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Thread: Experts question motives of mammogram guidelines

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    Re: Experts question motives of mammogram guidelines

    Quote Originally Posted by RightinNYC View Post
    Experts question motives of mammogram guidelines | Health | Reuters



    I'm all for cutting back on care that isn't cost-efficient, but the timing of this move really does make you wonder whether the new guidelines were influenced by something other than science.
    I feel that doctors order a lot of expensive diagnostics on flimsy grounds just because they are there. Not sure specifically on the mammogram.

    Case in point: Three years ago, a doctor told me I now have a heart murmur. I'm having no symptoms of decreased cardiac output. Since that time 2 other doctors have heard the murmur and recommend a baseline echocardiogram, which is an ultrasound of the heart that measures mechanical function of each chamber of the heart and the heart valves, and overall cardiac output.

    I work on a per diem basis in a hospital by choice so I can have maximum flexibility and control over my schedule. This means that I don't receive any health insurance through my work, but instead buy a policy with a $3000 deductible, 6 office visits a year, yearly checkup. A friend of mine with a similar policy and a heart murmur did get an echocardiogram and it cost $700.

    Yesterday at work I asked my favorite cardiologist for advise on my situation. He said he would listen to my heart and we could have the echo tech do a quickie unofficial echo if needed. He listened to my heart murmur and said that you can barely hear it and that I definitely don't need an echo done.

    This just proves to me that a lot of doctors are ordering expensive diagnostics, most likely to cover their asses, and also because they are there and insurance will pay.

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    Re: Experts question motives of mammogram guidelines

    Quote Originally Posted by MyOwnDrum View Post
    I feel that doctors order a lot of expensive diagnostics on flimsy grounds just because they are there. Not sure specifically on the mammogram.

    Case in point: Three years ago, a doctor told me I now have a heart murmur. I'm having no symptoms of decreased cardiac output. Since that time 2 other doctors have heard the murmur and recommend a baseline echocardiogram, which is an ultrasound of the heart that measures mechanical function of each chamber of the heart and the heart valves, and overall cardiac output.

    I work on a per diem basis in a hospital by choice so I can have maximum flexibility and control over my schedule. This means that I don't receive any health insurance through my work, but instead buy a policy with a $3000 deductible, 6 office visits a year, yearly checkup. A friend of mine with a similar policy and a heart murmur did get an echocardiogram and it cost $700.

    Yesterday at work I asked my favorite cardiologist for advise on my situation. He said he would listen to my heart and we could have the echo tech do a quickie unofficial echo if needed. He listened to my heart murmur and said that you can barely hear it and that I definitely don't need an echo done.

    This just proves to me that a lot of doctors are ordering expensive diagnostics, most likely to cover their asses, and also because they are there and insurance will pay.
    This is it, exactly....
    They need those tests to bump up the bottom line....
    This is no different than drug reps whining when their drug is taken off the preferred prescription list.....
    I find it hard to believe that Obama is dictating health policy to the CDC...
    I'm sure the recommendation for someone who has a history of breast cancer in their family would be different....
    The health care providers see it as ten years of revenue shot to hell, nothing more.....

  3. #23
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    Re: Experts question motives of mammogram guidelines

    Quote Originally Posted by underdog334 View Post
    The reccommendation was based on a cost-benefit analysis,which means that the panel had to arrive at the dollar value of a woman's life. I wonder what that value was. I notice on the EPA website that a human life is valued at around $5 Million. Folks,here's your death panel in action. I'm wondering do different races have different rates of breast cancer? If so,why no outcry over the racism of this decision?
    No, it was based on what is done elsewhere and what is standard practice elsewhere.

    It is not stopping women from having mammograms - just saying these are the ones we should concentrate on
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    Re: Experts question motives of mammogram guidelines

    Quote Originally Posted by RightinNYC View Post
    There's absolutely a way to know - conduct a scientific study. So far, no study has proven a link.

    You're free to err on the side of caution as it relates to your own personal choices, but when it comes to setting policy for the nation, we should be looking at scientific facts.
    Proven links and facts are not part of science really, that may be the mistake in thinking that.
    Science is falsifiable. Science as it concerns medicine is so primitve in terms of certainty that it's a terribly difficult job to promote national guildelins on health, and the understanding is that the guidlines will change relatively frequently.

    That's just how it is. Same with prostate exams, this isn't just breast cancer. Same with eating fat (learned fat from trans fat vs sat vs unsat), etc.

    Guidelines are what they are. Nothing beats discussing it, in an informed manner with your doctor(s). That's what the guidlines now prompt. Not "regular screening", but "consult with your doctor", because the pros are not significant enough. That could reverse in a few years with new information or new thinkers. But that's what science does. The alternative is God did it, just pray
    Between false positives, causing cancer, exacerbating existing cancer, biopsy risks, and no real help in terms of mortality (recalling news reports from memory here), it made sense to pull back on "suggested every year starting at 40".
    Last edited by Mach; 11-17-09 at 07:39 PM.

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    Re: Experts question motives of mammogram guidelines

    I know I sound like a broken record, but this is what happens when the government forces itself in to the free market.

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    Re: Experts question motives of mammogram guidelines

    Quote Originally Posted by Jackboot View Post
    I know I sound like a broken record, but this is what happens when the government forces itself in to the free market.
    And when the lawyers force their way into the free market of medicine, doctors order lots of diagnostic tests in order to cover their asses.

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    Re: Experts question motives of mammogram guidelines

    the rationing begins, at least that's how this story's gonna play across middle america

    politics is half the time just image

    other times it's real

    sometimes the two merge

    this appears to be one of those times

    politically, this story plays in harmony with "british women denied expensive breast cancer drugs, herceptin and aromasin:"

    British court denies woman's request for access to breast cancer drug

    http://www.telegraph.co.uk/news/ukne...ncer-drug.html
    Last edited by The Prof; 11-17-09 at 08:26 PM.

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    Re: Experts question motives of mammogram guidelines

    Quote Originally Posted by MyOwnDrum View Post
    This just proves to me that a lot of doctors are ordering expensive diagnostics, most likely to cover their asses, and also because they are there and insurance will pay.
    It's called defensive medicine and it wastes tens of billions of dollars. It's a shame that none of the health care bills offered by the Democrats addresses this problem.

    Quote Originally Posted by Mach View Post
    Between false positives, causing cancer, exacerbating existing cancer, biopsy risks, and no real help in terms of mortality (recalling news reports from memory here), it made sense to pull back on "suggested every year starting at 40".
    The report from the task force directly contradicts this.

    The task force concluded that one cancer death is prevented for every 1,904 women age 40 to 49 who are screened for 10 years, compared with one death for every 1,339 women age 50 to 74, and one death for every 377 women age 60 to 69.
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    Re: Experts question motives of mammogram guidelines

    It's a money saving measure... those who get breast cancer in their 40's won't be able to sue the government or these people who created these guidelines... so why not? This just goes to show, if this abortion of a health care bill gets passed more people will get health care, just not GOOD health care.

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    Re: Experts question motives of mammogram guidelines

    Quote Originally Posted by RightinNYC View Post
    The report from the task force directly contradicts this.
    No, it doesn't, beacuse the report does not discourge people from getting regular exams, it simply removes the federal guideline that it be every year with or without doctor/patient discussion on if it's necessary (it suggests something else, what...after 50 every other year or something like that).

    Let's put it this way RightinNYC, right now the medical establishment allows millions of people to die every day because they are not doing routine examinations, full body MRIs, etc. It's not that you shouldn't do these things, or that they are not helpful, it's their status as a medical guideline from that agency, which has a whole host of other factors involved. We're still free to push our doctors for whatever we want to pay for, or listent to their advice, or get 3 opinions, or get 3 opinions + follow federal guidelines...or not.
    Last edited by Mach; 11-18-09 at 01:18 PM.

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