Get your colonoscopy!

[TeeRuh]

Gail, I had mine last Friday and though all the paperwork isn't in the belief is that insurance is covering it. Mine is covered under "wellness checks" (not sure what the correct term in). i.e.; Insurance will cover one colonoscopy every x (5 or 10) years after age 50. Similar to annual blood work, periodic chest x-ray, etc.

t.r.

 

[Gail]

Apparently, the only way mine would be covered under my "wellness" plan is if it is done in a physician's office.

My thinking is, if I have to pay the entire cost, then I want to wait until after the first of the year so that it will apply to next year's deductible. It just doesn't make sense to pay out that much money this late in the calender year.

 

[PBAT]

Can your physician recommend a doctor that does these in an office rather than a hospital? Our doc is in a practice that includes an "endoscopy center" at a separate office, and that was not considered outpatient so we paid only the copay.

 

[TromboneAl]

I waited until I had something that caused me to meet my deductible (hernia repair), so that it was free. Perhaps you can delay a year or two until you have some other medical expense.

 

[Gail]

Al, that's why I'll probably wait until the first of the year. I'm not inclined to postpone beyond that, since my mother died recently from colon cancer. Even though she was 93, I'm a little nervous.

 

[Brat]

My experience with a procedure in an MD's office brought me to the conclusion that it was of limited value... and it wasn't a procedure that I want to repeat.

Years passed (at least 5) so I had one as an outpatient in a hospital which went well and turned out to have value. Frankly the anesthesia is why I would want to have the procedure in a full service facility.

 

[TeeRuh]

Amen to the anesthesia; I really can't imagine having one in a doctor's office.

Dr.: "Are you getting sleepy?"
Me: "No."
Nurse: "You're in recovery and the procedure is over. You can get dressed and go home."

 

[TromboneAl]

Dr.: "Are you getting sleepy?"
Me: "No."
Nurse: "You're in recovery and the procedure is over. You can get dressed and go home."

That's not bad, but this is better:

Dr.: "Are you getting sleepy?"
Me: "Oh, wow, man, this feels good. Oh, wow, I really..."
Nurse: "You're in recovery and the procedure is over. You can get dressed and go home."

 

[TeeRuh]

been there done that ... 1970 ... but I don't think I was in a Dr.s' office ...

 

[Gail]

You all have hit on the main reason that I have reconciled myself to paying for this out patient procedure....I want all the drugs that they can legally provide!

 

[happy2bretired]

Mine are done in an outpatient surgical center. It's a nice set up. Knock you into twilight sleep and you're out of the clinic in a couple of hours. Anyway, I think it's a couple of hours...I'm kinda goofy when I leave. My insurance pays for most of it. I can't remember how much.

 

[MikeD]

Dr.: "Are you getting sleepy?"
Me: "No."
Nurse: "You're in recovery and the procedure is over. You can get dressed and go home."

When I woke up from my most recent transplant in the ICU I thought I hadn't gone in for surgery yet. They found that amusing.

Mike D.

 

[Helena]

There is another side to this issue...

As American hospitals are staffed more and more
by third world immigrants, the quality of medical
care suffers.

I expose myself as little as possible to this danger.



Pittsburgh hospital urges its colonoscopy patients to undergo HIV testing

Provided by: The Canadian Press
Mar. 30, 2005

MONROEVILLE, Pa. (AP) - A suburban Pittsburgh hospital is urging about 200 patients who had colonoscopies during a four-month span to get tested for hepatitis and the virus that causes AIDS because the instruments may not have been disinfected adequately.


Forbes Regional Hospital officials said the patients' risk of exposure to a blood-borne virus was low. The hospital contacted patients who were exposed to the instruments during colonoscopies from Oct. 28 to Feb. 26, and offered them free HIV and hepatitis screenings immediately and again in six months.


Nearly 70 patients have contacted the hospital so far, said hospital spokesman Tom Chakurda.


Staff at the Monroeville hospital's lab discovered in February that secondary channels on two recently purchased colonoscopes might not have been adequately disinfected, the hospital said in a statement Wednesday. The auxiliary channels, which are designed to flush the colon, were not used in any of the colonoscopies performed.


Laura Tyler of manufacturer Olympus America Inc. said the Melville, N.Y., company has sent out reminder notices about the proper way to disinfect the instruments. The instruction manual is "detailed and explicit," she said.
Tyler said she had no evidence of a "larger problem" involving the scopes. Forbes, citing the Centers for Disease Control and Prevention, said similar concerns had been raised at hospitals in California and New York. CDC officials did not immediately return a call.


Pittsburgh hospital urges its colonoscopy patients to undergo HIV testing - Infection - AOL Health

 

[razztazz]

But Helena, if you don't accept the risk of Dr's and hospitals and "screening procedures" (which they will always seek to keep you from knowing. It's bad for business, ya know) you might get colon cancer someday! (But probably not) Whooo--booga booga! Better roll the dice on their terms and take your chances instead of just taking chances

 

[Helena]

I always thought it rather curious that colonoscopy became widely promoted
at the same time as a certain alternate lifestyle... quite a coincidence.

 

[FinanceDude]

I always thought it rather curious that colonoscopy became widely promoted
at the same time as a certain alternate lifestyle... quite a coincidence.

We need Rich to comment on that??

 

[cute fuzzy bunny]

Well now heres an interesting question with regards to HMO's and PPO's.

Seems like some folks are concerned that there may be a poor balance between the risks of the procedure vs the risk of the results. A regular doctor through a PPO plan obviously wants to do the right thing while the insurance company wants to minimize paying for unnecessary procedures. Obviously theres enough evidence to suggest that a colonoscopy as paid for by the insurer is either something they cant escape because nobody would buy their insurance without it or because the odds of finding something through the procedure produces a favorable cost analysis vs the odds of not doing one and having a serious illness develop.

In this case, the doctor has to weigh the risks and benefits of recommending a procedure that the patient and insurer pays for, and if something goes wrong in the procedure its on the head of the specialist who did the procedure, vs recommending against it and having the patient become ill and litigious because the physician said "I dont think this is necessary".

What about an HMO? Self contained and with any bad outcome/litigation possibilities all aimed at the same organization and all the yinging and yanging happening under one roof, would one consider that an HMO doctors suggestion for a colonoscopy being a more well weighed balance of costs and risks both in general and in particular to the patient?

Since moving from a PPO to an HMO, I've been pondering this aspect of my medical care. Some say you just wont get care from an HMO thats as good as a PPO because the doctor can fight against the insurance company to get whats best for the patient. Which works out great if whats right for the patient is the only consideration involved.

On the other hand, providing death isnt an acceptable outcome of the analysis, the HMO will do the least required to produce the most inexpensive outcome. Which in many cases might be the best thing for me.

Obviously the results could be very different between a good HMO and a bad HMO, or between a bad HMO and a great PPO doctor.

My HMO (Kaiser, highly rated) says the following:

Key points in making your decision

* Regular screening can greatly decrease your risk of colorectal cancer.
* Regular screening is recommended for everyone age 50 and older.
* Screening tests find colon polyps. Most cases of colorectal cancer begin as polyps. When polyps are found, they can be removed before they become cancer or while the cancer is in its early stages.
* Colorectal cancer rarely causes symptoms in the beginning. Symptoms such as bleeding from the rectum, a change in bowel habits, and weight loss usually occur later, when the cancer is harder to treat.
* You may need to begin screening at age 40 or earlier and be tested more often if you or members of your family have a history of colon polyps or colorectal cancer.
* You may need to begin screening earlier if you have Crohn's disease or ulcerative colitis.

Hmm, so if you're a high risk person they want to start doing it at 40 and recommend it for those 50 or older. Not a conditional "if your doctor recommends it" or any waffling at all.

Based on this, it seems to me that in a broad analysis, its more likely to be beneficial and reduce future medical costs and implications to have the test done. Their root fee for a PPO Kaiser member that has a high deductible is between $750 and $850. My cost as an HMO member is $0.

 

[razztazz]

A regular doctor through a PPO plan obviously wants to do the right thing

Oh really? I wouldnt bet the rent.

My HMO (Kaiser, highly rated) says the following:

Key points in making your decision

* Regular screening can greatly decrease your risk of colorectal cancer

"Greatly"? What do they mean by "greatly"? "Great" compared to what? "Risk"? What's the frequency, Kenneth? No need to ask questions. All we need to know is "RISK!" and GREATLY REDUCES!"

Regular screening is recommended for everyone age 50 and older.

On what basis? 50 is a round (profit maximizing) number? I can't find any Dr's office who can answer that. But I have found 2 that insist we need to start getting them at 40 not 50.

* Screening tests find colon polyps. No, they MIGHT find polyps. And they MISS lots of polyps thus reducing their efficacy even more.

Based on this, it seems to me that in a broad analysis, its more likely to be beneficial and reduce future medical costs and implications to have the test done.

Only "in the aggregate" (big roulette wheel) which does apply to any one individual nor address anyone's personalunfortunate sequelae

 

[cute fuzzy bunny]

Okay then, in that analysis nothing would ever be appropriate to do for anyone as long as there was even a single person whose risk rose above the risk of the medication/procedure.

And if you dont trust the doctor to make sure the risk is adjusted for the person or that the doctor has anything less than instilling good health in the patient, then you might as well drop your insurance, forget about the doctor and hope for the best.

That might work out pretty well for some people.

Probably not the way I'd go about it, but to each their own.

 

[FinanceDude]

I think virtual is the way to go........perforated colons don't sound fun at all..........

 

[razztazz]

And if you dont trust the doctor to make sure the risk is adjusted for the person or that the doctor has anything less than instilling good health in the patient, then you might as well drop your insurance, forget about the doctor and hope for the best.

What's one got to to with the other? Just because there are flaws in the tests and their application, and a person thinks more of himself than a mere statistic and doesn't have any reason to believe the doctor knows everything, is no reason to drop the insurance, stop being proactively health conscious and just hope for the best? Hoping for the best is sort of what underpins getting the test anyway.

 

[cute fuzzy bunny]

Okay I'm confused. You note that you dont feel that the doctor has my best interests at heart, but then that if thats the way one feels, one should continue to pay expensive insurance to receive care from the doctor who will have me do things that arent good for me?

Or is it that I should pay, go to the doctor, but second guess everything he tells me?

Nevermind...I've had a few too many of these conversations lately.

 

[Nords]

"Greatly"? What do they mean by "greatly"? "Great" compared to what? "Risk"? What's the frequency, Kenneth? No need to ask questions. All we need to know is "RISK!" and GREATLY REDUCES!"

How nice to have you [-]ranting[/-] back again, Razz. After more than a year, to what do we owe the occasion?

 

[razztazz]

How nice to have you ranting

Just going thru the attic. I see nothing's changed.

 

[FinanceDude]

How nice to have you ranting

Just going thru the attic. I see nothing's changed.

Post more....you have a fresh outlook...........