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  1. Cancer Care Unaffected by Doctor Reimbursement Changes
    Chemotherapy patients have not lost access to care despite federal legislation that has reduced reimbursements to their doctors in recent years, a new report finds.
    Critics feared the passing of the Medicare Modernization Act of 2003 would make treatment more difficult, but investigators from the Duke Clinical Research Institute (DCRI) found little difference in the distance chemo patients traveled to be treated and the time between diagnosis and start of treatment.
    “The Medicare Modernization Act took issue with the fact that oncologists were often reimbursed too much — sometimes as much as three times what they had paid — for the chemotherapy drugs they were giving their patients, and subsequently, doctors saw those reimbursement payments fall,” senior study investigator Dr. Kevin Schulman, director of the DCRI’s Center for Clinical and Genetic Economics, said in a prepared statement. “The concern was that patient care would suffer if doctors had to close their practices or scale back, making it necessary for patients to travel farther or go to inpatient facilities for treatment. Our study showed that this, in fact, has not yet occurred.”
    The researchers studied the treatment of people with leukemia, lymphoma, breast, lung or colorectal cancer from across the United States from 2003, before the act passed, through 2006.
    “The distance patients traveled for chemotherapy treatments did not considerably increase after passage of the act,” lead investigator Lesley Curtis, a health services researcher in the DCRI, said in a prepared statement. “And despite concerns that patients would have to go to inpatient settings with longer wait times to be treated, we observed a small shift in the provision of initial chemotherapy from inpatient to outpatient settings between 2003 and 2006.”
    The median amount of time between diagnosis and chemotherapy was 28 days and did not change significantly, regardless of the treatment settings between 2003 and 2006, Curtis said.
    “We did find that patients in rural areas tended to have to wait longer to begin their chemotherapy after diagnosis — their wait times increased by up to five days from 2003 to 2006,” Curtis said. “Whether this is something that could have a negative effect on treatment outcomes is still unknown, but it is something we should continue to follow.”
    The findings were published in the July 9 issue of theJournal of the American Medical Association.
    The lower reimbursement may still have long-term effects that have yet to be realized, Curtis cautioned.
    SOURCE: Duke University Medical Center, news release, July 8, 2008

  2. An article written in Medical News Today tells us that the American Society of Clinical Oncology (ASCO) is to issue guidelines on how physicians should discuss cost of treatment options with cancer patients.
    I never heard that ASCO has been knighted a regulatory agency. Some experts warn that the new guidelines could raise costs even further, thus limiting access to cancer patients.
    Study: Medicare Modernization Act Did Not Change Chemotherapy as Feared

  3. Healthgrades.com is a fraud.
    Dr. Kahane’s off-topic post above led me to look him up and what I found is that he is rated at the highest grade on Healthgrades.com even though HIS LICENSE IS REVOKED in Arizona and every reciprocal state in the US. Clearly Healthgrades.com is not a reliable source of information. Who is going to call them on this?

  4. Dr. Kahane,
    Right. For folks like yourself, none of your troubles ever have anything to do with you. It’s all someone else’s fault. You sound like a carbon copy of almost every doctor who ever finds himself in your position. Tell me this—even if they were really “out to get you”, do you think it’s just possible that there is anything in your personality or character that is so off-putting that people would delight in bringing you down? And please, don’t tell me they’re just jealous.
    Sorry. But your post just begs for this.
    Person who has spent a lifetime studying narcissistic personality disorder.

  5. Here’s another one for you Eric:
    Glad to see you’re realizing that cost control is the issue. Government run single-pay with budgets is the only way to control costs. Providers and users are going to have to share the pain. Maybe the Fed will bail out healthcare as well.
    Matthew, any way to rid us of these blog highjackers? No Eric, not you.

  6. It wasn’t Medicare that failed Betty McBee, it was her for-profit medi-gap insurance that failed her with its “previous condition” gimmicks. It was her private health care provider that took her money and then cut her off.
    The MMA changed how Medicare paid for doctor-administered drugs to a system based on doctors’ costs for the drugs from one based on average wholesale price. The government wasn’t reducing payment for cancer care, it was simply reducing overpayment for cancer drugs. The government can’t afford to overpay for these drugs in an era which they are fantastically expensive.
    Medical oncologists are now reimbursed for providing evaluation and management services, making referrals for diagnostic testing, radiation therapy, surgery and other procedures as necessary, and offer any other support needed to reduce patient morbidity and extend patient survival.

  7. Lior Kahane MD Speaks the Truth of Why He Lost His Medical License
    In life there are always two sides to a story.
    The feature headline, “Doc Who Lost License Becomes Love Guru” written by Carla McClain about me in The Arizona Daily Star on Jan 28, 2007 is simply untrue.
    It shocked me to read this article using words like “gross negligence” and “egregious” in an attempt to defame my character.
    In the process of getting a move on my life over the past couple years I made the best of the situation by letting things just be.
    At this point, I realize it’s time I speak my truth.
    Rather than go into the detail about the real reason “why” Carla wrote this story and her agenda of trying to destroy my career through the manipulation of the press – it’s not worth my time.
    Instead it’s important to focus on the reality of what happened in my legal case by sharing the facts of my story. The false judgments need to be corrected so others are justly informed.
    As a Trauma Surgeon I dealt with life and death on a daily basis. Throughout my career, I have operated on thousands of patients, including celebrities, politicians, physicians and their families and regular people just like you.
    The accusation that I was involved in deaths or wrongdoings of patients is false and misleading.
    The patients alluded to were very complex sick patients that did not die under my knife, nor was their demise attributed to my surgery.
    If anyone at the Arizona Daily Star paper would have taken the time to review public court documents they would have seen that world renowned experts have denounced my involvement in these so called “botched” and “unnecessary cases.”
    During my practice I was one of the busiest and most well respected surgeons in Nogales and Tucson. Over the years I also developed a reputation as a surgeon who was known to give freely of my compassion and empathy to patients of many different cultures.
    The Federal Government of Tucson sector honored me with commendations, and even an honorable citation for saving a Border Patrols agent life after a gun shot wound to the abdomen. The story was highlighted in the Arizona Daily Star on August 11, 1995.
    It’s been my honor to speak to audiences throughout the world and receive standing ovations based on the knowledge, wisdom and experience in the medical field.
    The bottom line is: I lost my medical license due to peers attacking me and not due to patient care.
    One peer in particular was Dr. Edward Schwager, a family Physician who knew me in Tucson, sat on the Board and persuaded them to revoke my license base solely on this ridiculous chart review.
    He too, is no longer on the Board and was not reappointed by the governor. Incidentally the attorney for the state medical board “Stephen Wolf” whom tried to make a name for himself by sensationalizing his comments against me has been removed and demoted since my case.
    My license was revoked in 2003 despite an administrative judge’s recommendation not to revoke it. The revocation was based solely upon one Board’s medical expert opinion Dr. William Kennell whom turns out never re-certified his Board Status and later admitted in not keeping up with his Continuing Medical Education as required by both Federal and Arizona state statutes.
    When complaints about this were posed against Dr. Kennell, the Board ignored these statutes.
    It is interesting soon after my case was finalized Dr. Kennel no longer qualified as an expert with the Medical Board. It is equally important to note all my experts completely disagreed with Dr. Kennell and there was no patient harm or complaints from any patients.
    Experts who testified on my behalf stated these few cases out of thousands of my cases met the standard of care.
    These experts are all well recognized Surgeons which included Dr. James Malone Professor of General and Vascular Surgery at the University of Arizona Medical School, as well as Tyler Kent MD, Alfredo Guevara MD and John Taylor MD, who is an internationally highly respected Surgeon and program director at The Baylor College of Medicine in Houston.
    Unless you’ve been involved in a media scandal it’s hard to understand how easily the press can manipulate the truth of what really has occurred at one point in time and the power over the people the media has – regardless whether what the press says is true or not.
    The business of the media is often to put a “spin” on a story, sensationalize an event and mislead the public in order to catch your attention, sell more papers and make more money.
    – Lior Kahane MD
    March 13, 2008
    Lior Kahane MD is a trauma surgeon and graduate of the prestigious Baylor College of Medicine and studied under the auspice of Michael E. DeBakey MD.

    • Hey Dr. kahane, this is jami parks, rebecca newcombs daughter. you met me when i was really litttle. My mom has been talking and talking about you, and wants really badly to contact you somehow. So if you could just give us a call or something that would be great. Email her at dangerfieldrebecca@yahoo.com or call at 804-255-8171. (:

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