| Lost password
137 users onlineYou are not loggend in.  Login
NA Dr. in CA
 1 2
 1 2
09/08/05 02:02
John

not registered

09/08/05 02:02
John

not registered

France

14,861 hospitalizations for Dupuytren's surgeries (fasciectomies) in 2001. How many got NA in France that year?

J Hand Surg [Br]. 2005 Oct;30(5):484-7.

Dupuytren's Disease in France - 1831 to 2001 - from Description to Economic Burden.

Maravic M, Landais P.
From the Hopital Necker Enfants Malades (APHP), Service de Biostatistique et Informatique Medicale, Paris Cedex, France.

We recorded all elective admissions for Dupuytren's disease from the French National Hospital Database. We used the data from first hospitalizations to calculate the 2001 hospitalization rates for this condition and determine geographical differences between different regions of France. We also calculated the hospital costs of treating admissions with this disease. Fourteen thousand eight hundred and sixty hospitalizations for Dupuytren's disease were reported in France in 2001, of which 93% were for a first treatment. The disease was mostly present in men and was mostly managed by surgical fasciectomy. Most operations were carried out in private hospitals, with a mean stay of 2 days. Geographical differences were found in men only. The total hospital cost for all elective admissions was 14, 179, 998 Euros, indicating the considerable financial burden to the State of treating this condition.

PMID: 15993524 [PubMed - in process]

09/08/05 02:00
Randy H.

not registered

09/08/05 02:00
Randy H.

not registered

Stranger than Fiction

"considerable financial burden to the State"

This is like someone repeatedly smashing their head into a cement wall, not knowing quite how to stop. Sometimes reports like this verge on the Surreal. Perhaps a Twilight Zone episode.

09/10/05 02:23
Hammer head

not registered

09/10/05 02:23
Hammer head

not registered

NA

Randy said: "When a general practitioner sees a Dups case, he ships the patient off to his favorite CHS." This has been correct in my case. My general practitioner has shown interest in NA after he saw the results of Dr. Eaton's work on my pinky. At his request, I sent him the list of NA practitioners that I posted in this forum. Perhaps it is the general practitioners we need to convince. They are much more receptive. They could refer NA cases to the nearest NA practitioner. In my case that would be Dr. Denkler.

09/12/05 02:29
Randy H.

not registered

09/12/05 02:29
Randy H.

not registered

Too Good to be True

I tend to agree Hammer. My GP was *amazed* at Eaton's work. "Who did this!!!" he nearly shouted when I showed him my Eatonized hand. "I'd *love* to have an alternative to the traditional surgery available to me." He added.

I shot him Eaton's web site. Who knows what he will do.

What I learned from the encounter was that if most GPs are like mine, the'll jump at a way to help their patients avoid OS. But like we have seen again and again, *seeing* is believing when it come to NA or anything that challenges a time honored tradition. It was my GP's visual experience of *seeing* my actual hand, before and after, that turned his head.

You'd think this would have the same effect on a CHS, but it doesn't appear to. I guess they just too highly trained and educated. :-) Again, Twilight Zone. Or maybe the assumption is that NA is just too good to be true. Got to be a catch. (Well there is, and that's higher recurrence rate)

Though the approach of recruiting GPs is certainly helpful, the real killer in my mind is Eaton's 2006 presentation to the society of CHS.

09/12/05 02:19
jim h

not registered

09/12/05 02:19
jim h

not registered

Who Stands to Gain from NA $$$$$

All MDs - GPs and surgeons - are increasingly just employees of clinics, HMOs and other corporate entities where they're told to refer patients to other "network providers" whenever possible. Add a little profit-sharing and other incentives to the mix and you have a nicely self-perpetuating system for confining patients to the options your company can currently provide.

When I talked to my GP about DC he just automatically gave me the name of the hand surgeon in their network and assumed that would be my next stop.

These guys may all think they're doing the right thing in some sense but it's a system that's highly resistant to change from below. And seen from the top, why jump at the chance to replace an expensive procedure with a cheap one?


Combining the GPs and the surgeons in one business creates one big conveyor belt to surgery. That's part of the reason so many unnecessary surgeries are done in this country.



09/12/05 02:30
Randy H.

not registered

09/12/05 02:30
Randy H.

not registered

Who Stands to Gain from NA $$$$$

Your points are well taken. "Top Down" is the most effective approach. That's why Eaton's involvement is so *incredibly* significant.

As far as profit, I've pointed out a number of times that the $$$/hr for NA at $700 a pop for a 30-45 minute in-office procedure is comparable to OS. Yes, supply/demand could eventually have downward pressure on that, but doctors do seen to get away with what would otherwise be considered "price fixing". I think the Rate has been set.

Who really stands to gain from NA are the insurance companies and the HMOs like Kiser where insurance and provider are one and the same. I'd love to see them on board. The PPOs like Blue Cross would wake up a lot faster and insist that OS will only be paid for *after* NA had proven unsuccessful in any particular case. Yep, I know I'm dreaming, but they could have saved a *bundle* on me if they only knew.

 1 2
 1 2
insurance   hospitalization   Biostatistique   practitioner   hospitalizations   fasciectomy   self-perpetuating   practitioners   fasciectomies   presentation   patients   eventually   considerable   admissions   professionals   profit-sharing   automatically   procedure   geographical   Informatique