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Old 05-05-2012, 03:24 PM   #21
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That is a lot of turmoil to go through and like everyone else I am glad it has a better outcome than expected.

My takeaway from your story is that if I end up in a similar situation, maybe I would question the "emergency" need for the test.

I went through quite a few months recently with my mom and a medical condition from which she ultimately -- and surprisingly -- died. During the last bits of those months I got a glimpse of "the man behind the curtain" and had to learn to ask questions much more diligently.

With medicine as with money, I feel no one will watch out for our interests as well as we do. We are our own first line of defense.

I have lost a lot of trust in those whom I trusted before.
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Old 05-05-2012, 04:53 PM   #22
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And finally, you probably shouldn't do anything else at all until the blood in your urine has gone away and you have a satisfactory explanation of what was causing it. Maybe both of those have happened, but you didn't report them yet.
ARB57...consider getting copies of the CT scan and get another opinion, preferably from a urologist. The CT scan results belong to you. I agree with BigNick in that you need to find the reason for the "large amount of blood". That would seem more important than the bill at the moment. Once you've done that, depending on the other opinion....you can decide how you want to handle the bill.
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Old 05-05-2012, 05:12 PM   #23
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IMHO, if the subsequent tests were only required to debunk the faulty diagnosis or only administered because of the faulty diagnosis, I'd work with you insurance company and the billing department to get those adjusted or eliminated. You do in fact owe them money, but you have recourse. You can dispute the bill and sate your reasons. Worse that can happen is you are told no.

I had a single drop of blood in the toilet one morning about 15 years ago. I searched high and low for the source. No external bleeding, no sneaky bloody nose, nothing! Just a single drop of blood in a bowl of yellow water. Urologist took tests, found nothing and shrugged his shoulders. I'm still alive. Glad it seems to be nothing, but definitely follow up with your urologist.
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Old 05-05-2012, 05:24 PM   #24
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Your profile indicates that you are in WA. Were I you I would find the best urologist in Seattle or Portland for a consult. If you don't know where to start I would look at faculty at the U of WA or OHSU. Bring a copy of all the lab results and CT scan.

Something bled into your bladder. You want to know why.
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Old 05-06-2012, 12:38 AM   #25
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Medicine is an Art not a Science

I am glad for you it wasn't a tumor that would have been a horrible diagnosis and one I wouldn't wish on anyone. I think $3k for peace of mind is okay. Empirically it probably was a stone (as you haven't told us yet what the final diagnosis is) and I question why a CT scan was performed when an ultrasound would have been faster and a lot cheaper. But, that is the choice the physician made at the time and based on what he sees. A lot of the diagnosis is based on clinical signs and symptoms. But, many patients present differently making that hard to interpret. The very best physicians I have worked with rarely order tests and treat empirically. It is also partially true that the malpractice issue is causing physicians to order tests to back-up their already formed diagnosis. There are others who are not so confident and perform "shot-gun" testing hoping to find something to assist them in the diagnosis. You can see the difference based on the amounts of tests ordered by a particular doctor. Most of medicine is really palliative care and 99% of problems will heal themselves and they know that well. In the ER it is hours of repeated sniffs and sniffles followed by the panic of real emergencies. In between are the "routine" emergencies. So, in their defense it gets frustrating to see so many patients coming to the ER with nothing serious wrong with them. Worse are the GOMERS (get out of my emergency room) who are chronic emergency room patients. So, it is a very tough profession. And the meaning of the word "professional" means in one sense artistic and not academic. That is the main difference between a PhD and an MD or for that matter a JD (Doctorate of Jurisprudence). A PhD is an academic degree based on skill and original research with significant contribution to science. A professional degree is largely "monkey see - monkey do" and rote learning. Did you know there aren't even grades at many Medical Schools? It is mostly pass/fail and if you fail you repeat the year you failed. But still it is a good system and the US has some of the best medical schools in the world. It just isn't the same thing as an academic degree nor should it be. The extremely gifted actually go on to earn a PhD after their medical school and are who I look for to have as my own personal physician. Additionally, the mannerism of their professional conduct can make the largest difference in outcomes. I have seen doctors that are perceived to be the very best who really are that good but have that added ability to act well and to make a theater of each patient's treatment. It is a very interesting fact that the patient's perception of the care is a large part of recovery and successful outcome. Compassionate and personal attention goes a long way towards successful treatment. Anyway, I though a bit of insight into the world of Emergency Medicine might help understand some of the issues from the other side of things.
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Old 05-06-2012, 10:00 AM   #26
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Originally Posted by Accidental Retiree View Post
During the last bits of those months I got a glimpse of "the man behind the curtain" and had to learn to ask questions much more diligently.

With medicine as with money, I feel no one will watch out for our interests as well as we do. We are our own first line of defense.

I have lost a lot of trust in those whom I trusted before.
+1. We ask more questions too, though we do our research first in an effort to not waste a doctors time with meandering questions. However, we find a lot of doctors are almost immediately put off even offended by any questions. But I'm hard to intimidate so I insist on answers to my (hopefully) concise questions. Another reason to ask only a limited number of good questions, obviously an irritated doctor might not provide the best care.

It's a balance. But after several conflicting diagnosis for DW on some serious but not life threatening conditions (and paying for all of them, good and bad), we also 'watch out for our interests.'

We don't have the same blind trust in doctors any more either, which can be "interesting" with a father who's a retired orthopedic surgeon...
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Old 05-06-2012, 10:02 AM   #27
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IMHO, if the subsequent tests were only required to debunk the faulty diagnosis or only administered because of the faulty diagnosis, I'd work with you insurance company and the billing department to get those adjusted or eliminated. You do in fact owe them money, but you have recourse. You can dispute the bill and sate your reasons. Worse that can happen is you are told no.
How do you make this work? Whenever we've asked about any discount for conflicting diagnosis, the insurance companies haven't been interested, they act like it's a waste of time...
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Old 05-06-2012, 10:47 AM   #28
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The delay and waste of time is posturing. There is a risk that subsequent diagnosis changes will cost more in the long run. They are in business primarily to make money by providing the belief of service so as to continue adding sales. There is a breakpoint where being too stingy on payouts has a backlash and reduces additional sales. It is financially more profitable to not provide any service but that isn't sustainable so it is a constant war within a given organization as to what they will or will not do. Then there are the actual rules which these days have no teeth. The best thing to do is to be knowledgeable about potential medical conditions, be fully aware of your family history and know your own personal normal values. Then ask questions and don't be put off by improper answers. Physician are limited to 15 minutes per patient but don't put up with that. It is tough on them and pushes the schedule behind and they are loathe to do it as they want to go home more or less on time as well but it is a patient's right to get straight answers. If you don't then vote with your feet.
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Old 05-06-2012, 10:57 AM   #29
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