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Re: The lowly PAP smear...From: Garry E. Siegel (garrys@mindspring.ocm)Sat Jul 22 11:57:39 2000
In our office, we pretty much can divide the insurers into two groups: Those who we know will pay for a ThinPrep, and those that we just don't know one way or the other. So: In patients with a prior abnormal pap/previous treated dysplasia, etc., I recommend a ThinPrep, irrespective of payor status. In patients on a plan *known* to cover a ThinPrep, I do one, irrespective of her history. In patients who are a low risk for dysplasia (the prototype is the married multip who has had normal annual paps for years in your office and doesn't smoke) who are on insurance plans that may or may not pay for a ThinPrep, I tell them flatly that the ThinPrep is a better test, but that their history and reliability in having annual paps is sufficient. I sometimes tell them that the regular pap is a Chevrolet, and the ThinPrep is a Cadillac. In some instances, the patient may end up having to pay around $50 to the lab over and above the cost of the visit if the ThinPrep isn't covered. Many of them want it regardless, and that is fine. We have a homemade handout that is one page, laminated, that gives a brief comparison between "new paps" and "old paps." It is on the clipboard they get when they sign in and do paperwork, and on the counters in the exam rooms, and the nurses ask the patients to read it. FWIW, the 6 week checkup moms never do--they're overloaded already :). Garry
-- Garry E. Siegel, M.D., F.A.C.O.G. Private Practice Roswell, GA
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