Comments on: My take: Henschke, insolvency, MIs, specificity http://www.kevinmd.com/blog/2008/03/my-take-henschke-insolvency-mis.html medical blog Sun, 22 Nov 2009 14:15:05 -0500 http://wordpress.org/?v=2.8.4 hourly 1 By: Anonymous http://www.kevinmd.com/blog/2008/03/my-take-henschke-insolvency-mis.html/comment-page-1#comment-84619 Anonymous Sat, 29 Mar 2008 15:33:00 +0000 http://clients.emmense.com/kevinmd/2008/03/my-take-henschke-insolvency-mis-specificity.html#comment-84619 My antidotal experience with breast MRI's is that they are not good screening tools. <br/><br/>I interact with a group where all the women have already had breast cancer, so they're considered high risk. A number have had MRI's as a matter of their routine follow-on, and more than half (of a very small number) have had biopsies -- none of which have resulted in anything besides a fee for the facility. <br/><br/>If I were a payer I would be setting conditions on MRI usage because it seems like they just run up bills and worry without actually finding very much. My antidotal experience with breast MRI’s is that they are not good screening tools.

I interact with a group where all the women have already had breast cancer, so they’re considered high risk. A number have had MRI’s as a matter of their routine follow-on, and more than half (of a very small number) have had biopsies — none of which have resulted in anything besides a fee for the facility.

If I were a payer I would be setting conditions on MRI usage because it seems like they just run up bills and worry without actually finding very much.

]]> By: Anonymous http://www.kevinmd.com/blog/2008/03/my-take-henschke-insolvency-mis.html/comment-page-1#comment-84615 Anonymous Sat, 29 Mar 2008 11:58:00 +0000 http://clients.emmense.com/kevinmd/2008/03/my-take-henschke-insolvency-mis-specificity.html#comment-84615 Ignoring Cave Troll Lawyer for a moment, I'm still confused about the massive conflict of interest tobacco has with regard to lung cancer scanning. If anything it would detect more lung cancers. It's typical of the kneejerk reaction that (vilified industry) must have a secret hidden evil reason for everything, much like Dick Cheney in his hidden secret base. Sometimes a cigar is just a cigar.<br/><br/>The patent stuff is totally unacceptable, but she'll get hammered for that (and rightfully). But the furor over the tobacco money, complete with allegations of "blood money" is absurd. Ignoring Cave Troll Lawyer for a moment, I’m still confused about the massive conflict of interest tobacco has with regard to lung cancer scanning. If anything it would detect more lung cancers. It’s typical of the kneejerk reaction that (vilified industry) must have a secret hidden evil reason for everything, much like Dick Cheney in his hidden secret base. Sometimes a cigar is just a cigar.

The patent stuff is totally unacceptable, but she’ll get hammered for that (and rightfully). But the furor over the tobacco money, complete with allegations of “blood money” is absurd.

]]> By: Anonymous http://www.kevinmd.com/blog/2008/03/my-take-henschke-insolvency-mis.html/comment-page-1#comment-84613 Anonymous Sat, 29 Mar 2008 05:03:00 +0000 http://clients.emmense.com/kevinmd/2008/03/my-take-henschke-insolvency-mis-specificity.html#comment-84613 According to Kevin, most physicians on here prescribe all kinds of tests people don't need and that aren't medically indicated out of a fear that they might not have as much money in their pockets.<br/><br/>But this woman should be vilified for doing the same thing?<br/><br/>Not to mention that nearly every physician is in bed with "Big Tobacco" on tort reform, and all so they can both keep a few dollars, but again this woman should be questioned because she's also in bed with Big Tobacco?<br/><br/>Sounds like physicians are finding the speck in another's eye. According to Kevin, most physicians on here prescribe all kinds of tests people don’t need and that aren’t medically indicated out of a fear that they might not have as much money in their pockets.

But this woman should be vilified for doing the same thing?

Not to mention that nearly every physician is in bed with “Big Tobacco” on tort reform, and all so they can both keep a few dollars, but again this woman should be questioned because she’s also in bed with Big Tobacco?

Sounds like physicians are finding the speck in another’s eye.

]]> By: Ian Furst http://www.waittimes.blogspot.com http://www.kevinmd.com/blog/2008/03/my-take-henschke-insolvency-mis.html/comment-page-1#comment-84607 Ian Furst http://www.waittimes.blogspot.com Fri, 28 Mar 2008 23:59:00 +0000 http://clients.emmense.com/kevinmd/2008/03/my-take-henschke-insolvency-mis-specificity.html#comment-84607 About once a month someone arrives at our clinic with chest pain or some sort of funky arrhythmia (usally afib with rapid response). I'm blown away at how reluctant staff and patients are to call 911. Someone can be having classic chest pain and they still want to drive to hospital. I think it's a desire not to squander resources but I wonder what the effect has been of campaigns to stop useless 911 calls. Maybe we need to go back to the early 1980's campaigns when 911 was first introduced? About once a month someone arrives at our clinic with chest pain or some sort of funky arrhythmia (usally afib with rapid response). I’m blown away at how reluctant staff and patients are to call 911. Someone can be having classic chest pain and they still want to drive to hospital. I think it’s a desire not to squander resources but I wonder what the effect has been of campaigns to stop useless 911 calls. Maybe we need to go back to the early 1980’s campaigns when 911 was first introduced?

]]> By: DDx:dx http://www.kevinmd.com/blog/2008/03/my-take-henschke-insolvency-mis.html/comment-page-1#comment-84600 DDx:dx Fri, 28 Mar 2008 20:41:00 +0000 http://clients.emmense.com/kevinmd/2008/03/my-take-henschke-insolvency-mis-specificity.html#comment-84600 I vote for a "Kevin's Take" section with comments available for each separate post...<br/>#1<br/>Why isn't this behavior just a logical extension of fee for service medicine? So she's making a buck(or 2) on a scheme. Would not a true free market supporter(like Kevin) relish this entrepreneurial attitude? Docs are human. Systems need to reflect this. <br/>#3. Gosh Kevin, it sounds like you are infavor of promoting public awareness rather than investigating another coated stent. Is the "public health" side of you showing?<br/>#4.<br/>Ferreting out the nuance and subtlety of statistical screening specificity/sensitivity can only be accomplished by a motivated individual. The only way I can imagine the public finding this motivation is if the decisions involves THEIR money. But screening is an impossible sell to the general public. SO, again, should market forces be applied or a public health model? <br/>Most civilized nations agree the public health is in the public's interest to fund. And control. Then if the folks with big bucks want an elective Breast screening MRI to feel special...let 'em. I vote for a “Kevin’s Take” section with comments available for each separate post…
#1
Why isn’t this behavior just a logical extension of fee for service medicine? So she’s making a buck(or 2) on a scheme. Would not a true free market supporter(like Kevin) relish this entrepreneurial attitude? Docs are human. Systems need to reflect this.
#3. Gosh Kevin, it sounds like you are infavor of promoting public awareness rather than investigating another coated stent. Is the “public health” side of you showing?
#4.
Ferreting out the nuance and subtlety of statistical screening specificity/sensitivity can only be accomplished by a motivated individual. The only way I can imagine the public finding this motivation is if the decisions involves THEIR money. But screening is an impossible sell to the general public. SO, again, should market forces be applied or a public health model?
Most civilized nations agree the public health is in the public’s interest to fund. And control. Then if the folks with big bucks want an elective Breast screening MRI to feel special…let ‘em.

]]> By: Anonymous http://www.kevinmd.com/blog/2008/03/my-take-henschke-insolvency-mis.html/comment-page-1#comment-84599 Anonymous Fri, 28 Mar 2008 19:57:00 +0000 http://clients.emmense.com/kevinmd/2008/03/my-take-henschke-insolvency-mis-specificity.html#comment-84599 At least Claudia Henschke didn't take a pen or a sticky pad. At least Claudia Henschke didn’t take a pen or a sticky pad.

]]> By: Edward Sodaro MD http://www.kevinmd.com/blog/2008/03/my-take-henschke-insolvency-mis.html/comment-page-1#comment-84597 Edward Sodaro MD Fri, 28 Mar 2008 16:47:00 +0000 http://clients.emmense.com/kevinmd/2008/03/my-take-henschke-insolvency-mis-specificity.html#comment-84597 Medicare projected cumulative deficits are well into the double figure trillions (no, not a misprint). <br/><br/>Medicare is therefore simply a classic Ponzi Scheme, albeit perhaps the largest in human history, nearing the mathematical end of the scam. <br/><br/>And yet the vast majority of the Ponzi Scheme's victims (doctors and patients) are totally oblivious to the obvious. The mental mechanism of denial never ceases to amaze.<br/><br/>Dr. Wes' brilliant analysis is the first blueprint I have read, with prescriptions for surviving the near future inevitable. Well worth a read.<br/><br/>http://drwes.blogspot.com/2008/03/imagine-world-without-medicare.html Medicare projected cumulative deficits are well into the double figure trillions (no, not a misprint).

Medicare is therefore simply a classic Ponzi Scheme, albeit perhaps the largest in human history, nearing the mathematical end of the scam.

And yet the vast majority of the Ponzi Scheme’s victims (doctors and patients) are totally oblivious to the obvious. The mental mechanism of denial never ceases to amaze.

Dr. Wes’ brilliant analysis is the first blueprint I have read, with prescriptions for surviving the near future inevitable. Well worth a read.

http://drwes.blogspot.com/2008/03/imagine-world-without-medicare.html

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