Critical observations of health, science, and the physical therapy profession.
This is interesting: MSNBC did some calculations of the US budget and presented it in terms of a $1000 household budget. Most of your tax dollars go to finance healthcare. Personally disturbing for me, b/c I spent less than $400 on healthcare for myself last year!
For the picture, click here.
I wonder how much we could deduct off that amount if no needless MRI’s were performed. (see previous post)
ABSTRACT:
Using data from a large insurer in California, we identified the self-referral status of providers who billed for advanced imaging in 2004. Nearly 33 percent of providers who submitted bills for magnetic resonance imaging (MRI) scans, 22 percent of those who submitted bills for computed tomography (CT) scans, and 17 percent of those who submitted bills for positron-emission tomography (PET) scans were classified as “self-referral.” Among them, 61 percent of those who billed for MRI and 64 percent of those who billed for CT did not own the imaging equipment. Rather, they were involved in lease or payment-per-scan referral arrangements that might violate federal and state laws. [Health Affairs 26, no. 3 (2007): w415-w424 (published online 17 April 2007; 10.1377/hlthaff.26.3.w415)]
In other words, and put less politely, 60% of doctors were illegally billing for imaging studies. As you know, MRI and CT scans are expensive, often over $1000. The ability of a doctor to be paid for a test like this is just way to fishy for me. I wonder if the patients sent for theses images have the ignorant good fortune to hear, “Good news, your MRI was negative!” more than those patients whose doctors were not getting illegal kickbacks.
The proper use of advanced imaging is to rule in/out a diagnosis. The overuse of these images is rampant, as many people just order the image to “see what’s going on in there” as opposed to performing a thorough and telling clinical exam.
Another excerpt from the article:
I guess this is just another bit of evidence for why we should, as a society, increase our skepticism of the medical profession. They are, after all, human. Check out the WSJ Health Blog on this subject.
Today a patient came to see me with knee pain that she’s had for over 6 months. She had been to see a variety of care providers at different locations around the globe. Radiological imaging was performed and the resounding result of all her previous exams and imaging was “Nothing Found.”
Kurt Vonnegut has died. He split his head in a fall and last night he died. And so it goes…
“When the last living thing
has died on account of us,
how poetical it would be
if Earth could say,
in a voice floating up
perhaps
from the floor
of the Grand Canyon,
“It is done.”
People did not like it here.”
Labels: current press
Perhaps not directly, but a recent BMJ article says it can help in improving physical function and quality of life measures in patients with early stage breast cancer. Some of the physical measures noted were a 12 minute walk test and a measurement of shoulder mobility. Interesting to note, the physical measures improved right away, but it took some time for the quality of life measures to show an intervention effect.
There have been a series of studies (and this one) recently dealing with the issue. I find the concept refreshing, as it really makes sense to get some supportive literature behind some good integrative care. Perhaps with enough of this type of literature, a woman diagnosed with breast cancer will be able to receive treatment not just for her cancer, but also for her receding quality of life and upper limb function…and have it reimbursed!
I may have mentioned this in a previous post, but this article provided a nice overview of the events surrounding the emergence of a potentially fatal fungus in the Pacific Northwest.
A quote from the article:
“An alien fungus took root on Vancouver Island eight years ago and has since killed eight people and infected at least 163 others, as well as many animals.”
One very popular instance of serendipitous research occurred when Pfizer was working on an angina medicine and discovered the profound effects of Viagra. Here is another, less popular instance…The Anti-Hoarding Drug!
Excerpts from especially memorable patient encounters:
ME: So what made your back pain worse?
Patient: The Physical Therapy made is worse.
ME: Well, what did you do in PT?
Patient: What they told me to do.
ME: What did they tell you to do?
Patient: Things that hurt.
Excellent!
Labels: physical therapy
Labels: health policy, health tools, Science Literacy
Labels: current press, misc.