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Breast Cancer - Biopsy vs. Surgery

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An estimated 182,800 new cases of invasive breast cancer will be diagnosed in 2000. Approximately 42,200 deaths will occur in women from breast cancer in 2000. One in eight women or 12.6% of all women will get breast cancer in her lifetime.

Women are advised to perform a breast cancer self exam monthly.  If an unusual lump is found, they should see their doctor.  However, what happens next is often sub-optimal care. For most lumps, it is best to do a needle biopsy first.  About 80% of these show that the lump is not cancer and further surgery is not necessary.  However, often doctors will do a surgical biopsy which is a more complicated procedure and in most cases has no better detection rates.  If cancer is detected, a second surgical procedure will need to be performed.

Here is a recent study which highlights the sub-optimal treatment path which causes more complications and expense than necessary.

American Journal of Surgery

The New York Times

Here is a good reference on breast cancer.

National Cancer institute

 

C-Sections and Induced Births - Necessary?

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The Caesarian section has for a long time been used to save mothers and children who are at risk of complications near full term.

However, increasingly, "elective C-Section" is being used for the convenience of doctors and patients without medical justification.  This has important health and cost impacts which should be carefully considered.  Often the C-section comes about as a complication of induced labor.  These are highlighted clearly in the following set of articles:

Cesareans and Induced Births: Who Is Choosing These Procedures--and Why? Part 1

Since 1975 the rate of C-sections has tripled to now constitute 30% of all births.  The number of induced labors has risen to 22% and 40% of these are "elective".

Unfortunately, induced labor causes problems for mothers and babies.  Babies are more likely to require neonatal intensive care and mothers at a minimum have a long and difficult recovery from surgery.

If you or your doctor are considering induced labor, please consider the health and financial implications carefully.

 

 

How to buy your health care

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Even if you have the best insurance in the world, you need to be conscious of price when you purchase health care services.  The price will affect your deductible and your out of pocket expense.

There are a few important rules to follow:

Shop around.

Don't be afraid to ask the price and to shop around for a better price.  You may find that you can negotiate in advance.  Many hospitals and doctors offices are not used to patients asking about prices and may not be prepared but you should be persistent and insist on a firm quote.  They may also hedge by saying that they can't predict the price since everyone is different.  Do not accept these prevarications!  Almost all medical care is well defined and the cost can be predicted.  There are commonly used coding systems for medical billing (HCPCS and CPT procedure codes) that have exact values.  If your are told you need a service, get the procedure code(s).  You can look these up (see our resources section) to find out what a reasonable charge for the service should be in advance.

Get a firm quote in advance

It is best to get a quote in writing and make sure that it is not an "estimate".  Often hospitals and doctors will give an estimate that allows them to add charges.  It is very difficult to get them to explain or modify these extra charges after the service.  You should receive an exact quote for the cost of a service without any conditions which would permit them to bill for extras.

 

Doctor Visit Prices

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How do doctors bill for visits?

What is the "Level of service"?

How is the "Level of service determined"?

Are you being charged the proper level of service?

What are standard charges for each level of service?

 

Last Updated on Monday, 22 November 2010 19:40
 

MRI Scans

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What is a MRI?

What is it used for?

Do you need it?

How to get the best price.

Last Updated on Monday, 22 November 2010 19:40
 


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