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Re: Doctors withholding information
2003-07-11 04:29:35
In article
Gretchen Evans >On 10 Jul 2003 09:19:12 -0500, hrubin@odds.stat.purdue.edu (Herman >Rubin) wrote: > >>In article >>Orac >>>In article >>> hrubin@odds.stat.purdue.edu (Herman Rubin) wrote: >> >>>> In article >>>> Orac >>>> >In article >>>> > hrubin@odds.stat.purdue.edu (Herman Rubin) wrote: >> >> ...................... >> >>>> But a large part of the blame is on the medical profession >>>> and even more on the government. If they tell you that >>>> they are doing what is right for you, and it goes wrong, >>>> they are to blame. >> >>>On the other hand, in this country, no amount of explanation will >>>convince all too many people that there are limits to medicine; that a >>>bad outcome does not equal malpractice; and that even perfect care will >>>not always result in a patient's cure. If your baby is has cerebral >>>palsy, it can't be the result of nature--it must be the obstetrician's >>>fault! Never mind that the obstetrician explained all the risks over and >>>over again. >> >>For one thing, we need REAL consent forms and consent >>procedures. Someone cannot give informed consent who >>does not understand the information. It need not be >>the physician who makes the explanation, but it must >>be made and understood before the action is taken. > >I'd certainly agree with that, Herman. The 'Informed Consent' >currently used neither informs nor provides sufficient information for >the patient to give consent. The a 'one size fits all' type form is >virtually impossible to develop since the comprehensive abilities of >each patient vary so greatly. > >To properly inform you'd probably need a trio of 'Philadelphia >Lawyers' standing by for each patient and you know what that would >bring about.. It HAS improved in recent years but there's a lot of >work still to be done. > ><< Remainder snipped >> > >pixie Of course when the studies show that the amount of medical care given in an area depends on how many people need to make their living from giving that care, it is obvious that patients feel they cannot refuse medical procedures offered. Consent forms are meaningless. They are simply a legal device to stop lawsuits. -- George Conklin, Durham, NC: Medicare For All Ages If HMOs ran the post office, the AMA (American Mail Association) would declare that getting mail was a privilege, not a right and 43 million Americans would get no mail delivery.
2003-07-12 05:59:34
On 11 Jul 2003 04:29:35 -0700, jeptha@shell.ntrnet.net ((null)) wrote:
>In article >Gretchen Evans >>On 10 Jul 2003 09:19:12 -0500, hrubin@odds.stat.purdue.edu (Herman >>Rubin) wrote: >> >>>In article >>>Orac >>>>In article >>>> hrubin@odds.stat.purdue.edu (Herman Rubin) wrote: >>> >>>>> In article >>>>> Orac >>>>> >In article >>>>> > hrubin@odds.stat.purdue.edu (Herman Rubin) wrote: >>> >>> ...................... >>> >>>>> But a large part of the blame is on the medical profession >>>>> and even more on the government. If they tell you that >>>>> they are doing what is right for you, and it goes wrong, >>>>> they are to blame. >>> >>>>On the other hand, in this country, no amount of explanation will >>>>convince all too many people that there are limits to medicine; that a >>>>bad outcome does not equal malpractice; and that even perfect care will >>>>not always result in a patient's cure. If your baby is has cerebral >>>>palsy, it can't be the result of nature--it must be the obstetrician's >>>>fault! Never mind that the obstetrician explained all the risks over and >>>>over again. >>> >>>For one thing, we need REAL consent forms and consent >>>procedures. Someone cannot give informed consent who >>>does not understand the information. It need not be >>>the physician who makes the explanation, but it must >>>be made and understood before the action is taken. >> >>I'd certainly agree with that, Herman. The 'Informed Consent' >>currently used neither informs nor provides sufficient information for >>the patient to give consent. The a 'one size fits all' type form is >>virtually impossible to develop since the comprehensive abilities of >>each patient vary so greatly. >> >>To properly inform you'd probably need a trio of 'Philadelphia >>Lawyers' standing by for each patient and you know what that would >>bring about.. It HAS improved in recent years but there's a lot of >>work still to be done. >> >><< Remainder snipped >> >> >>pixie > > Of course when the studies show that the amount of medical >care given in an area depends on how many people need to make >their living from giving that care, it is obvious that patients >feel they cannot refuse medical procedures offered. Consent >forms are meaningless. They are simply a legal device to stop >lawsuits. OK, Georgie..Just which studies 'show that the amount of medical care given depends on how may people need to make their living, etc." Please provide sufficient info so I can confirm your claim. Otherwise it's simply one more of your utterly asinine statements. pixie
2003-07-12 12:35:08
"Gretchen Evans" news:gdqvgvgd9rge42t38h0f1rg4ctlkut5c8a@4ax.com... > On 11 Jul 2003 04:29:35 -0700, jeptha@shell.ntrnet.net ((null)) wrote: > > >In article > >Gretchen Evans > >>On 10 Jul 2003 09:19:12 -0500, hrubin@odds.stat.purdue.edu (Herman > >>Rubin) wrote: > >> > >>>In article > >>>Orac > >>>>In article > >>>> hrubin@odds.stat.purdue.edu (Herman Rubin) wrote: > >>> > >>>>> In article > >>>>> Orac > >>>>> >In article > >>>>> > hrubin@odds.stat.purdue.edu (Herman Rubin) wrote: > >>> > >>> ...................... > >>> > >>>>> But a large part of the blame is on the medical profession > >>>>> and even more on the government. If they tell you that > >>>>> they are doing what is right for you, and it goes wrong, > >>>>> they are to blame. > >>> > >>>>On the other hand, in this country, no amount of explanation will > >>>>convince all too many people that there are limits to medicine; that a > >>>>bad outcome does not equal malpractice; and that even perfect care > >>>>not always result in a patient's cure. If your baby is has cerebral > >>>>palsy, it can't be the result of nature--it must be the obstetrician's > >>>>fault! Never mind that the obstetrician explained all the risks over > >>>>over again. > >>> > >>>For one thing, we need REAL consent forms and consent > >>>procedures. Someone cannot give informed consent who > >>>does not understand the information. It need not be > >>>the physician who makes the explanation, but it must > >>>be made and understood before the action is taken. > >> > >>I'd certainly agree with that, Herman. The 'Informed Consent' > >>currently used neither informs nor provides sufficient information for > >>the patient to give consent. The a 'one size fits all' type form is > >>virtually impossible to develop since the comprehensive abilities of > >>each patient vary so greatly. > >> > >>To properly inform you'd probably need a trio of 'Philadelphia > >>Lawyers' standing by for each patient and you know what that would > >>bring about.. It HAS improved in recent years but there's a lot of > >>work still to be done. > >> > >><< Remainder snipped >> > >> > >>pixie > > > > Of course when the studies show that the amount of medical > >care given in an area depends on how many people need to make > >their living from giving that care, it is obvious that patients > >feel they cannot refuse medical procedures offered. Consent > >forms are meaningless. They are simply a legal device to stop > >lawsuits. > > OK, Georgie..Just which studies 'show that the amount of medical care > given depends on how may people need to make their living, etc." > Please provide sufficient info so I can confirm your claim. > > Otherwise it's simply one more of your utterly asinine statements. > > pixie > Back to your ignorance phase aren't you. Do you ever learn anything or do you always want to be a professional ignorant?
2003-07-13 04:04:06
In article
Gretchen Evans >On Sat, 12 Jul 2003 12:35:08 GMT, "George Conklin" > > >> >>"Gretchen Evans" >>news:gdqvgvgd9rge42t38h0f1rg4ctlkut5c8a@4ax.com... >>> On 11 Jul 2003 04:29:35 -0700, jeptha@shell.ntrnet.net ((null)) wrote: >>> >>> >In article >>> >Gretchen Evans >>> >>On 10 Jul 2003 09:19:12 -0500, hrubin@odds.stat.purdue.edu (Herman >>> >>Rubin) wrote: >>> >> >>> >>>In article >>> >>>Orac >>> >>>>In article >>> >>>> hrubin@odds.stat.purdue.edu (Herman Rubin) wrote: >>> >>> >>> >>>>> In article >>> >>>>> Orac >>> >>>>> >In article >>> >>>>> > hrubin@odds.stat.purdue.edu (Herman Rubin) wrote: >>> >>> >>> >>> ...................... >>> >>> >>> >>>>> But a large part of the blame is on the medical profession >>> >>>>> and even more on the government. If they tell you that >>> >>>>> they are doing what is right for you, and it goes wrong, >>> >>>>> they are to blame. >>> >>> >>> >>>>On the other hand, in this country, no amount of explanation will >>> >>>>convince all too many people that there are limits to medicine; that a >>> >>>>bad outcome does not equal malpractice; and that even perfect care >>will >>> >>>>not always result in a patient's cure. If your baby is has cerebral >>> >>>>palsy, it can't be the result of nature--it must be the obstetrician's >>> >>>>fault! Never mind that the obstetrician explained all the risks over >>and >>> >>>>over again. >>> >>> >>> >>>For one thing, we need REAL consent forms and consent >>> >>>procedures. Someone cannot give informed consent who >>> >>>does not understand the information. It need not be >>> >>>the physician who makes the explanation, but it must >>> >>>be made and understood before the action is taken. >>> >> >>> >>I'd certainly agree with that, Herman. The 'Informed Consent' >>> >>currently used neither informs nor provides sufficient information for >>> >>the patient to give consent. The a 'one size fits all' type form is >>> >>virtually impossible to develop since the comprehensive abilities of >>> >>each patient vary so greatly. >>> >> >>> >>To properly inform you'd probably need a trio of 'Philadelphia >>> >>Lawyers' standing by for each patient and you know what that would >>> >>bring about.. It HAS improved in recent years but there's a lot of >>> >>work still to be done. >>> >> >>> >><< Remainder snipped >> >>> >> >>> >>pixie >>> > >>> > Of course when the studies show that the amount of medical >>> >care given in an area depends on how many people need to make >>> >their living from giving that care, it is obvious that patients >>> >feel they cannot refuse medical procedures offered. Consent >>> >forms are meaningless. They are simply a legal device to stop >>> >lawsuits. >>> >>> OK, Georgie..Just which studies 'show that the amount of medical care >>> given depends on how may people need to make their living, etc." >>> Please provide sufficient info so I can confirm your claim. >>> >>> Otherwise it's simply one more of your utterly asinine statements. >>> >>> pixie >>> >> >> Back to your ignorance phase aren't you. Do you ever learn anything or do >>you always want to be a professional ignorant? >> > >Waiting Georgie, Just WHERE are these "studies" that you cite. Could >it be that.... as usual.... they simply don't exist? > >And I have NO idea of why you're being so nasty, don't you believe >that even 'ignorant' people should learn? Or is that your usual >temperment? > >pixie Do like last time: check Health Affairs out. The article is on line, and ampie-boy, the child with a data base, claimed that the editor of Health Affairs misquoted the article, which I read completely, and found the web site accurate. It is only one of a large number of similar cases, but then you are trained, not educated. -- George Conklin, Durham, NC: Medicare For All Ages If HMOs ran the post office, the AMA (American Mail Association) would declare that getting mail was a privilege, not a right and 43 million Americans would get no mail delivery.
2003-07-14 02:40:49
In article
Matt Beckwith >Doctors were asked whether they ever failed to inform patients of treatment >options because those treatment options were not covered by their health >insurance plans. The doctors said yes. > >Examples of such "withholding of information" which occur daily in any >doctor's practice include: > >1. The patient has pneumonia. You'd like to give Avelox, which is a very >strong antibiotic. But the patient's insurance plan doesn't cover it. >Instead, you give Azithromycin, which is an adequate antibiotic for >pneumonia but is just a bit less likely to be effective. You don't tell the >patient that he could pay for the Avelox out-of-pocket, because it would >cost him a lot of money. And the Azithromycin is adequate. > >2. The patient has acid reflux (heartburn). You'd like to give Nexium, but >the insurance plan doesn't cover it. Instead, you give Zantac. Zantac is >less likely to be effective for the heartburn, but might work just fine. >You don't tell the patient that he could pay for the Nexium out-of-pocket, >because the Zantac might be effective, and the Nexium would cost a great >deal of money. > >3. An elderly patient needs physical therapy because of an unsteady gait. >The patient complains that he'll have to get his nephew to drive him to the >physical therapy sessions. You don't tell him that he can pay out-of-pocket >for a physical therapist to come to his home, because you figure he couldn't >afford it. > >You can see from these examples that "withholding of information" does not >imply that the doctor is doing anything against the interests of the >patients. Yet, the way this study was reported in the media, it sounds like >the doctors are doing something terrible. And from the comments I've read >on this thread, it seems that many of the people in this group are >interpreting it that way too. > >The problem (if there is a problem) is with managed care. Doctors are in >the habit of assuming that, if something's not covered by the patient's >insurance plan, then it isn't a treatment option. Most patients cannot affo >rd to pay for their own medicines, so I don't even consider suggesting it. >Not when there's a nearly equivalent covered medicine available. Exceptions >are smoking cessation and diet pills. In these cases, there are no covered >medications that are nearly equivalent, and it makes sense for the patient >to pay out-of-pocket. > >Matt Beckwith, M.D. >http://www.doctorbeckwith.com > > > This was all posted before...why again? The original question did not contain the details you post. It was in fact a horrible question to which everyone would have to answer yes. -- George Conklin, Durham, NC: Medicare For All Ages If HMOs ran the post office, the AMA (American Mail Association) would declare that getting mail was a privilege, not a right and 43 million Americans would get no mail delivery.
2003-07-14 11:14:47
On 13 Jul 2003 04:04:06 -0700, jeptha@shell.ntrnet.net ((null)) wrote:
>In article >Gretchen Evans >>On Sat, 12 Jul 2003 12:35:08 GMT, "George Conklin" >> >> >>> >>>"Gretchen Evans" >>>news:gdqvgvgd9rge42t38h0f1rg4ctlkut5c8a@4ax.com... >>>> On 11 Jul 2003 04:29:35 -0700, jeptha@shell.ntrnet.net ((null)) wrote: >>>> >>>> >In article >>>> >Gretchen Evans >>>> >>On 10 Jul 2003 09:19:12 -0500, hrubin@odds.stat.purdue.edu (Herman >>>> >>Rubin) wrote: >>>> >> >>>> >>>In article >>>> >>>Orac >>>> >>>>In article >>>> >>>> hrubin@odds.stat.purdue.edu (Herman Rubin) wrote: >>>> >>> >>>> >>>>> In article >>>> >>>>> Orac >>>> >>>>> >In article >>>> >>>>> > hrubin@odds.stat.purdue.edu (Herman Rubin) wrote: >>>> >>> >>>> >>> ...................... >>>> >>> >>>> >>>>> But a large part of the blame is on the medical profession >>>> >>>>> and even more on the government. If they tell you that >>>> >>>>> they are doing what is right for you, and it goes wrong, >>>> >>>>> they are to blame. >>>> >>> >>>> >>>>On the other hand, in this country, no amount of explanation will >>>> >>>>convince all too many people that there are limits to medicine; that a >>>> >>>>bad outcome does not equal malpractice; and that even perfect care >>>will >>>> >>>>not always result in a patient's cure. If your baby is has cerebral >>>> >>>>palsy, it can't be the result of nature--it must be the obstetrician's >>>> >>>>fault! Never mind that the obstetrician explained all the risks over >>>and >>>> >>>>over again. >>>> >>> >>>> >>>For one thing, we need REAL consent forms and consent >>>> >>>procedures. Someone cannot give informed consent who >>>> >>>does not understand the information. It need not be >>>> >>>the physician who makes the explanation, but it must >>>> >>>be made and understood before the action is taken. >>>> >> >>>> >>I'd certainly agree with that, Herman. The 'Informed Consent' >>>> >>currently used neither informs nor provides sufficient information for >>>> >>the patient to give consent. The a 'one size fits all' type form is >>>> >>virtually impossible to develop since the comprehensive abilities of >>>> >>each patient vary so greatly. >>>> >> >>>> >>To properly inform you'd probably need a trio of 'Philadelphia >>>> >>Lawyers' standing by for each patient and you know what that would >>>> >>bring about.. It HAS improved in recent years but there's a lot of >>>> >>work still to be done. >>>> >> >>>> >><< Remainder snipped >> >>>> >> >>>> >>pixie >>>> > >>>> > Of course when the studies show that the amount of medical >>>> >care given in an area depends on how many people need to make >>>> >their living from giving that care, it is obvious that patients >>>> >feel they cannot refuse medical procedures offered. Consent >>>> >forms are meaningless. They are simply a legal device to stop >>>> >lawsuits. >>>> >>>> OK, Georgie..Just which studies 'show that the amount of medical care >>>> given depends on how may people need to make their living, etc." >>>> Please provide sufficient info so I can confirm your claim. >>>> >>>> Otherwise it's simply one more of your utterly asinine statements. >>>> >>>> pixie >>>> >>> >>> Back to your ignorance phase aren't you. Do you ever learn anything or do >>>you always want to be a professional ignorant? >>> >> >>Waiting Georgie, Just WHERE are these "studies" that you cite. Could >>it be that.... as usual.... they simply don't exist? >> >>And I have NO idea of why you're being so nasty, don't you believe >>that even 'ignorant' people should learn? Or is that your usual >>temperment? >> >>pixie > > Do like last time: check Health Affairs out. The article is >on line, and ampie-boy, the child with a data base, claimed that >the editor of Health Affairs misquoted the article, which I read >completely, and found the web site accurate. It is only one of a >large number of similar cases, but then you are trained, not >educated. Nothing spotted in the current index.. Guess it's just one more of your fantasies, Georgie pixie
2003-07-15 11:28:21
In article
Gretchen Evans >On 14 Jul 2003 13:02:04 -0700, jeptha@shell.ntrnet.net ((null)) wrote: > >>In article >>Gretchen Evans >>>On 13 Jul 2003 04:04:06 -0700, jeptha@shell.ntrnet.net ((null)) wrote: >>> >>>>In article >>>>Gretchen Evans >>>>>On Sat, 12 Jul 2003 12:35:08 GMT, "George Conklin" >>>>> >>>>> >>>>>> >>>>>>"Gretchen Evans" >>>>>>news:gdqvgvgd9rge42t38h0f1rg4ctlkut5c8a@4ax.com... >>>>>>> On 11 Jul 2003 04:29:35 -0700, jeptha@shell.ntrnet.net ((null)) wrote: >>>>>>> >>>>>>> >In article >>>>>>> >Gretchen Evans >>>>>>> >>On 10 Jul 2003 09:19:12 -0500, hrubin@odds.stat.purdue.edu (Herman >>>>>>> >>Rubin) wrote: >>>>>>> >> >>>>>>> >>>In article >>>>>>> >>>Orac >>>>>>> >>>>In article >>>>>>> >>>> hrubin@odds.stat.purdue.edu (Herman Rubin) wrote: >>>>>>> >>> >>>>>>> >>>>> In article >>>>>>> >>>>> Orac >>>>>>> >>>>> >In article >>>>>>> >>>>> > hrubin@odds.stat.purdue.edu (Herman Rubin) wrote: >>>>>>> >>> >>>>>>> >>> ...................... >>>>>>> >>> >>>>>>> >>>>> But a large part of the blame is on the medical profession >>>>>>> >>>>> and even more on the government. If they tell you that >>>>>>> >>>>> they are doing what is right for you, and it goes wrong, >>>>>>> >>>>> they are to blame. >>>>>>> >>> >>>>>>> >>>>On the other hand, in this country, no amount of explanation will >>>>>>> >>>>convince all too many people that there are limits to >medicine; that a >>>>>>> >>>>bad outcome does not equal malpractice; and that even perfect care >>>>>>will >>>>>>> >>>>not always result in a patient's cure. If your baby is has cerebral >>>>>>> >>>>palsy, it can't be the result of nature--it must be the >obstetrician's >>>>>>> >>>>fault! Never mind that the obstetrician explained all the risks over >>>>>>and >>>>>>> >>>>over again. >>>>>>> >>> >>>>>>> >>>For one thing, we need REAL consent forms and consent >>>>>>> >>>procedures. Someone cannot give informed consent who >>>>>>> >>>does not understand the information. It need not be >>>>>>> >>>the physician who makes the explanation, but it must >>>>>>> >>>be made and understood before the action is taken. >>>>>>> >> >>>>>>> >>I'd certainly agree with that, Herman. The 'Informed Consent' >>>>>>> >>currently used neither informs nor provides sufficient information for >>>>>>> >>the patient to give consent. The a 'one size fits all' type form is >>>>>>> >>virtually impossible to develop since the comprehensive abilities of >>>>>>> >>each patient vary so greatly. >>>>>>> >> >>>>>>> >>To properly inform you'd probably need a trio of 'Philadelphia >>>>>>> >>Lawyers' standing by for each patient and you know what that would >>>>>>> >>bring about.. It HAS improved in recent years but there's a lot of >>>>>>> >>work still to be done. >>>>>>> >> >>>>>>> >><< Remainder snipped >> >>>>>>> >> >>>>>>> >>pixie >>>>>>> > >>>>>>> > Of course when the studies show that the amount of medical >>>>>>> >care given in an area depends on how many people need to make >>>>>>> >their living from giving that care, it is obvious that patients >>>>>>> >feel they cannot refuse medical procedures offered. Consent >>>>>>> >forms are meaningless. They are simply a legal device to stop >>>>>>> >lawsuits. >>>>>>> >>>>>>> OK, Georgie..Just which studies 'show that the amount of medical care >>>>>>> given depends on how may people need to make their living, etc." >>>>>>> Please provide sufficient info so I can confirm your claim. >>>>>>> >>>>>>> Otherwise it's simply one more of your utterly asinine statements. >>>>>>> >>>>>>> pixie >>>>>>> >>>>>> >>>>>> Back to your ignorance phase aren't you. Do you ever learn >anything or do >>>>>>you always want to be a professional ignorant? >>>>>> >>>>> >>>>>Waiting Georgie, Just WHERE are these "studies" that you cite. Could >>>>>it be that.... as usual.... they simply don't exist? >>>>> >>>>>And I have NO idea of why you're being so nasty, don't you believe >>>>>that even 'ignorant' people should learn? Or is that your usual >>>>>temperment? >>>>> >>>>>pixie >>>> >>>> Do like last time: check Health Affairs out. The article is >>>>on line, and ampie-boy, the child with a data base, claimed that >>>>the editor of Health Affairs misquoted the article, which I read >>>>completely, and found the web site accurate. It is only one of a >>>>large number of similar cases, but then you are trained, not >>>>educated. >>> >>>Nothing spotted in the current index.. Guess it's just one more of >>>your fantasies, Georgie >>> >>>pixie >> >> You fit the usual Usnet mode. Health Affairs has an article >>on the subject. Ampie-boy, the child with a data base states >>that the editor of Health Affairs misstates his own article; the >>whole article is on their web site and parts of it were cut and >>pasted on tpm, as you well remember. So you post more lies >>hoping that no one remembers, except you, who deliberately >>ignores the whole thing. You never read the schoarly literature >>anyway. > >And you fit your usual psychopathic mode, Georgie... As I stated there >was no reference to the subject in the general index as of yesterday.. >Obviously just one more of your fantasy posts.. > >pixie For a topic that bounced around tpm for over a month with citations and page numbers attached, you outdo yourself this time with the usual lies. -- George Conklin, Durham, NC: Medicare For All Ages If HMOs ran the post office, the AMA (American Mail Association) would declare that getting mail was a privilege, not a right and 43 million Americans would get no mail delivery.
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