Posted On: May 18, 2007, 2:10 pm CDT

Posted By: a doc

Jane Q. Public - I am sorry for your loss. If you did suggest an imaging study and your mothers doctor refused - I'm sure that makes your hurt and anger even worse. In many cases pancreatic cancer is very difficult to cure, even if caught early and treated with surgery. It really is one of the worst cancers a person can get.

What you suggest about the smoking and drinking wouldn't work - at least not in the US. Ethically, medical systems couldn't deny treatment to someone simply because they are the cause of their own disease. I can't tell you how many times I saw alcoholics brought into the ER, allowed to sober up, given the card for the local AA meetings and caringly encouraged to get sober - only to see them back again within the week. (Healthcare cost$ - each visit probably cost minimum $200-300 and usually the hospital has to write this cost off because the patient has no insurance.) Yes, I know, alcoholism is a disease. Would you be the person standing in the ER doors blocking the stretcher from rolling in the door? What if this guy vomits and suffocates on his vomitus? Or, how about the lifelong smoker who is dearly loved by her 25 family members and has severe emphysema. Could you deny her a breathing treatment when you see she might die from not getting it?

Capitation simply allows the insurance companies to keep piling more patients onto a physicians panel without allowing for the time he/she will need to properly care for them. Do you like 5-7 minutes for doctors visit? Docs face falling reimbursement from the gov't and private insurance, plus increasing costs to run their offices due to HIPAA. I know, I know poor doctors . . . but if put your life on hold for 11 (family doc like me) or more years to pursue a profession and accumulate typically greater than $200,000 in debt to get there. . . I want to make more than the RN who works (usually very hard) beside me with only 4 years of schooling.

more later - gotta go