[ilovetv]

Originally Posted by shrink

I sat in with my husband during his exam. The conversation somehow turned to me. And the cardiologist never asked me for a referral from my primary. Just scared me and scheduled me. Then scheduled me some more. Then some more. Then some more. I believe I underwent seven different expensive tests. My primary care doc out of state (whom I trust completely) was shocked when I told him what was done. His comment was, "No wonder insurance costs are so high".

Did Medicare actually PAY all these claims?

[shrink]

They paid and my secondary paid. Not only did they pay the claims for what was done, they paid for a procedure that was never done! Thousands total!

[graciegirl]

This is a slippery slope. Unless we have a medical degree it is almost impossible to decide what tests are needed and what tests are not needed.

Many medical problems are without symptoms, and when you get to the level of symptoms in cardiovascular illness, such as shortness of breath, blueness, pain, fatigue, swollen ankles,rapid heartbeat, fainting, than you have missed an opportunity to correct some serious problems earlier. Generally there is an ekg, a stress test and then a Thalium stress test and if that discovers something wrong, then a cardiac ultrasound and perhaps a 24 hour Holter monitor and then a cardiac catherization. It is apparent without extensive tests if a person is having some risk factors to further investigate, such as overweight, a sedentary life style and a history of smoking and high cholesteral levels.

It could be that these tests were a scam to make money and it could be that they ascertained that you were alright dispite the risk factor that you mentioned of smoking. This is a very difficult area. I agree with Ilovetv that generally a person is refered to a cardiologist by a primary care physician.

It is wise to check out a physicians background as you say. That in itself is difficult. Even excellent doctors have suits brought against them. There are suit happy people out there. And some not great doctors never get in trouble that is traceable. To figure out who is good, not great and bad in an MD is almost impossible. Large teaching hospitals have very high standards for their physicians and they have ethics committees too and I feel more comfortable with seeking treatment for serious issues by going to a doctor and group associated with a large teaching facility such as Shands in Gainesville or the Mayo Clinic in Jacksonville.

A friend who is himself an MD and lives here in The Villages goes to Shands in Gainesville, for his medical care. I myself trust large teaching hospitals and the doctors associated with them the most because of our frequent experiences with our daughters extensive birth related heart problems.

I am not a medical person..and I am sorry that you, OP had this experience. I think it was very odd you had the Thalium stress test without a regular one first. If you were charged for the plain one and Medicare paid for a test that wasn't performed, that is fraud.

[senior citizen]

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[senior citizen]

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[senior citizen]

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[samhass]

Originally Posted by graciegirl

This is a slippery slope. Unless we have a medical degree it is almost impossible to decide what tests are needed and what tests are not needed.

Many medical problems are without symptoms, and when you get to the level of symptoms in cardiovascular illness, such as shortness of breath, blueness, pain, fatigue, swollen ankles,rapid heartbeat, fainting, than you have missed an opportunity to correct some serious problems earlier. Generally there is an ekg, a stress test and then a Thalium stress test and if that discovers something wrong, then a cardiac ultrasound and perhaps a 24 hour Holter monitor and then a cardiac catherization. It is apparent without extensive tests if a person is having some risk factors to further investigate, such as overweight, a sedentary life style and a history of smoking and high cholesteral levels.

It could be that these tests were a scam to make money and it could be that they ascertained that you were alright dispite the risk factor that you mentioned of smoking. This is a very difficult area. I agree with Ilovetv that generally a person is refered to a cardiologist by a primary care physician.

It is wise to check out a physicians background as you say. That in itself is difficult. Even excellent doctors have suits brought against them. There are suit happy people out there. And some not great doctors never get in trouble that is traceable. To figure out who is good, not great and bad in an MD is almost impossible. Large teaching hospitals have very high standards for their physicians and they have ethics committees too and I feel more comfortable with seeking treatment for serious issues by going to a doctor and group associated with a large teaching facility such as Shands in Gainesville or the Mayo Clinic in Jacksonville.

A friend who is himself an MD and lives here in The Villages goes to Shands in Gainesville, for his medical care. I myself trust large teaching hospitals and the doctors associated with them the most because of our frequent experiences with our daughters extensive birth related heart problems.

I am not a medical person..and I am sorry that you, OP had this experience. I think it was very odd you had the Thalium stress test without a regular one first. If you were charged for the plain one and Medicare paid for a test that wasn't performed, that is fraud.

Well said, Gracie.

[senior citizen]

Originally Posted by samhass

Well said, Gracie.

Teaching hospitals are an excellent choice as Gracie said in earlier post.
However, even they use trials and experimental type procedures that they no doubt know might not end in a happy way for the patient.

We have a family member who was given an extended five years of life via great care and experimental treatment at DUKE UNIVERSITY in N.C. for liver cancer. However, they've now been told they have dementia as a result of the treatment. Early 50 years old and has been told the cancer is chronic but treatable with radioactive isotopes?? However, she has had to seek early retirement and go on disability via medicare. Duke is a great teaching hospital. Very forgetfull and unable to work as a result of the treatment.

Ditto for Dartmouth in Hanover, New Hampshire......to which many of our townsfolk go for their cancers. Lots of experimental treatments.
It may "buy time" but ultimately most are dying eventually. It's sad to see....esp. among the young women in their 40's........all doctors are well aware that the chemo is poison to healthy cells as well as the cancer cells. We know people who've lost all feeling in their hands and feet; neuropathy, due to treatment. It will never return.

We do have an oncology center as part of our hospital, but for the more aggressive types, they send them to Dartmouth or to Boston....or even Mount Sinai in New York City. It's been a sad ending for all of them and their families.

When my mother in law had cancer back in 1970 (and years prior) there was no treatment at all.....she eventually did pass, with no pain at all.
Was able to function up to the end. Painless death. At the time, the family was told that her many cancers were caused by early xray treatment given to her during her pregnancies........30 years prior.

[graciegirl]

Originally Posted by senior citizen

Teaching hospitals are an excellent choice as Gracie said in earlier post.
However, even they use trials and experimental type procedures that they no doubt know might not end in a happy way for the patient.

We have a family member who was given an extended five years of life via great care and experimental treatment at DUKE UNIVERSITY in N.C. for liver cancer. However, they've now been told they have dementia as a result of the treatment. Early 50 years old and has been told the cancer is chronic but treatable with radioactive isotopes?? However, she has had to seek early retirement and go on disability via medicare. Duke is a great teaching hospital. Very forgetfull and unable to work as a result of the treatment.

Ditto for Dartmouth in Hanover, New Hampshire......to which many of our townsfolk go for their cancers. Lots of experimental treatments.
It may "buy time" but ultimately most are dying eventually. It's sad to see....esp. among the young women in their 40's........all doctors are well aware that the chemo is poison to healthy cells as well as the cancer cells. We know people who've lost all feeling in their hands and feet; neuropathy, due to treatment. It will never return.

We do have an oncology center as part of our hospital, but for the more aggressive types, they send them to Dartmouth or to Boston....or even Mount Sinai in New York City. It's been a sad ending for all of them and their families.

When my mother in law had cancer back in 1970 (and years prior) there was no treatment at all.....she eventually did pass, with no pain at all.
Was able to function up to the end. Painless death. At the time, the family was told that her many cancers were caused by early xray treatment given to her during her pregnancies........30 years prior.

Senior.

Helene and I are cancer survivors and what you say is true...HOWEVER a person is not given experimental treatment as a matter of course. The risks are carefully explained and most people who receive treatment in these studies have been on a waiting list and carefully evaluated and usually because all other options have not been successful in stopping their cancers.

Chemo does kill healthy cells and people do get other side effects from chemo but at this point it is what we have to save lives.

Helene and I feel very fortunate to still be here. Cancer is survivable.

There are horror stories about radiation that was used in the 40's thinking it would help. Much more is known about radiation today and although there is still a risk factor, it too is a tool in saving people.

When we are diagnosed with a serious disease we need to expend every effort to find the best place to treat the disease and try to continue to live the life we are given.

[shrink]

Thanks for your good advice, Graciegirl. Well said and things to keep in mind. I do like the idea of Shands, and if we ever NEED serious intervention, that is where we will go!

[shrink]

Originally Posted by samhass

Well said, Gracie.

Yes indeed, it is fraud. I believe the reason I was charged for both was to "justify" to insurance the reason for giving the nuclear stress test, i.e., "tried the treadmill, couldn't complete, had to give thallium". This has been reported to both Medicare and my private insurance company which paid for all. Interestingly, when I tried to tell Medicare about everything that was done without medical necessity, they were unable to investigate anything other than the bogus charge. I did go on the site Vitals.com under the doctor's name and found other such complaints against him. Although anyone can go on that site and leave comments (such as the doctor himself, his family, his friends, etc.), its still a wise idea to look there before going to anyone new. Thanks for writing.

[gemorc]

Sorry Shrink, I do not understand. By not posting this doctors name, you cast aspersions on all LOCAL cardiologists. Maybe it is my doctor, I don't know. If you are going to post a thread like this, have the nerve to state the facts.

[Villages PL]

Originally Posted by shrink

They paid and my secondary paid. Not only did they pay the claims for what was done, they paid for a procedure that was never done! Thousands total!

The problem might have started when the doctor found out that you had secondary insurance. He thought, "Wow, I'll be able to talk her into all kinds of expensive tests and she'll go for it. Ca-ching! $$$$$$"

I don't blame you, I blame the doctor. But I think it's all too easy for the patient to be trusting when cost is not a factor. If you had to pay 20% you might not have been so trusting.

[Villages PL]

Originally Posted by gemorc

Sorry Shrink, I do not understand. By not posting this doctors name, you cast aspersions on all LOCAL cardiologists. Maybe it is my doctor, I don't know. If you are going to post a thread like this, have the nerve to state the facts.

All heart patients should be warry of all heart doctors, in my opinion. Most of them (again my opinion) will never give the option of lifestyle changes to reverse coronary artery disease. They are in business to make money and placing stints or giving by pass surgery pays a heck of a lot more than giving someone a stern warning and a diet/exercise plan.

[graciegirl]

Originally Posted by Villages PL

All heart patients should be warry of all heart doctors, in my opinion. Most of them (again my opinion) will never give the option of lifestyle changes to reverse coronary artery disease. They are in business to make money and placing stints or giving by pass surgery pays a heck of a lot more than giving someone a stern warning and a diet/exercise plan.

I disagree.