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Oct 1, 2024
2:03
:25
pm
Bobber
Political Junky
clinically benign diagnosis provides value, removal adds value, biopsy adds more value
why can't the patient choose?
Why does anyone else care so much that the patient must be FORCED to pay for the "full meal deal" when they only want the cheeseburger?
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Bobber
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Bobber
Joined
Nov 10, 2011
Last login
Oct 1, 2024
Total posts
548 (21 FO)
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Messages
Author
Time
Why do so many dermatologists insist that if they remove a mole, the patient MUST pay for a biopsy?
Bobber
Political Junky
Oct 1, 1:49pm
Because they need the kickbacks from the lab to make their Porsche payment.
cheezedawg
Oct 1, 1:51pm
Are doctors required by law or medical boards to disclose any "kickback" relationship with the lab?
Bobber
Oct 1, 1:54pm
Read up on the Stark Law.
TN_Coug
Oct 1, 2:05pm
Tony Stark?
ochobeeguy
Oct 1, 2:07pm
Yes, Tony Stark Law.
TN_Coug
Oct 1, 2:07pm
That would be against the Stark Law.
TN_Coug
Oct 1, 1:55pm
"Because the patient declined to pay for that analysis"
Skeptical Optimist
Oct 1, 1:58pm
Ask a lawyer. Doctors wonder that all the time.
TN_Coug
Oct 1, 2:05pm
That’s not enough. “Because patient declined test despite my recommendation
cougaman
Oct 1, 2:16pm
How does "could be cancerous" not apply to all clinically benign moles?
Bobber
Oct 1, 2:30pm
You are complaining about a cost. If he didn’t biopsy it and it ended up being
cougaman
Oct 1, 2:40pm
Ummm.. of course you can be sued for misdiagnosing a benign appearing mole
cougfanz
Oct 1, 2:51pm
It was a joke
cheezedawg
Oct 1, 2:43pm
yes, but the OP didn't seem like he knew that.
TN_Coug
Oct 1, 8:18pm
<< Deleted >>
Acorn
Oct 1, 1:52pm
Because when the mole is not removed, you can monitor it for changes to
cougaman
Oct 1, 1:53pm
Is that a worse patient outcome than leaving the mole in place?
Bobber
Oct 1, 2:00pm
You are asking the dermatologist to remove it, expect them to biopsy. I don’t
cougaman
Oct 1, 2:13pm
Because someone once did that and missed cancer and got sued
JimmyZ
Oct 1, 1:55pm
Yup, it's standard of care and could make a potential insurance/malpractice claim invalid.
CSoul
Oct 1, 1:57pm
So doctors can be sued for not following a standard of care that only benefits doctors?
Bobber
Oct 1, 2:08pm
Are you always this obtuse?
JimmyZ
Oct 1, 2:09pm
I mean, I'd saying finding out the mole was cancerous or not also benefits the
fattycoug
Oct 1, 2:35pm
You asked an industry specific question and a few practitioners made a good faith attempt to answer it honestly.
JarJarBeeps
Oct 1, 3:23pm
Why is the doctor liable for failing to identify cancer in a clinically benign mole, if the patient declined biopsy?
Bobber
Oct 1, 2:19pm
Because jurors don’t think you’re smart enough to make these decisions
cougfanz
Oct 1, 2:25pm
Appears benign clinically
WorfoSAUR
Oct 1, 1:57pm
clinically benign diagnosis provides value, removal adds value, biopsy adds more value
Bobber
Oct 1, 2:03pm
RE: clinically benign diagnosis provides value, removal adds value, biopsy adds more value
TN_Coug
Oct 1, 2:06pm
Then remove it yourself.
IGlowInTheDark
Oct 1, 2:07pm
If that's the medical establishment's response to an obvious failure to provide patient-centered care
Bobber
Oct 1, 2:14pm
The whole premise of your OP is patently false. “Clinically benign”? Please.
IGlowInTheDark
Oct 1, 3:53pm
Are you saying the term "clinically benign" is not a thing?
Bobber
Oct 1, 6:49pm
Patient satisfaction leads to 26% increase in mortality. This isn’t the
Groym
Oct 1, 3:56pm
Thanks for the helpful response. I understand nothing is ever certain in clinical diagnosis
Bobber
Oct 1, 6:55pm
That boat isn't going to pay for itself
Skeptical Optimist
Oct 1, 1:57pm
Also, that typically makes it covered under insurance, where if there is no
BYU-Ite
Oct 1, 1:58pm
Removal of a clinically benign mole is never covered by insurance, is it?
Bobber
Oct 1, 2:07pm
I had a clinically benign mole removed, sent to the lab, and the insurance covered it.
TN_Coug
Oct 1, 2:10pm
Did it have other medical indications (irritation, bleeding)?
Bobber
Oct 1, 2:22pm
It did not. It appeared clinically benign.
TN_Coug
Oct 1, 2:28pm
OK, your experience appears to be very unusual
Bobber
Oct 1, 2:31pm
Same story for me. I had one removed from my face. Doc told me to have it
BYU-Ite
Oct 1, 2:30pm
Lawyers. Answer is always lawyers.
BGRTHNUMEGO
Oct 1, 1:58pm
Especially when they want to use a deli slicer to get it:
Doctor Rosenrosen
Oct 1, 2:00pm
Call your insurance company and ask why they refuse to cover things.
IGlowInTheDark
Oct 1, 2:00pm
With high deductible plans these days, most of the time it's still an out-of-pocket expense
Skeptical Optimist
Oct 1, 2:03pm
Root of problem remains insurance companies
IGlowInTheDark
Oct 1, 2:05pm
That they don't cover it, or that you can't actually call anyone and find out?
ochobeeguy
Oct 1, 2:09pm
You answered your own question, you just don't like the answer. Emphasis added
Sparkling Delirium
Oct 1, 2:17pm
He doesn't want there to be an answer.
TN_Coug
Oct 1, 2:19pm
Anytime I cut a tissue out of the mouth, I biopsy it. I’m not removing anything
blackandblue
Oct 1, 2:24pm
Over 15 years, I’ve found 2 squamous cell carcinomas.
blackandblue
Oct 1, 2:56pm
I agree with that policy, but I'm asking about biopsy of a clinically benign mole
Bobber
Oct 1, 7:01pm
Yeah, I see your point. And I get it. My wife had a mole removed from her
blackandblue
Oct 1, 7:11pm
So maybe what I should do is get a dermatologist to evaluate, but go to a cosmetic surgeon to remove?
Bobber
Oct 1, 7:28pm
The dermatologist has the same liability.
cougaman
Oct 1, 7:39pm
The cosmetic surgeon has the same liability than a dermatologist if they remove a lesion
TN_Coug
Oct 1, 8:19pm
I am ONLY talking about a mole that a competent dermatologist has diagnosed as benign
Bobber
Oct 1, 9:32pm
Doesn’t matter. All parties are sued. The surgeon and the dermatologist.
cougfanz
Oct 1, 10:07pm
But how is the liability risk any different when the mole is NOT removed?
Bobber
Oct 1, 10:57pm
Yep. Thats why in medicine you don’t do something unless you want to
cougfanz
Oct 1, 11:10pm
If you biopsy a mole and don’t get path done and a patient dies from melanoma
Groym
Oct 1, 2:27pm
^ this can end the thread.
cougfanz
Oct 1, 2:32pm
thanks, that's a helpful explanation of the current state of things
Bobber
Oct 1, 2:33pm
Liability and patient safety. First and foremost
byusage
Oct 1, 2:33pm
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