Blue Cross just advised a twenty-six-year old woman I know that it will cut off payments for the physical therapy that was making it possible for her to sit at a keyboard for eleven hours a day. Her thirty sessions were up.
The young woman has an overuse injury to both of her arms that causes so much pain she can’t even mix up a salad dressing. “I am not getting any better,” she said. “To do that I would have to stop working or scale back the number of hours required by my job.” Those physical therapy sessions offer strengthening exercises that reduce swelling and inflammation and make it possible for her to keep working.
Shifting Medical Costs to Patients
One cannot entirely fault insurance companies for trying to clamp down on medical costs, but rather than actually lowering the underlying costs of medical services, their solution is to Read more »
*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*
I saw a lady with a boil. It began as a small red bump which got bigger and harder, then drained white stuff, and was now getting better.
The reason she was worried about it was its location: it was on her breast. This was why the chief complaint officially read, “Breast lump” despite the fact that it was technically no such thing.
I examined her carefully, determining that the pathologic process was indeed confined to the skin and clinically did not involve the actual breast tissue in any way. However because she was of an age for screening mammography, I did take the opportunity to urge her to have it; which she did. The problem arrived with the radiology report:
A marker is placed over the area of palpable abnormality. Mammographic images reveal normal breast tissue with no mass or architectural distortion. The pathologic process is confined to the skin. Recommend surgical excision. (emphasis mine)
Um, no. Read more »
*This blog post was originally published at Musings of a Dinosaur*
Chronically-ill Medicare patients spent fewer days in the hospital and received more hospice care in 2007 than they did in 2003, but their intensity of care increased as well, according to a report by the Dartmouth Atlas Project.
While in the hospital less, patients had many more visits from physicians, particularly specialists, and spent more days in intensive care units, as result of growth in intensive care and specialist capacity, the researchers said.
Intensive interventions can lower a patients’ quality of life and cost more, the researchers noted. About one-fourth of all Medicare spending stems from the last year of life, and much of the growth in Medicare spending is the result of the high cost of treating chronic disease, the authors noted. Following patient preferences for end-of-life care may reduce such spending. Read more »
*This blog post was originally published at ACP Hospitalist*