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Author: alstroemeria Big gold star, 5000 posts Top Recommended Fools Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: of 883921  
Subject: saving money on medical care Date: 12/4/2012 9:44 AM
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I have an opportunity to save money on my cataract surgery by participating in a study:

PROS

+ Saves $475 off the cost of the procedure (my insurance only pays 10% of the expense--just the actual removal of the cataract, not the lens replacement)

+ My ophthalmologist likes the relatively minor change in his procedure so far and if all goes well throughout the study, plans to switch to this method.

+ He has done 110 eyes on 80 patients using the new method so far. He'll have done another dozen by the time my surgery is scheduled.

+ This is the foremost ophthalmologist in my area with many years of experience. My BFF, who moved to another state, is coming back to him to have her second eye done.

+ They gave me another 2 hours of tests yesterday (on top of all the testing 2 months ago when I was first looking into my vision problems). This practice seems organized and thorough.

CONS

- Relatively untried, not the standard of care.

- Doc has only been performing the new procedure for a couple of months.

I signed the paperwork, but can rescind at any time before surgery is performed (next week).
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Author: oncqueen Three stars, 500 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 869277 of 883921
Subject: Re: saving money on medical care Date: 12/4/2012 10:39 AM
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If this is the foremost, guru ophth doc who has practiced for years, and he/she likes the "relatively minor change" that this involves, I would have no problem doing the study. The doc is not going to risk their reputation for the study, and 110 eyes is enough that he/she would have found out about complications or glitches by now. 110 does not sound like a lot, perhaps, but this is on top of the thousands the doc has done before. However tricky, it is still a repetitive motor task, and the learning curve is early on, just like flipping a pancake or sewing on a button; our local guru does an eye in 6 minutes flat!

The fact that your doc is going to switch to this when it becomes available is a good sign, too.

It's always a bit scary to think of any procedure, or any study, but it's always fair to ask the doc, "What would you do if it were you/your wife/mother/etc.?" Docs are often careful about not pushing a patient to any particular conclusion, but generally know absolutely what they would do in their own situation, and that can be valuable.

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Author: VeeEnn Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 869278 of 883921
Subject: Re: saving money on medical care Date: 12/4/2012 11:39 AM
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Ditto what oncqueen says, 'cept

Saves $475 off the cost of the procedure (my insurance only pays 10% of the expense--just the actual removal of the cataract, not the lens replacement)

It's a "study"....it should be *free* and not *$450 off* (heck, if it's a study you should be paid for being a guinea pig)


My ophthalmologist likes the relatively minor change in his procedure so far and if all goes well throughout the study, plans to switch to this method.

There's the *if* factor.

Cataract surgery looks tremendously straighforward to me (not being an ophthalmologist, mind) so I don't see that you have too much to lose either way. My husband had both eyes done in stages last year and, if he has any regrets at all, it's because he didn't get it done sooner.

Prepare to see the world in a new and garishly coloured light.

Good Luck!

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Author: toberead Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 869279 of 883921
Subject: Re: saving money on medical care Date: 12/4/2012 1:31 PM
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I have an opportunity to save money on my cataract surgery by participating in a study:

One thing you might want to ask your doctor is if the study will require additional monitoring after your surgery, and whether any additional exams or tests will have an additional cost. Many times, when doctors are performing a study, they will monitor the patients over time to make sure the new procedure doesn't have long term side effects. This might require extra exams or tests (or it might not).

I was part of a study of cancer drugs a few years back, and the study required additional testing and monitoring over the next 5 years. Some of the tests were normal tests that I would have had anyway, but some of them were extra tests that my doctor might not have done otherwise. My insurance paid for it all, but I made sure to ask about it beforehand. (My insurance has a specific policy for clinical trials.) After I moved and changed doctors, I also had to send my medical records back to my old doctor so he could update the study - a minor inconvenience.

Karen

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Author: joelxwil Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 869282 of 883921
Subject: Re: saving money on medical care Date: 12/4/2012 2:47 PM
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Definitely go with the study.

But, "(my insurance only pays 10% of the expense--just the actual removal of the cataract, not the lens replacement)"! So get another insurance company if you can. That is really terrible.

I have had cataract surgery/lens replacement on both eyes, and it was a very good experience both times. The only side effect is that on a bright day (like this one here) the sun is blinding. You should definitely consider dark glasses.

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Author: MetroChick Big funky green star, 20000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 869283 of 883921
Subject: Re: saving money on medical care Date: 12/4/2012 3:47 PM
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I would ask if there's any additional risks/side-effects from the "new" method. If there isn't, than I'd go with the new method.

Doctors/surgeons seem to have the opinion there are "great" surgeons and "bad/sloppy" surgeons - and nothing inbetween. If he's known for being great at established methods, he'll do well at newer methods.

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Author: vkg Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 869285 of 883921
Subject: Re: saving money on medical care Date: 12/4/2012 9:08 PM
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I was part of a study of cancer drugs a few years back, and the study required additional testing and monitoring over the next 5 years. Some of the tests were normal tests that I would have had anyway, but some of them were extra tests that my doctor might not have done otherwise

My husband's cancer treatment included a clinical trial. He will have some additional tests over the next few years. The cost of those tests will be covered by the clinical trial.

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Author: pauleckler Big funky green star, 20000 posts Top Favorite Fools Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 869287 of 883921
Subject: Re: saving money on medical care Date: 12/4/2012 9:41 PM
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Personally, I would not take the risk. $475 is not much compensation. If the procedure goes wrong, you probably have no recourse. You have signed away that right.

Let someone else be the guinea pig for new procedures.

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Author: PolymerMom Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 869290 of 883921
Subject: Re: saving money on medical care Date: 12/4/2012 11:45 PM
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alstro,

Depending upon the reason for the study, it might be a good deal.

Presumably, there is something different involved, other than a different surgery technique. Typically studies like this test products, rather than techniques, but then again, maybe your doc is part of a med school.

I participated in a glaucoma study w/ my opthalmologist. Glaucoma is a condition that has a slow progression and I was already using Xalatan drops to control it. He was testing a delivery method/device, so I figured it wasn't a big deal. I could always go back to using Xalatan. The device was really intended for people who couldn't reliably use the drops.

Cataract surgery is a different animal, in that it's surgery (messing with my eyes). I'd do some research on my own (Google, MedScape, the company who makes the product, etc.)

Good luck, on whatever your choice is. I'll be interested in what your experience is, if you go ahead with it. MDH has cataracts and will have to deal with surgery.

PM

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Author: tconi Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 869291 of 883921
Subject: Re: saving money on medical care Date: 12/5/2012 3:31 AM
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it's always fair to ask the doc, "What would you do if it were you/your wife/mother/etc.?"

i go with this question.

Recently the elf had to have oral surgery.
the surgeon knew that insurance would not cover it and it would be all out-of-pocket for us.

He kept offering to perform the surgery (with general anesthesia) in his office or a local surgical center to save some $$.

I asked where he would do it if it was his child, with the same considerations*, and he said No question, the hospital


peace & would you rather...
t





* prior to this surgery, the elf had only ever had 2 prescription medicines. Allergic reactions to both.
I was quite concerned that he would have a reaction to whatever was being used for the procedure and i wanted ALL the options available.

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Author: VeeEnn Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 869355 of 883921
Subject: Re: saving money on medical care Date: 12/7/2012 10:08 AM
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I would ask if there's any additional risks/side-effects from the "new" method. If there isn't, than I'd go with the new method.

Well, if this is an actual bone fide ongoing "sudy" (as opposed to someone trying a new procedure on willing subjects) then those data aren't going to be available until well after the study has been completed and reported upon.


Doctors/surgeons seem to have the opinion there are "great" surgeons and "bad/sloppy" surgeons - and nothing inbetween.

I think you might not have a true perspective here. FWIW, *most* surgeons fall into the "inbetween" category, if they did but know it.

Per the original post.....if an ophthalmologist has already had the opportunity to test drive a new procedure with *110 eyes on 80 patients* well, that looks to me like someone with significant experience in what he/she's doing. If it's a true representation well then, you're not the first guinea pig

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Author: MetroChick Big funky green star, 20000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 869357 of 883921
Subject: Re: saving money on medical care Date: 12/7/2012 10:40 AM
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Well, if this is an actual bone fide ongoing "sudy" (as opposed to someone trying a new procedure on willing subjects) then those data aren't going to be available until well after the study has been completed and reported upon.

Not necessarily, as many studies have more than 1 phase. For instance it became known during initial studies for the Transcatheter Heart Valve replacement that there was an increased risk of stroke - but it still got approved for a certain group of high risk patients, and as additional phases go on, it's slowly being expanded to more patients.


http://www.forbes.com/sites/larryhusten/2012/10/19/fda-appro...

I think you might not have a true perspective here. FWIW, *most* surgeons fall into the "inbetween" category, if they did but know it.

And what makes you think you have the "true persepctive"?

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Author: alstroemeria Big gold star, 5000 posts Top Recommended Fools Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 869577 of 883921
Subject: Re: saving money on medical care Date: 12/13/2012 10:19 PM
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DENOUEMENT

About my semi-experimental cataract surgery...I had it yesterday and went to the followup appointment today.

I did go ahead with the study--the doctor has done another 24 procedures using the new laser technique. I can't compare it to the "standard of care" procedure since it's the only one I've had. While I wouldn't call the experience a pleasure--well the organized and very kind staff of my doctor were awesome, it was alright. And I can't believe how great my vision is already in my left eye--it tested 20/25! Hasn't been that good for 30 years.

Someone asked why the procedure wasn't free since it's part of a study...only one aspect is different than the usual procedure, so the $475 off deal is all there is, take it or leave it. I had to pay full price for the surgery center and anesthetist and half price for the ophthalmologist. I decided to take the deal, and I'm glad I did. If my other eye needs cataract surgery soon enough to participate in the study again, I expect I will if all continues to go well.

Someone asked about our cr@ppy health insurance that doesn't pay for lens replacement after cataract removal...my husband is a state employee (until the end of this month), and govt employee health insurance is not gold-plated in most locales these days.

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Author: VeeEnn Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 869596 of 883921
Subject: Re: saving money on medical care Date: 12/15/2012 12:35 PM
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My husband had his "worst" eye done first and the procedure was complicated a bit by him have a sort of panic attack and being unable to stop shaking. A good dose of strong stuff fixed that. He almost didn't bother with the second surgery his vision was so good but when he did decide, there were no panic issues then.

Comical thing is, he was in total denial that there was anything wrong with his eyes.....but for not seeing well in the dark......or bright light......or seeing faces.....or small things. When I was decorating our bedroom, he decided to help me out by painting the window while I was out shopping. That's just what he did....more paint on the window than the trim. He couldn't see why I was so mad at the extra work for me, so I left part of the trim as was, pending his surgery so I could show him what a bloke with eyes that work right would've been able to avoid.

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