Re: Is it ethical to charge for a wrong diagnosis?
- From: p.clarkii@xxxxxxxxx
- Date: Tue, 27 May 2008 19:09:23 -0700 (PDT)
On May 27, 11:25 am, ray <spamm...@xxxxxxxxxxxxxxxx> wrote:
On Mon, 26 May 2008 20:48:20 -0700 (PDT), p.clar...@xxxxxxxxx wrote:
and again, it sounds like you've seen 3 different eye docs and 2 have
given you diagnoses other than Fuch's, while only 1 has suggested
Fuch's is the cause. why do you believe the diagnosis from the
single doctor as compared to the other two? on what basis do you
judge which doctor is right?
A good question to which I wish I had the definitive answer. Fuchs'
is diagnosed based on the guttata and corneal thickness. In my case
he judged the guttata as stage 3+ (0 is good 5 is worst). This is a
subjective measurement. Normal corneal thickness is about 550, it
does not usually get worse than 700. Mine measured 630 and 645 which
is an objective measurement and most likely indicates Fuchs'. Fuchs'
affects about 1% of the population and many doctors don't look for it.
I am told that when it exists it is not difficult to diagnose. Both
doc1 and doc3 said there are cataracts, but neither thought they were
the major cause of my problem.
i'm not trying to beat up on you, but I think you are believing that
medical services that are rendered by a doctor are the same as
returning a defective product at Wal-Mart.
On the other hand, whether or not you specifically requested that the
ophthalmologist perform a refraction and give you a valid eyeglass
prescription I don't know. if you didn't request it, then you "might"
try not paying the fee for the refraction and return any written-out
spectacle prescription you might have been given. If you didn't ask
for a valid prescription then it could be viewed as an unnecessary
procedure. Kind of like the cashier at Wal-Mart throwing something
extra in your bag that you didn't want to buy.
Doc1, the optometrist did a refraction, said my prescription was off
by .25 diopters in one eye which he said did not warrant new glasses,
He did not charge for the refraction. Doc2, whose ethics I am
questioning, did not explain to me that Medicare does not pay for
refraction, did not mention any extra charge, and did not give me an
option to accept or decline the refraction. His refraction was off by
the same amount as doc1. If given the option I probably would have
declined based on the opinion of doc1.
In the past I have faced similar situation. I was prescribed an arm
brace which Medicare does not pay for. I was given the option and
charges were explained. I accepted and paid. It did not help my
pituitary condition and I did not complain. I thought it was
perfectly fair.
and to reiterate, why do you believe the doc who gave you the Fuch's
diagnosis versus the other two? its 2 against 1 and for some reason
you're convinced the 1 is correct.
I think I addressed it above, but I will give two more examples of
medical diagnosis. I had an problem where I could not lift my right
hand above my head. I got 6 opinions as to the cause of the problem.
They included sprain, carpal tunnel, calicific tendenitis,
malingering, bone spur, etc. The orthopedic surgeon found a bone spur
that no one saw. Even I could see it when he took the X-ray from the
right angle. He did a MRI that showed no problem with rotator cuff. I
agreed to have him operate. The bone spur was 10mm, one of the
largest he ever saw. When he was in there scoping around he found the
real problem and sewed up the torn rotator cuff. Clearly this is not
a case where taking a vote. I have hypo pituitary condition that took
12 different doctors to diagnose. How do I know the last guy is
correct? I don't know for sure, but hormone replacement certainly
makes all the symptoms go away.
Fuch's is diagnosed by the appearance of the endothelial cell layer.
The presence of guttatta and polymegathism are positive signs.
Corneal thickness measurements are not diagnostic for Fuch's.
Furthermore there are significant differences in corneal thickness
between individuals with perfectly normal unaffected eyes. Corneal
thickness readings of 645 do not suggest Fuch's, only that a persons
cornea is thicker than average. Nothing more. The fact is that most
Fuch's cases, unless they are severe, do not affect a person's visual
acuity that much.
.
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