tag:blogger.com,1999:blog-18943510.post6439081571388112556..comments2023-08-21T02:57:37.362-05:00Comments on Dr. Wes: It's Official: Guidelines for Care Are Now Mandates for CareDrWeshttp://www.blogger.com/profile/17438019699222125477noreply@blogger.comBlogger14125tag:blogger.com,1999:blog-18943510.post-76012163769917846552010-06-24T23:42:23.979-05:002010-06-24T23:42:23.979-05:00There should always be too many pacemakers implant...There should always be too many pacemakers implanted, just as there should always be too many people transported to trauma centers. <br /><br />The sensible position is to try to get it right, but we will always need to leave a margin for error, because patients do not always present with clear diagnoses and information about the way they will respond to treatment- the kind of information that Rogue Medichttps://www.blogger.com/profile/07598646309630074992noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-59718693102070698622010-06-24T08:16:05.183-05:002010-06-24T08:16:05.183-05:00Jodi,
There is no discrepancy in my argument. Ma...Jodi,<br /><br />There is no discrepancy in my argument. Many of these devices are installed for the right purposes, but some are not. Patients in many institutions may not always be "referred" in the way you define it. If they show up at the ER off hours, it may be the cardiologist on call is the only choice. Many may also be referred by their PCP, but there are also PCPs who Keithnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-64711998660058850922010-06-23T16:45:53.597-05:002010-06-23T16:45:53.597-05:00Keith,
That is the case for a pacemaker in an eme...Keith,<br /><br />That is the case for a pacemaker in an emergent situation. Bureaucratic hoops, government or otherwise, won't solve that problem either. If it's an emergency, it must be done.<br /><br />Your earlier argument was that too many doctors are putting in too many devices. Then you said things have to be done emergently or patients will pass out. Which is your argument, Jodihttps://www.blogger.com/profile/02317972207150149720noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-12033380566043265462010-06-23T14:40:52.445-05:002010-06-23T14:40:52.445-05:00Jodi,
the trouble with your argument in the case ...Jodi,<br /><br />the trouble with your argument in the case of a pacemaker is that you really don't have the opportunity to shoop around for a pacemaker once you are told you need one. More often than not, patients are told they need to have it placed now, or potential dire consequences may occur. And when you pass out at home, you don't get to pick the hospital you are taken to either!Keithnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-45954121499752863402010-06-23T12:08:28.507-05:002010-06-23T12:08:28.507-05:00good post. Funny though that when they decreased C...good post. Funny though that when they decreased Chemo payments, doctors administered more chemo and expensive Chemos for lung cancer patients in recent study. Profits and margins will always prevail when there is a business to run!Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-42667406876090533362010-06-23T12:03:55.260-05:002010-06-23T12:03:55.260-05:00Keith,
Wouldn't transparency in health care b...Keith,<br /><br />Wouldn't transparency in health care be a better way to penalize the bad cardiologist, while rewarding the good. If doctors and hospitals had to post stats on amounts of devices used, for what reasons, etc. then referring physicians, and insurers, would be much wiser in their choices (as well as, ideally, patients). The "good" cardiologist would get more businessJodihttps://www.blogger.com/profile/02317972207150149720noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-46676983780407573002010-06-23T12:00:28.513-05:002010-06-23T12:00:28.513-05:00Keith,
What about more transparency in health car...Keith,<br /><br />What about more transparency in health care? If doctors and hospitals had to post their amounts and uses of devices so that referring physicians, patients, and insurers can know who may be overusing, etc., then the "good" cardiologists will get more business when they're practicing more conservatively, and the "bad" ones will get less (via referrals). IJodihttps://www.blogger.com/profile/02317972207150149720noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-17882736893423756812010-06-23T10:50:43.809-05:002010-06-23T10:50:43.809-05:00While I am not opposed to some government regulati...While I am not opposed to some government regulations, every time the government tries to "correct" the behaviors of companies, consumers end up paying for it. Yet, the government continues to think their strong arm is needed to "protect us". Who is going to protect us from the government? When do we get to sue them for malpractice?<br /><br />Rather than our government Jodihttps://www.blogger.com/profile/02317972207150149720noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-24323181736451504062010-06-23T10:29:30.846-05:002010-06-23T10:29:30.846-05:00I saw this coming. Physician's clinical judgm...I saw this coming. Physician's clinical judgment reduced to an algorithm. Hmmm, that's how machines work. I wonder what's next?<br />Cynthia Bailey MD<br />http://www.otbskincare.com/blog/cynthia bailey mdhttp://www.otbskincare.com/blog/noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-6631230939947267002010-06-23T10:28:01.670-05:002010-06-23T10:28:01.670-05:00Some of the problem can be blamed on inappropriate...Some of the problem can be blamed on inappropriate overuse of these devices as well. How are insurers to address costs if they cannot weed out these unnecesary and very expensive procedures and devices? Tell me there is not overuse or inappropriate use and I can see your point.<br /><br />Of course, this penalizes all the good cardiologists that do things the right way. I think that what we Keithnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-79148338931078916012010-06-23T08:57:23.269-05:002010-06-23T08:57:23.269-05:00I know cardiologists are aggressive in treating li...I know cardiologists are aggressive in treating lipid disorders, but now, apparently, you're melting so much fat you're a "rendering physician."Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-237048059755176632010-06-23T06:49:16.346-05:002010-06-23T06:49:16.346-05:00Anony-
This new effort at covert rationing of med...Anony-<br /><br />This new effort at covert rationing of medical devices is mandated by the insurance company. Entire blogs have been <a href="http://covertrationingblog.com/" rel="nofollow">written</a> on the insidious nature of covert rationing to divide the doctor and patient. This is but one more example.<br /><br />We should only wish health care economics were a free market, but they are DrWeshttps://www.blogger.com/profile/17438019699222125477noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-32517146613438154102010-06-23T02:03:17.726-05:002010-06-23T02:03:17.726-05:00I don't understand. Is this mandated by Unite...I don't understand. Is this mandated by United Healthcare, a health insurance company, or is it a federal government mandate? If it is the policy of the insurance company, why are you castigating the federal government? It seems to me that health care reform was an effort to eliminate such practices by insurance companies and this is a loophole that the company is using to its advantage Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-78310322984571618522010-06-22T22:14:24.915-05:002010-06-22T22:14:24.915-05:00How is that different then Blue Cross Blue Shield ...How is that different then Blue Cross Blue Shield Policy. bivent implant with defibrilator for me last year, after the procedure was completed and when they got the big bill, they ask for documentation and complete medical history from Univerity of Chicago. They did approve everything at the end. But they kept sending me copies of the letters of denial and asking for additional documentation fromAnonymousnoreply@blogger.com