Report: 700 doctors wrote possibly harmful Medicare prescriptions
據報導：七百位醫生所開的健保處方可能有害 (3)
【Comment】: 【醫生與患者對此事的看法】
1) From
an MD with 50 years in Cancer Medicine. 一位對腫瘤科(癌症)醫療有50年經騐的醫師：
The
abuses
linked to physicians and other healthcare practitioners involved with Medicare
and costing the taxpayer via the US Government billions of dollars is
JUST another example of how wasteful our Washington bureaucrats are. This is
part of the UNWINDING
of AMERICA that Packer has written about.
與醫生和其他醫療從業者有關的一些濫用醫藥，不過是與我們華盛頓的官僚們如何浪費的另一例子，這些醫療從業者牽連到健保局，和經由美國政府而花費了納稅人好幾十億的錢。這就是Packer所曾經寫到的美國『無法解開的結』
2. Physicians send patients to other physicians for consults with the expectation that those being referred patients will refer patients back to them. One hand washes the other.
醫生把患者介紹給其他醫生，是期待這些被推蔫的患者，會再把患者介紹回去給他們。用一隻手洗另一隻手。
3. Physicians who have their own in-office labs will order tests repeatedly despite being normal.
3. Physicians who have their own in-office labs will order tests repeatedly despite being normal.
儘管檢騐報告正常，而自已診內又所設有檢騐室的醫生們，還會一再要求患者作檢騐。Why?
3. Physicians will hire physician's assistants who bill Medicare as if the MD had seen the patient. These PA's will simply copy and paste from prior office visits and charge the highest level of office visit. This is fraud.
4. Men with prostate cancer will be sent for bone scans and CT (CAT) scans that cost hundreds of millions of dollars annually, yet the peer-reviewed literature shows that such studies are so INSENSITIVE as to not be useful in the staging of newly diagnosed men with PC.
患有攝護腺癌的男性患者，會被送去作骨格掃描或CT掃描，這兩種掃描每年要花幾仟萬元。可是依同輩醫師審查過的文献顯示，這些研究如此不『具檢騐的敏感性』，以致於對新近被診斷出患有攝護腺癌的患者，要確定其罹疾的期數是沒有幫助的。
5. MDs will order DXA scans to assess bone density yet in middle age or older men and women those tests are grossly inaccurate due to osteoarthritis, degenerative joint disease and vascular calcification. Yet these in-office tests are done because they generate income.
醫生們會命令病人作DXA掃描以評估骨質密度，可是對於中年或年歲較大的男女，這些檢騐粗劣地說是不準確的，因為他們若患有骨關節炎、退化性關節疾病和血管鈣化。但這些檢騐還是在診所內做了，因為醫生可以藉此製造收入。
6) When the U.S. government spends taxpayer dollars without due diligence on how that money is spent, it is as if the American taxpayer has donated money in a blindfolded fashion. Instead of hiring Americans to inspect physicians billings and penalize MDs committing fraud, they encourage fraud, because the oldest profession has become the oldest profession. Physician income > Patient outcome.
6) When the U.S. government spends taxpayer dollars without due diligence on how that money is spent, it is as if the American taxpayer has donated money in a blindfolded fashion. Instead of hiring Americans to inspect physicians billings and penalize MDs committing fraud, they encourage fraud, because the oldest profession has become the oldest profession. Physician income > Patient outcome.
當美國政府花了納稅人的錢，而未審慎去注意這些錢是如何花掉的；彷彿納稅人被蒙著眼睛，盲目地捐款。未僱用美國人來檢查醫生開列的帳單，和醫生的欺騙行為，相反地他們鼓勵犯罪，因為最古老的職業已變成最老舊的欺騙行業。醫生的收入大於病人接受醫療的結果。
7)
So is there a practical mechanism by which such practices can be reported to
authorities? If you are a physician who observes bad care by another doctor, or
a patient who receives it, what can you do about it?
因此有沒有一種實際的機制，可藉此機制向有關當局舉報這種法行為?
如果你本身是醫生，而看到另一位醫生做此不法的事，或病人受到不法的醫療，憑良心你該怎麼辦?
-Dr. Stephen B. Strum醫師
(待續)
Justin Lai, 07/06/2013
Jlai77168@gmail.com
chiayihischool@gmail.com
嘉中校友聯誼會
AACHW13
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