tag:blogger.com,1999:blog-6296669137299786155.post2994964782916390709..comments2023-07-20T05:30:32.466-07:00Comments on In My Humble Opinion: Who's Your Daddy Now?Jordan Grumethttp://www.blogger.com/profile/12566078305685946261noreply@blogger.comBlogger3125tag:blogger.com,1999:blog-6296669137299786155.post-37904433607266308822013-01-28T13:40:52.124-08:002013-01-28T13:40:52.124-08:00There's a delay before getting a defibrillator...There's a delay before getting a defibrillator to reduce the problem of people whose heart function will improve with medicine and lifestyle changes being bullied into getting an ICD that puts them at high lifetime risk of tricuspid regurgitation and needless shocks. BTW, if they're pressured to wear a defibrillator vest, they might want an absolute numerical estimate of how likely they are to benefit (probably less than a 1% chance - the clinical trial data are not impressive). Then they might ask themselves how likely it is that accepting an exaggerated fear of sudden death will discourage them from doing heart-strengthening aerobic activity. Putting limits on Medicare payments for ICDs isn't just to save bucks; it's to save often severe iatrogenic harm to people who aren't likely to benefit.<br /><br />Likewise, the PSA test isn't being discouraged to save tax dollars, but because it saves few lives, and for every life saved, a couple dozen men wind up wearing diapers for no benefit. I do understand that doctors are excessively burdened by paperwork and regulations already, and that it's getting worse under Obamacare. But you're asking for sympathy for the time-wasting excess that's forced on doctors, while complaining about any efforts to limit the time-wasting excess that doctors sometimes virtually force on patients. (PSA testing is often done without consent and even over patient objections, and "consent" for ICDs is rarely fully informed and often follows heavy doses of biased emotional rhetoric.) If doctors don't do more to police themselves, most citizens won't object to seeing the government do it - and someone has to draw those lines, because the resources available to pay for four-plussing of the elderly are substantial but not infinite.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-6296669137299786155.post-85419764070307825242013-01-16T05:18:18.775-08:002013-01-16T05:18:18.775-08:00I concur with your statements up until the non or ...I concur with your statements up until the non or barely clinical administrators. You have missed a very important part of the team the case manager. I am a case manager who has been in healthcare for almost 30 yrs now. I have worked my way up from volunteer candy striper to student in nrsg at votech to CNA to corpsman in the USN, back home to nursing school while working as a HHA. Graduated Nursing school and up until approx 10 years ago was bedside nursing. There is nothing I havent seen. My yrs of experience not only make me perfect for the job as case manager but also as advocate for my patients. Yes I've gone toe to toe many a time to fight for what I think is best for my patient! So please remember there's a case manager who was a nurse first whose best interest is always and has always been for the pt first ! youngredsoxhttps://www.blogger.com/profile/01127740051309660072noreply@blogger.comtag:blogger.com,1999:blog-6296669137299786155.post-43011963750752178642013-01-15T09:38:05.181-08:002013-01-15T09:38:05.181-08:00Superbly and succinctly said. Excellent summation...Superbly and succinctly said. Excellent summation at the close. A frightening reality that bodes ill for us all. It's a realitiy that will especially shock those who felt that moving healthcare further into government control was a good thing.<br /><br />JamesAnonymousnoreply@blogger.com