Re: Canadian doctors coming to the US

From: George Conklin (nilknoc_at_earthlink.net)
Date: 09/06/04 

Date: Mon, 06 Sep 2004 13:25:18 GMT

"dahmd" <dahmd@cfl.rr.com> wrote in message
news:deO_c.16827$uN5.2066@tornado.tampabay.rr.com...
>
> "George Conklin" <nilknoc@earthlink.net> wrote in message
> news:c1M_c.7373$Wv5.2280@newsread3.news.atl.earthlink.net...
> >
> > "dahmd" <dahmd@cfl.rr.com> wrote in message
> > news:51H_c.15386$Of3.6663@tornado.tampabay.rr.com...
> > >
> > > "Founding Father" <ff@qwest.net> wrote in message
> > > news:BLo_c.28$0P5.5692@news.uswest.net...
> > > >
> > > > "dahmd" <dahmd@cfl.rr.com> wrote in message
> > > > news:7iPWc.47629$4s6.35165@tornado.tampabay.rr.com...
> > > > >
> > > > > "George Conklin" <nilknoc@earthlink.net> wrote in message
> > > > > news:UdlWc.1231$Y%3.494@newsread2.news.atl.earthlink.net...
> > > > > >
> > > > > > Good. Would you support laws which allow pharmacists to
> > substitute
> > > > if
> > > > > > the patient wants a generic and that little box on the
> prescription
> > > pad
> > > > is
> > > > > > not checked?
> > > > > >
> > > > >
> > > > > No problem.
> > > >
> > > > But I bet there WILL be a problem if the patient has a bad outcome
> with
> > > the
> > > > generic and sues the doctor - even if the problem isn't even
directly
> > > > related to the generic. If it is, he should, of course, sue the
> > > pharmacist,
> > > > but you know THAT won't happen - deep pockets and all that (just ask
> > John
> > > > Edwards).
> > > >
> > > > > To my knowledge that's how it's done in Florida.
> > > > > Alternatively, I receive faxes from insurers every day that
request
> > > > > substitution of a name-brand to a generic, or from one type of
> > > medication
> > > > to
> > > > > a similar, less expensive medication. I review these and, almost
> > > always,
> > > > > auathorize the change. Note that I receive no compensation for
this
> > > > > service, which does not benefit me in any way. Further, you might
> be
> > > > > interested to know that patients (not physicians) are the driving
> > force
> > > > > behing requests for name-brand prescriptions. Most patients want
> "the
> > > > very
> > > > > best" and are unhappy about receiving generics. Ask any
pharmacist.
> > > They
> > > > > want the name-brand, because they "are paying good money for
> > insurance."
> > > >
> > > > There's that damned insurance problem again. People always want the
> > most
> > > > expensive when someone else is paying for it.
> > >
> > > Absolutely. It's human nature. Very few of us are altruistic enough
to
> > > reject "the best" care for the second-tier care, even if it's almost
as
> > > good. If an x-ray can diagnose the problem 97% of the time but a CT
> scan,
> > > which is about 10 times more expensive, can make the diagnosis 98% of
> the
> > > time, people are going to want the CT scan.
> >
> > Such scans are pushed by the medical-industrial complex. Stop
blaming
> > the public if they bought into the propagana machine that 'we have the
> best
> > medicine in the world.' That mantra demands that people ask for 'the
> best,'
> > not second best. As for 'people.' Are you saying everyone? Or just
those
> > who think we get the best medical care in the world? I know we do NOT,
> and
> > do not ask for tests.
> >
>
> For certain medical therapies, such as pharmaceutical agents, I would
agree
> with you. However, who "pushes" CT scans?! Doctors get nothing out of
> ordering them. I can't recall ever seeing an ad for a CT scan, although
> there are a few ads out there for "open MRI" machines. It's possible that
> physicians in part are to blame for overstating our ability to diagnose
and
> cure illnesses, but I thought those days were gone. If anything,
physicians
> are so paranoid about lawsuits that they understate the potential for
cure,
> so that patients don't get their hopes falsely elevated. After all, if
you
> expect the procedure to have problems, and problems occur, you
theoretically
> are less likely to sue. I have not heard a physician say that a treatment
> is "a piece of cake" in many years. Rather, when I hear informed consent
> conversations, they usually involve a detailed discussion (in part) of all
> the bad things that could happen if you choose that therapy. I stand by
my
> original comments: one of the reasons we have costly health care is that
> patients are pseudo-consumers. They want the best available, regardless
of
> cost, but don't have to pay for it directly. When was the last time you
> went into a store and bought something without knowing how much it cost?
> Medical consumers frequently demand expensive tests or medications, and
> don't even know the cost differential between that therapy and less
> expensive ones.
>
> Ashley
>

  Let me follow up my earlier posts based on Clinton's heart bypass.
Surgeons stated for the press that they do NOT give out death risks, unless
directly asked. NY State is very advanced in making risk-adjusted death
rates available for every hospital. But I don't think the public knows
enough to ask for that data, and press reports state you must know about it
AND ask to get it.

  The hospital where Clinton rests has a risk-adjusted death rate of 4%, vs.
2% for NY State as a whole. This is a figure adjusted for something like
30+ risk factors, so all hospitals are rated as if they were operating on an
idential patient.

  Hospitals bitterly fought NY State's plans to release risk-adjusted death
rates, but they lost. One earlier report cited the good which has come from
it. One hospital had a very high death rate and was investigated by a team
of experts. They found out that the hospital was so efficient they rushed
surgery soon after a heart attack. That turned out to be the risk. When
they waited several days, their rates fell to average. That was a new
finding. Press reports also state that at some hospitals deaths following
heart bypass surgery apporach one third. Do you think ANY patient would go
to that hospital if they knew? But nothing is done about that kind of thing
in most states.

   So, let me ask you this: If you had a 4% risk of death from a certain
surgery, would you get it? Given that you are equally as likely to be alive
after a heart attack in Canada after 5 years (or 9 I think), and they don't
do that much bypass surgery, would you go for the surgery? And heart
catherizations go with a certain risk too. When my wife asked about the
death rate from this at UNC Hospitals, she was given NATIONAL data. When
she ask what the risks were for UNC Hospitals, she was told, "We don't know
that." Right!!!!

  So do you get all the data? Heck no. You either are not told, or are
told "We don't know," or you have to know the data is there, and demand it,
or look it up yourself.

   Several musicians I follow have died following heart procedures. June
Carter Cash and Carl Story are two. They would still be around if they had
just said NO.

  So what would you do Ashley? I'd go for another hospital myself. A
different team.

Relevant Pages

  • Re: Canadian doctors coming to the US
    ... Let me follow up my earlier posts based on Clinton's heart bypass. ... Surgeons stated for the press that they do NOT give out death risks, ... The hospital where Clinton rests has a risk-adjusted death rate of 4%, ... Hospitals bitterly fought NY State's plans to release risk-adjusted death ...
    (sci.med.nutrition)
  • Re: Canadian doctors coming to the US
    ... Let me follow up my earlier posts based on Clinton's heart bypass. ... Surgeons stated for the press that they do NOT give out death risks, ... The hospital where Clinton rests has a risk-adjusted death rate of 4%, ... Hospitals bitterly fought NY State's plans to release risk-adjusted death ...
    (sci.med.cardiology)
  • Re: Canadian doctors coming to the US
    ... NY State is very advanced in making risk-adjusted death ... > The hospital where Clinton rests has a risk-adjusted death rate of 4%, ... so all hospitals are rated as if they were operating on ... That turned out to be the risk. ...
    (sci.med)
  • Re: Canadian doctors coming to the US
    ... NY State is very advanced in making risk-adjusted death ... > The hospital where Clinton rests has a risk-adjusted death rate of 4%, ... so all hospitals are rated as if they were operating on ... That turned out to be the risk. ...
    (sci.med.cardiology)
  • Re: Canadian doctors coming to the US
    ... NY State is very advanced in making risk-adjusted death ... > The hospital where Clinton rests has a risk-adjusted death rate of 4%, ... so all hospitals are rated as if they were operating on ... That turned out to be the risk. ...
    (sci.med.nutrition)