Breast Cancer .
Are You At
reast Cancer is the most frequently diagnosed
non-skin cancer in American women. The
risk of breast cancer increases as women get older. No one knows why some women develop breast cancer and others
do not. Over the years,
researchers have identified certain characteristics, usually called
“risk factors,” that influence a woman’s chance of getting the
disease. Still, many women who develop breast cancer have no known
risk factors other than growing older, and many women with known risk
factors do not get breast cancer.
In the fall of 1998, the results of a large study
that looked at the feasibility of preventing breast cancer was released.
This study demonstrated that if a woman is at high risk of
developing breast cancer, it is possible to reduce the chance of getting
breast cancer by 50%, by the use of a medication called Tamoxifen for five
years. The most powerful
predictors of breast cancer risk are a first-degree relative (mother,
sister or daughter) with breast cancer and a personal history of a
previous biopsy that showed abnormal non-cancerous cells.
We, at the Plentywood
Clinic, now have available, the parameters that were used to enroll
women in the study and calculate their overall risk of developing breast
cancer. Should you desire to
have a FREE risk calculation, our nursing & medical assistant
staff are more than happy to do this.
A number of issues come up when deciding to have your risk
calculated. If your
risk of breast cancer is above the recommended cutoff point then treatment
with tamoxifen for five years is
an option you may decide to take. This
treatment is not without it’s own substantial cost--financial, emotional
and medical. The medical costs include an increased risk of cancer of the
uterus (none of it fatal in the study), blood clots, strokes and hot
flashes. The financial cost
is $1200 per year for five years and most likely will not be covered by
insurance although companies may differ in this.
The medication is stopped after five years and it’s benefit
continues for at least 10 years and probably more.
This is just the beginning of a new era in medicine
in which tools are being developed to predict disease risk and therefore
allow earlier interventions to ameliorate the diseases effects.
Changes . . .
Just as the practice of medicine has become more
complex over the past 15 years, the business of medicine has also changed.
The days of simplicity in billing and filing insurance claims are
long over. We at the Plentywood
Clinic have resisted the flow as long as possible, but the tidal wave
is now visible on the horizon. We
deal with over 50 insurance companies, all of whom have different
deductibles, co-pays, service charges, etc. In addition there are over
10,000 diagnosis codes and procedure codes, many of which change from year
to year. This all makes the
fair and equitable aspect of the “business” of medicine an
increasingly difficult commodity to judge. There
are going to be some significant changes in how this aspect of our
practice operates. We will
continue to submit the first two insurance claims for our patients free of
charge, but will charge $8.00 for each claim over two.
We will have to begin adding interest charges for all
accounts not paid after 120 days from the date of service.
This allows four months for your insurance to process and act on
your claim. We
encourage you to keep up-to-date with what your insurance company is doing
during this four months.
Because of the complexities of the various insurance
policies, you may well find that the same services offered by this office
have different charges. Indeed,
the same insurance company will have many different policies that results
in many different charges for the same procedure.
Common sense is not a requirement of these policies.
I have never felt that medical services should be withheld from
those who are unable to pay (unwilling to pay is another story).
Should your financial
situation be such that this is a concern for your, please talk with Nancy
Lasar, my office manager, or myself to see what can be worked out.
Nowadays, there is often a wide gulf between what
needs to be done and what can be done.
You also have to be aware of what your insurance will cover.
The time to talk about these things is before
the bill becomes unmanageable. There
well may be alternatives that have not been looked at.
New Policy . . . We ask that you please bring
in your Insurance Card to EVERY visit.
We are having trouble with some patients switching Insurance
Companies and not letting us know when we send claims in. Also other Insurance Companies themselves are changing names,
addresses, etc. Thank You for
Marci Butcher, our Dietitian/Certified Diabetic Educator (CDE) will be
leaving. Her husband Jason
Butcher has taken a position at Fairfield High School.
Marci has been a very helpful part of setting up our diabetic
In the near future, we will be hiring another
dietitian and CDE. However,
our diabetic program is still up & running. Appointments
can be made during office hours. Diabetic Clinics are on alternating Wednesdays & Fridays.
Dr. Stoner, Nancy Lasar, RN and Lisa Fawcett, RN have
just returned from the American Diabetic Association Conference in Great
Falls. The Plentywood Clinic
was praised for having done an outstanding job of diabetic patient
education. This was
documented by a dramatic improvement in patient hemoglobin A1C lab values. We are very excited about this and are looking forward to
seeing continual improvements in our diabetic patients.
If you have any questions about the Diabetic
Education Program, please call Nancy Lasar, RN, Monday - Friday at the
doctor visits are by appointment only.
The following is a schedule for the Plentywood Clinic.