Re: Would love to have your medical opinions on this
From: art fougner, md (evsono@pipeline.com)
Fri Apr 18 08:16:21 2008
Is there ANY medical evidence favoring a practice of routine post-op
HCG's after D&C for miscarriage? Anyone? Bueller?
Art
At Fri, 18 Apr 2008, Don Miller wrote:
>
>At Fri, 18 Apr 2008, Charles Bloom wrote:
>
>>Equating doing a $1 urine HCG at the time of a post-op visit for D&C with
>>doing a chest x-ray is preposterous.
>
>An HCG done 26 years ago was not $1 (it may have cost more than a chest
>x-ray). I would guess that the overwhelming majority of practices would
>bill for such testing especially if sent to an outside lab (e.g. many
>folks send out testing for Trich). Anyway, the comparison was not about
>cost - the comparison was about routine testing, done without clinical
>evidence or cost-benefit analysis, just because that is "what I've done
>for 26 years."
>
>>Since it is part of the visit, I don't
>>bill insurance so no red flags for that dollar.
>>
>>Benefits to me:
>
>Personally, I don't have a problem at all if physicians take the hit
>themselves financially and do something for their own peace of mind
>especially when the *first* test is non-invasive (urine HCG I presume).
>
>What I do have a problem with is the follow-up visits, follow-up testing
>(serum HCGs?, ultrasounds?), and subsequent patient anxiety that results
>when "pet" tests are performed and something is not quite right. The
>costs of all of that when projected to 1 million spontaneous abortions
>yearly in the U.S would be staggering.
>
>In the real world unfortunately, to patients, doctors who do extra
>testing are considered "thorough" and "better" than those doctors who
>choose to avoid such testing. That goodwill is often incentive enough
>for some to continue unfounded practices.
>
>>Since
>>no one has a given a good reason for not doing it, I'll continue with my
>>current practice.
>
>I'm sure you will.
>
>--
>Donald W. Miller, Jr., MD, FACOG
>eNATAL, LLC
>http://www.eNATAL.com
>
--
art fougner, md
"May The Wings of Liberty Never Lose a Feather." - Jack Burton
