Richard Periut wrote:
> Dr. Andrew B. Chung, MD/PhD wrote:
>
> > Richard Periut wrote:
> >
> >
> >>Dr. Andrew B. Chung, MD/PhD wrote:
> >>
> >>
> >>>liaM wrote:
> >>>
> >>>
> >>>
> >>>>If someone comes in to the emergency ward with all the symptoms
> >>>>of clogged arteries, but he has no money, will he still be
eligible
> >>>>for open heart surgery ??
> >>>>
> >>>>liaM
> >>>
> >>>
> >>>Homeless and destitute people arrive in emergency rooms all over
the
> >>>U.S. on a daily basis and receive the best available emergency
room care
> >>>despite inability to pay. If such a person comes in with a bullet
> >>>through the chest, s/he will receive open chest/heart surgery if
needed
> >>>to save his/her life. Appropriate care is given as needed on an
> >>>emergency basis without regards to ability to pay here in the
America.
> >>>May God continue to bless America and the president He has chosen.
> >>>
> >>>Servant to the humblest person in the universe,
> >>>
> >>>Andrew

> >>
> >>Very true with one exception.
> >>
> >>If you have good insurance, chances are you are going to get a
cath, and
> >>with many people, a CABG.
> >>
> >
> >
> > This would be an instance where having good insurance may lead to
suboptimal
> > medical care. One of the ironies of life in this world.
> >
> >
> >>If you don't have insurance, they do what they are suppose to do
with an
> >>uncomplicated first time MI; stratify you and place you on medical
> >>treatment without intervention.
> >>
> >
> >
> > Unless you stratify into the high risk group of multivessel or
left-main
> > disease.
> >
> >
> I meant stratify to low risk, and optimize medical management.
>
> >>Physicians practice a lot of the medicine their own way. The heart,
> >>blood, lung institute still recommends beta blokers and diuretics
as
> >>first line agents for HTN; most docs usually jump to an ACE or
> >>ARB--medications that are ultra expensive when it comes to BB and
> >>furosemide.
> >>
> >
> >
> > Yes, each doctor has his/her own "style."

>
> Which scares the f**K out of me, if I ever end up in a hospital. BTW,
I
> have a handful of colleagues which will be the only physicians that
may
> take care of me, should I fall ill and require hospitalization. God's

> will allowing of course. I'm serious. My jaw drops in awe, when I see

> many of our colleagues practice and get away with unbelievable stuff.
>
> Many times, I have to instruct diabetics, to carry glucose tablets,
> check their glucose frequently in order to recognize patters of high
Bg
> and their association with diet, activity, medications, et cetera.
I'm
> pulmo not endo.
>
> There are damn good internists out there, but the majority are just
> money making Rx writers.
>
>
> >
> >
> >>And we wonder why the cost of health care is through the roof; not
to
> >>mention those inevertebrates; the malpractice lawyers.
> >>
> >
> >
> > So to reduce costs you would propose that we stop providing medical
care to
> > the uninsured and indigent folks?

> > Or would you have all doctors practice medicine uniformly ?
>
>
> No, provide the proper care to uninsured, and stop cathing/bronching
> (whatever) every body that is brought into a hospital.
>
> Also, stop those PCP's which treat you like a car in a car wash: ekg,

> bone density study, x-ray, spiro, echo (for those with balls,) and in

> the end, they didn't address the patients CC.
>
> I don't have anything against Cardios, but I stopped referring to a
> particular group, because every patient I sent to them received a
cath.
> It's like they helped the patient mouth the words "I have substernal
> chest pain that radiates down my left arm, when I walk a couple of
feet,
> and the medications are not helping me!" : )




This is a good conversation. About medicine, cardiology, with two
physicians discussing technique and practices in a learned manner.
Welcome Richard. Stay awhile.

Zee