This actually came up in inpatient medicine morning rounds today concerning a
patient with pyelonephritis. We instructed the intern that we need to use
Cipro IV rather than PO for purely financial motivations. Insurance will not
pay for an inpatient day without an IV therapy (of course you could just
administer fluids). This is all in the face of no evidence to support IV over
PO administration.
To counter this foolishness, we can join hospital CQI process groups and try to
advocate for evidence-based medicine. In the end, it's up to government
regulatory agencies to end such illogical insurance company practices.
I wonder if we could move this EBM email list to a service like www.Topica.com
or www.Onelist.com, so that readers could comment on specific threaded emails
to the list. Then members could read just the threads they're interested in.
I manage our residency list on Topica and have found it much easier to manage,
and members have an easier time performing list functions, eg. to subscribe,
requesters may just hit the "Reply" button on their email program, after
recieving their "opt-in" message.
Enoch Choi, MD
UC Davis, Modesto Family Practice Residency
[log in to unmask]
--- Klazien Matter-Walstra <[log in to unmask]> wrote:
> I wonder what the impact of earning money is. Even with the best evidence
> available, to "handle" in spite of this evidence may be driven by money ?
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