congress considering deep cuts to laboratory fees

[scienceguy19]

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http://www.darkdaily.com/why-congre...-to-medical-laboratory-test-fees-101811#more-

thanks a lot congress! argh screw us pathologists over.

 

[pathstudent]

http://www.darkdaily.com/why-congre...-to-medical-laboratory-test-fees-101811#more-

thanks a lot congress! argh screw us pathologists over.

The lab fees are dirt cheap compared to the information they provide. If they want to save money on something that provides scant information compared to cost they would get rid of the brochoscope and eus-fna

 

[WEBB PINKERTON]

The lab fees are dirt cheap compared to the information they provide. If they want to save money on something that provides scant information compared to cost they would get rid of the brochoscope and eus-fna

Our eus-fna are very useful at my institution but we have very good pulmonologist with lot of experience doing it. I dont see them as a waste of money at all. A fairly high percentage of the time, they are the only specimen with diagnostic material. Tissue are too small and dont survive processing.

They continue to screw us over because we have shown that we are good at bending over and taking it without much of a fight. Dont worry about it scienceguy, everyone knows that we will just order more special stains and other unnecessary tests to make up any cuts. That is how medicine works, someone taketh and you find creative, difficult to detect ways to make the money back.

 

[BamaAlum]

The lab fees are dirt cheap compared to the information they provide. If they want to save money on something that provides scant information compared to cost they would get rid of the brochoscope and eus-fna

Yeah, that is not the case here either. EUS-FNA for the initial diagnosis of pancreatic lesions is the standard of care in our area. Our GI docs are so good at it that we make the diagnosis in the first 2 passes >60% of the time. Our pulmonologists seem slightly less skilled but can usually get diagnostic material. Surprisingly, if they fail to get an answer for a lymph node by EBUS they will send the patient the next day for EUS by the GI docs (who more often than not are successful).

We were the only center in our area doing EUS for years, but now 4 hospitals in the surrounding area have recently started doing them. I don't think they are going away any time soon.

 

[pathstudent]

Yeah, that is not the case here either. EUS-FNA for the initial diagnosis of pancreatic lesions is the standard of care in our area. Our GI docs are so good at it that we make the diagnosis in the first 2 passes >60% of the time. Our pulmonologists seem slightly less skilled but can usually get diagnostic material. Surprisingly, if they fail to get an answer for a lymph node by EBUS they will send the patient the next day for EUS by the GI docs (who more often than not are successful).

We were the only center in our area doing EUS for years, but now 4 hospitals in the surrounding area have recently started doing them. I don't think they are going away any time soon.

In my experience it doesn't change much at all. It doesn't replace any other steps usually. It doesn't decrease morbidity or mortality. It just adds cost and gives a gastroenterologist something to do.

 

[BamaAlum]

In my experience it doesn't change much at all. It doesn't replace any other steps usually. It doesn't decrease morbidity or mortality. It just adds cost and gives a gastroenterologist something to do.

The studies I have read have shown that EUS-FNA actually reduces costs as it spares a good number of people a surgical intervention. You could argue that for those with pancreatic lesions who end up with adenoCa and are surgical candidates the procedure is unnecessary, but I have seen lesions thought to be adenoCA turn out to be chronic pancreatitis, etc.

Having a diagnostic Whipple is a steep price to pay.