222125477noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-45318123894715018852011-09-28T12:16:02.241-05:002011-09-28T12:16:02.241-05:00Greatnews! They have made me king! Let it be kno...Greatnews! They have made me king! Let it be known that as of today there is no Obamacare, no Medicare, no Medicaid and no insurance companies, no mandates, no more regs, no more FDA. Medical care will be between the doc and the patient. Charge what you will, doc. Patient, pay what you can. Hospitals - collect directly from the patient. There. That's taken care of. Everybody happy?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-66178473768656114582011-09-28T09:12:47.530-05:002011-09-28T09:12:47.530-05:00I'm with Keith.
There is no one saying you ca...I'm with Keith.<br /><br />There is no one saying you can't prescribe it, just that the insurance wont pay for it. At some point people have to make a choice to pay for (some of) their own health careERDocnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-22996137364761380352011-09-27T22:02:24.379-05:002011-09-27T22:02:24.379-05:00Perhaps they think TEE followed by flutter ablatio...Perhaps they think TEE followed by flutter ablation w lovenox bridge and at least 1 month of coumadin would be cheaper. <br />CardioNPAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-5138171453883152972011-09-27T16:25:51.816-05:002011-09-27T16:25:51.816-05:00Correct me if I am wrong, but the insurer is not s...Correct me if I am wrong, but the insurer is not saying you can't use the medication; just that they will not pay for it. So this is an insurance issue; not one of commanding that we can only treat according to what insurance dictates.<br /><br />From a practical standpoint, I realize that this may mean that the patient cannot afford the medication, but this speaks more to the high cost of Keithnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-23004571084783818812011-09-27T14:09:20.964-05:002011-09-27T14:09:20.964-05:00I am certain you are a diligent and smart doc. Sin...I am certain you are a diligent and smart doc. Since I am neither, I defer to you, but would gently ask -<br />If the "number needed to treat to prevent one (nonhemorrhagic) stroke with dabigatran (150 mg twice daily) is 357" is this therapy appropriate for many patients? <br /><br />How do you control skyrocketing costs, a few $ per month v $350 (approx) if the payback is really that Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-19927233164192829362011-09-27T13:34:24.390-05:002011-09-27T13:34:24.390-05:00It is sad and frustrating that our doctors can...It is sad and frustrating that our doctors can't make the decisions regarding our healthcare. The same insurance company that made my doctor send me home three days after major surgery sends me message that say "You have these conditions. You should contact this kind of specialist." I shake my head in confusion over this. First off, I don't have all the conditions they say I Lisa https://www.blogger.com/profile/09324961653370110887noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-87114308739364316122011-09-27T13:30:25.398-05:002011-09-27T13:30:25.398-05:00Wes,
Don't let my flip attitude in the post d...Wes,<br /><br />Don't let my flip attitude in the post deceive. <br /><br />I agree that performing additional testing to appease the insurance companies is ridiculous. If that's what it takes, though, I'll do it. It beats the alternatives.<br /><br />Yours is a higher mission. By bringing this nonsense into the public realm, you hope to effect some changes to this crazy system. Jayhttps://www.blogger.com/profile/10897176780069403370noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-14358797357319061472011-09-27T10:39:27.403-05:002011-09-27T10:39:27.403-05:00Jay-
More testing, more costs. So much for savin...Jay-<br /><br />More testing, more costs. So much for savings, eh? <br /><br />No wonder we're the problem.DrWeshttps://www.blogger.com/profile/17438019699222125477noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-29978698705766263172011-09-27T09:59:32.898-05:002011-09-27T09:59:32.898-05:00Not surprisingly, we have the same problem in alle...Not surprisingly, we have the same problem in allergy/immunology. One insurer recently moved us to a 'non-preferred' provider status, because among the various medications we use for asthma is omalizumb, a monoclonal antibody directed against IgE approved for moderate to severe asthma. And we’re hardly putting every patients on this admittedly expensive drug. Accordingly, by doing a Matthew Bowdish MDhttps://www.blogger.com/profile/00751737204523529971noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-26376885943982211342011-09-27T09:09:48.147-05:002011-09-27T09:09:48.147-05:00If you can't beat 'em, join 'em.
I...If you can't beat 'em, join 'em.<br /><br />I'm sure her insurance would be glad to pay for a 24 hour Holter. You could then scrutinize for any evidence of a fib (which almost always turns up if you look hard enough). <br /><br />New diagnosis. Problem solved.Jayhttps://www.blogger.com/profile/10897176780069403370noreply@blogger.com