Patients
Joined: 15 Mar 2003
Posts: 2
Posted: Sat Mar 15, 2003 6:56 am Post subject: Who Sets the Protocols for Dialysis Units?
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Dialysis units of different companies have opposing protocols. For ex. the protocol for a high negatve arterial pressure is -200 while another company's protocol is -300. Or it is the policy for one company to "dump the prime" whereas this protocol is strictly prohibited by another company. <
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>The large variance in protocols is very confusing and upsetting to patients who already have enough to deal with. Should a patient change units, his entire dialysis routine may change and he will be chastized should he prefer the procedures/protocols he was accostomed to or which he preferred. Patients' choices in procedures for their care are stripped away in deferance to the company's choices for speed or profitiability which may not be in the patients' best interests.<
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>What has happened to the doctor's Rx pad and the doctor's order? IS IT TRUE that dialysis company governing bodies hold more sway over patients' lives then the doctors who take an oath to deliver care that is in the patients' best interests? Why are there no across the board STANDARDS in dialysis units which take into account patients' rights?
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Say
Joined: 15 Mar 2003
Posts: 2
Posted: Sat Mar 15, 2003 9:43 am Post subject: Physicians sold you out.
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Its the Drs. who sold the patients and the prescription pad! If the doctors werent greedy,this also wouldnt be in the condition that it is in.<
>Anywhere from 60 thousand to 100 thousand per patient commodity is what your worth patients.<
>If this group of physicians were under the Stark Law and werent immune from the Anti-kickback law,these for profits wouldnt have something to buy from the physicians,<
>You need to realize its about money and to be allowed to sell a patient is wrong and to have them on the stockmarket is wrong. To be allowed to self police themselves is wrong.<
>But it started with the physicians themselves.<
>
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Then
Joined: 15 Mar 2003
Posts: 1
Posted: Sat Mar 15, 2003 10:21 am Post subject: What Will Come First?
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Standards or Home Hemo, because patients are clearly prisoners of a greedy system.. <
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>Why aren't these doctors under the Stark Law? "Who" made them immune to the Anti-kickback law? Is this really still America?
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FRN
Joined: 24 Feb 2003
Posts: 25
Posted: Sat Mar 15, 2003 1:42 pm Post subject: Standards
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It has been 3 years since the senate hearings and we were promised Standards of care that very same year. We are still waiting!<
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>Yes, each company/unit sets their own set of standards and procedures/policies for doing things and all the big companies loudly proclaim that they have the best outcomes. So how do we know who has the best outcomes? We don't because there are no set standards of care for dialysis patients. What we have are the so called DOQI Guidelines that these companies use as THE STANDARD. But these so called guidelines come with a disclaimer that they ARE NOT to be used as a standard, but as a guideline for making up standards. <
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>The reason these Dr's are not under these laws is because years ago, there was not the demand for dialysis as there is today. Nephrologists were not in the majority of Dr's and they were usually the only ones who set up dialysis clinics for their patients. It cost a lot of money to do so as the machines were costly. <
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>But now that the government has guaranteed payment for dialysis patients, it is a big money maker if you know how to play the reimbursement game. That is why the dialysis industry has grown into the $$$$$$ monster it now is.
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plugger
Joined: 11 Jan 2003
Posts: 258
Posted: Sat Mar 15, 2003 2:40 pm Post subject: Stark law
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What exactly does this Stark law state?
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Lin
Joined: 28 Oct 2002
Posts: 337
Posted: Sun Mar 16, 2003 7:50 am Post subject: Best outcomes?
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Seems more like they think they have
agging rights, but it's to the best of the worst! My clearance was 87% and I was overjoyed, until they took it over and it was 70%; the nurse telling me that was FABULOUS! Sorry, not impressed just because it's above the standard, which in my book stinks! The standard is the point at which people are kept alive, but not really "living". Lin.
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say what
Joined: 11 Mar 2003
Posts: 29
Posted: Sun Mar 16, 2003 8:43 am Post subject: Anti Kickback and Stark Law
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All physicians except the nephrologists are immune from the Anti-Kickback and the Stark Law. However the way the law is set up they could be
ought into the folds as other doctors if the government finds the need.<
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>Briefly this means that the physicians cannot have a conflict of interest. They cannot profit from their patients being it laboratories or relatives working in business or having a company giving cash or other incentives to send the patients in them. In other words physicians do and order what is needed for the patients and not have incentives to benefit from a patients illness.<
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>This is what the Senate Hearings even with full documentation and knowing this through investigations were aware of and the fact that you the patients are on the stock market and your physician is most cases benefits from their own laboratories and your physician has sold the prescription pad to the companies. They simply have conflict of interest. This is what the Stark Law and the Anti Kickback law was to prevent.<
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>This industry has left themselves vunerable and have always felt that with "self policing" of the industry would keep this secret for another 30 plus years. <
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>Look at the reuse issue,this can be taken away tomorrow if the FDA wanted to. Public being informed and getting the word out will save lives. But know that you have rights and your basic patient right of "Informed Consent" is missing.<
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>Arlene
