[email protected] hath wroth:
I think that it is more likely that the Europeans and Canadians come
to US because they can buy medical procedures there that look like
dangerously premature interventions to medicos outside the U.S.
I beg to differ. My friends in Canada tell me that it takes forever
to obtain even an evaluation appointment, much less surgery, in
Canada. I can supply a few horror stories if you're interested. It's
the long wait that inspires the pilgrimage.
My medically qualified younger brother tells me that U.S. doctors
spend a lot more money on tests than their foreign counterparts, and
are much more likely to intervene (at vast expense).
Yep. I just went through that myself. I had my prostate and a large
piece of my bank account surgically removed at a local hospital.
Patients that have insurance, Medicare, medical, medicruz, or other
reluctant payers, tend to over test. Similar surgeries required a
wide spectrum of pre-operative testing, most of which were to assure
the financial provider that the surgery is really necessary and that
some alternative treatment isn't possible. It also satiates the legal
departments appetite for cover-thy-posterior test to avoid subsequent
litigation for malpractice or damage mitigation.
The usual result is that surgery and other expensive procedures are
delayed until the absolute last moment. All manner of alternative
remedies are attempted in the hope that the condition will fix itself
or the patient will die prematurely, thus avoiding patient
compensation. Only after all the cheaper alternatives have been
explored, is surgery authorized.
In my situation, I paid cash, mostly in advance. Strangely, after the
price was renegotiated multiple times, it was almost as cheap to pay
for local surgery, than to make the pilgrimage to India or Mexico.
Take out the insurance companies and government assistance, and what's
left is fairly affordable medicine. Anyway, instead of a multitude of
pre-operative tests, I had exactly 2 invasive tests (other than the
usual blood test and chest x-ray). Most of the others were apparently
un-necessary to properly perform the surgery.
Anxious patients often want their doctors to "do something" when the
Cochrane collaboration would advise a wait-and-see approach
http://www.cochrane.org/reviews/en/ab004326.html
Maybe. I have a dim view of sites that have a financial agenda
(selling some potion or procedure). Chochrane is not one of those.
They have no obvious agenda, but are lacking in the numerical detail
to substantiate their conclusions. They also tend to be rather
simplistic. Methinks it is much better to dig through the complex and
confusing medical research reports reference on Medline or various
online medical journals, than to rely on what I consider to be a
simplistic conclusion. For those that want fast answers, sites such
as Cochrane are good enough.
I agree on the wait-n-see approach. Many conditions magically fix
themselves without any intervention or treatment. I know of one
person with an obvious case of prostate cancer that juggled his diet a
little, but basically did nothing. The cancer was gone in about 6
months and hasn't come back in the last 2 years. I decided to try
several alternative treatments, each with their fan clubs and
promoters. Nothing worked. When it was obvious that I was headed for
surgery (or radiation), it took about 3 months to schedule the surgery
(which was rescheduled 3 times). Judging by the pathology report,
another month or two, and the cancer would have spread. Wait-n-see
has it's benefits, but don't drag it right to the bitter edge.
