Comments on: "Prostatempathy"

By: Anonymous

Anonymous — Tue, 10 Jul 2007 20:30:00 +0000

Medicare does not pay enought to cover the cost to do the procedure unless the biopsy is positive
Yes, but there is this little thing called “overdiagnosis” that increases the number of positive biopsies as well.
More tests = more diagnoses; but as of yet this hasn’t been shown to actually reduce mortality.

By: Anonymous

Anonymous — Tue, 10 Jul 2007 18:19:00 +0000

ERMURSE: Prostate biopsies are a loss leader in my office(I am a urologist). Medicare does not pay enought to cover the cost to do the procedure unless the biopsy is positive.

By: Anonymous

Anonymous — Tue, 10 Jul 2007 17:56:00 +0000

Yeah… maybe… but more likely you don’t know what you are talking about becuase you have never studied stats.

By: ERMurse

ERMurse — Tue, 10 Jul 2007 16:57:00 +0000

Or maybe Urologist order more PSA’s because they know that there are a lot of false positives but the only way to rule that out is to perform a very lucrative procedure (biopsy of the Prostrate) that coincidently they are able to perform. No that couldn’t be. No responsible Physician would want to order tests that could lead to unnecessary procedures.

By: Anonymous

Anonymous — Tue, 10 Jul 2007 16:40:00 +0000

Or maybe urologists order PSA more often because they are being sent problems that have prostate cancer in the differential and it needs to be ruled out. Look beyond the stats here guys. Just because a urologist finds more bladder cancer does that mean if you go to a urologist you are more likely to have bladder cancer. Think!

By: Anonymous

Anonymous — Tue, 10 Jul 2007 15:56:00 +0000

Maybe the urologists and older docs how unreliable and fragile guidelines, consensus panels, and expert recommendations really are.
Or maybe they are too arrogant to ignore guidelines based on studies and evidence and rely on their entirely anecdotal information.

By: Anonymous

Anonymous — Tue, 10 Jul 2007 15:34:00 +0000

So the better trained and more experienced are less likely to follow guideline, are more likely to exercise their own judgment, than those whose training is to just follow guidelines. Where is the news here? Maybe the urologists and older docs how unreliable and fragile guidelines, consensus panels, and expert recommendations really are.