Re: Too Much Medicare "Care" Again


"George Conklin" <georgeconklin1@xxxxxxxxxxxxx> wrote in message
news:BnUNh.17979$Jl.3222@xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
We have known that other nations that spend less on medical care get
better
results. Once again we can see why with this following report:

------

The study of more than 2,000 patients found that those who underwent the
expensive procedure, known as angioplasty, in non-emergency situations
were
no less likely to suffer a heart attack or die than those who only took
aspirin and other medicines to thin their blood and lower blood pressure
and
cholesterol, along with adopting life style changes.


The study is the first large, well-designed comparison of angioplasty to
non-surgical care for patients who are not actually having heart attack or
in imminent danger of one. Patients routinely undergo the procedure to
relieve chest pain and to reduce the risk of having or dying from a heart
attack.

"The data are compelling," said William E. Boden of the University of
Buffalo, whose findings were released Monday by The New England Journal of
Medicine to coincide with a presentation at a meeting of the American
College of Cardiology in New Orleans. "We do too many of these
procedures."

Several experts said they expected the findings will prompt a major shift
in
how doctors treat thousands of patients suffering from heart disease --
the
nation's leading cause of death.

"These findings are pretty explosive," said Steven Nissen, president of
the
American College of Cardiology. "I think this is going to shake things up
pretty significantly."

The findings underscore the danger of rushing to adopt a procedure before
careful studies have been conducted to fully determine its benefits, Boden
and others said.

"There was just this intuitive belief that it would be beneficial," Boden
said. "But no one had ever done a proper randomized trial to see whether
it
actually improved outcomes. In the meantime, a whole industry has been
created around this."

------
Notice the words:

"The findings underscore the danger of rushing to adopt a procedure before
careful studies have been conducted to fully determine its benefits."

Remeber HRT? It was harmful? Now we need to find out about PSA
tests...so
far no good evidence they do any good either.

Ah, there you go again George. Now you just know that's gonna draw me right
in.

HRT was not harmful. Read the studies and look at the RAW data, not just
the sensationalistic conclusisions drawn. But you know what, I'm not here
to talk about HRT.

Let's talk about PSA.

Fact - prostate cancer kills people. Fact - screening with PSA detects more
prostate cancer than not screening with PSA. Fact - there have been
randomized controlled done comparing, after a diagnosis of prostate cancer,
men with no surgery vs. men who undergo surgery. This has shown a clear
overall and disease specific survival for those treated with surgery.

So we KNOW operating on prostate cancer saves lives. We KNOW screening with
PSA detects prostate cancer (and thus saves lives).

What we do NOT know is which patients will have that benefit and which
won't. I am far more stringent in my criteria for operating than 90% of
those in my field, but even I acknowledge there are certainly people who's
lives I'm saving by operating. I just wish I knew beforehand who they were.
Sadly, I don't have a crystal ball.

Before you go off on a reimbursement rant - I HATE prostatectomies as a
surgery. I would prefer not to do them. They can get kind of dicey, you
take a percentage of men who have no urinary complaints and make them
inctontinent. You make a good number impotent if they aren't already. It
can be letigious. I can get paid FAR more money for several office based
procedures and not have the hassle of inpatients, complications, postop
followup, etc. So spare me.


.

Relevant Pages

  • Re: Too Much Medicare "Care" Again
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