10 ms·

> He said the use of the larger test was appropriate because it could catch a wider range of diseases, particularly for those who were symptomatic. [0] Cant’t

> He said the use of the larger test was appropriate because it could catch a wider range of diseases, particularly for those who were symptomatic. [0] Cant’t believe this isn’t an ethics violation, it is like going into the car dealership to change my oil and them charging me to take apart the engine because “It could catch a wider range of issues”. I know what service I want and would consent to, this “Technically correct but costs 50x as much” is harmful. [0] This is the doctor’s response when asked why he is testing for ~20 other respiratory diseases in the drive-through coronavirus line.

peeters 6y ago
Yeah that's straight up malpractice. If there's a 99% chance it's Covid and not something else, you do the Covid test first and if that comes back negative, then you test for the "something else" (if symptoms are severe enough).
- arcticfox 6y ago
  It's even worse than that, he was testing asymptomatic patients with a full panel. That part takes it from probably unethical to full-blown fraud for me. > But in interviews, asymptomatic patients said they had also received the more expensive test.
  - vharuck 6y ago
    For asymptomatic patients, doing those tests could easily cause net harm from follow-up to false positives. So, even if the tests had been free, it's probably unethical. This is why organizations like the United States Preventative Services Task Force exist. They review studies and recommend best practices for medical screening. They do recommend against asymptomatic screening for a lot of tests.
throwaway0a5e 6y ago
>it is like going into the car dealership to change my oil and them charging me to take apart the engine because “It could catch a wider range of issues”. This kind of stuff is pretty par for the course. They try and up-sell. If you agree then you're on the hook for the bill. That's just how the industry works. But businesses that make a habit of being sleazy don't survive long because the bill must be agreed upon beforehand and customer is free to go elsewhere with little friction and there isn't all sorts of gatekeeping and regulatory capture constraining supply.
- sjg007 6y ago
  There's a reason it's endemic and that's because people fall for it. Every few months there's an investigation by the government and some oil changer business gets fined for it. Dealers do it too but if your car is under warranty these days it tends to be less of an issue. Cars are more reliable now too. Out of warranty though, hold onto your hat!
  - h_anna_h 6y ago
    > Cars are more reliable now too This is hard to believe. If anything they are more disposable.
    - omgwtfbyobbq 6y ago
      Average age has been ticking up for a while, at least in the US. https://www.bts.gov/content/average-age-automobiles-and-trucks-operation-united-states https://www.bts.gov/content/average-age-automobiles-and-truc... I feel like the disposability angle comes from having relatively expensive parts/repair costs with low value older vehicles, which results in them being retired because of the economics of having someone else repair them.
      - pnutjam 6y ago
        That and the ever present complaint that they can't take a hit like they used too. Never mind that makes them way safer and saves tons of lives. Some people want to crash up derby their car every weekend.
        mrguyorama 6y ago
        It's also not even remotely true. Check out the IIHS crashing a 60s bel air into a modern malibu. "They don't make them like they used to" has always been a nostalgic crock of shit, like the people who think the NES was the golden age of video games, despite the vast majority of the 700 or so releases being utter trash for $60 that sometimes didn't even work! https://www.youtube.com/watch?v=C_r5UJrxcck https://www.youtube.com/watch?v=C_r5UJrxcck
sjg007 6y ago
It is probably an ethics violation. I am sure he probably covered himself in the fine print but as you can see the customers are confused so that means they didn't expect the full respiratory panel testing. Insurance companies may have rules on it too so he could be in violation of contracts. I would expect negative flu test, negative covid test, then that justifies the remaining panel if symptoms worsen or what not. This is though the same thing car dealers do. They always want to up sell services.
danpalmer 6y ago
This also betrays a lack of understanding of testing by the doctor. If each test has a 1% chance of returning a false positive (and false positives are possible in most tests), there's a significant chance that one of the 20 will return a false positive, which will then prompt unnecessary treatments, further tests, etc. The general medical guidance is to only test when there's a legitimate suspicion that a patient has the illness. In this case, these patients wouldn't have been tested for a wide range of respiratory issues anyway, and given the pandemic it's much more likely that they've got coronavirus, so they really shouldn't be tested for the other things, especially if asymptomatic.
- deleted 6y ago
  [deleted]
nitrogen 6y ago
Was this a modern machine-based test where testing for one disease is just as easy as testing for 20 at a time? There's been a lot of false information and insurance screwups in the news about such tests. A single lab test that the machine vendor charges $200 for, and thus costs the hospital probably $50 or less if they own the machine, gets coded by insurance as 20 separate tests. We 100% should be using these kinds of tests way more often. If this was such a rapid multi-test, the villain here is the billing department and insurance.
renewiltord 6y ago
Sure, on a forum like this you can talk like that. Go anywhere else and you'll be instantly shut down with "Oh, so you're supposed to know better than a guy who went to school for 15 years?!" It's a beautiful rhetorical technique. Very effective.

peeters 6y ago

Yeah that's straight up malpractice. If there's a 99% chance it's Covid and not something else, you do the Covid test first and if that comes back negative, then you test for the "something else" (if symptoms are severe enough).

arcticfox 6y ago
It's even worse than that, he was testing asymptomatic patients with a full panel. That part takes it from probably unethical to full-blown fraud for me. > But in interviews, asymptomatic patients said they had also received the more expensive test.
- vharuck 6y ago
  For asymptomatic patients, doing those tests could easily cause net harm from follow-up to false positives. So, even if the tests had been free, it's probably unethical. This is why organizations like the United States Preventative Services Task Force exist. They review studies and recommend best practices for medical screening. They do recommend against asymptomatic screening for a lot of tests.

throwaway0a5e 6y ago

>it is like going into the car dealership to change my oil and them charging me to take apart the engine because “It could catch a wider range of issues”. This kind of stuff is pretty par for the course. They try and up-sell. If you agree then you're on the hook for the bill. That's just how the industry works. But businesses that make a habit of being sleazy don't survive long because the bill must be agreed upon beforehand and customer is free to go elsewhere with little friction and there isn't all sorts of gatekeeping and regulatory capture constraining supply.

sjg007 6y ago
There's a reason it's endemic and that's because people fall for it. Every few months there's an investigation by the government and some oil changer business gets fined for it. Dealers do it too but if your car is under warranty these days it tends to be less of an issue. Cars are more reliable now too. Out of warranty though, hold onto your hat!
- h_anna_h 6y ago
  > Cars are more reliable now too This is hard to believe. If anything they are more disposable.
  - omgwtfbyobbq 6y ago
    Average age has been ticking up for a while, at least in the US. https://www.bts.gov/content/average-age-automobiles-and-trucks-operation-united-states https://www.bts.gov/content/average-age-automobiles-and-truc... I feel like the disposability angle comes from having relatively expensive parts/repair costs with low value older vehicles, which results in them being retired because of the economics of having someone else repair them.
    - pnutjam 6y ago
      That and the ever present complaint that they can't take a hit like they used too. Never mind that makes them way safer and saves tons of lives. Some people want to crash up derby their car every weekend.
      - mrguyorama 6y ago
        It's also not even remotely true. Check out the IIHS crashing a 60s bel air into a modern malibu. "They don't make them like they used to" has always been a nostalgic crock of shit, like the people who think the NES was the golden age of video games, despite the vast majority of the 700 or so releases being utter trash for $60 that sometimes didn't even work! https://www.youtube.com/watch?v=C_r5UJrxcck https://www.youtube.com/watch?v=C_r5UJrxcck

sjg007 6y ago

It is probably an ethics violation. I am sure he probably covered himself in the fine print but as you can see the customers are confused so that means they didn't expect the full respiratory panel testing. Insurance companies may have rules on it too so he could be in violation of contracts. I would expect negative flu test, negative covid test, then that justifies the remaining panel if symptoms worsen or what not. This is though the same thing car dealers do. They always want to up sell services.

danpalmer 6y ago

This also betrays a lack of understanding of testing by the doctor. If each test has a 1% chance of returning a false positive (and false positives are possible in most tests), there's a significant chance that one of the 20 will return a false positive, which will then prompt unnecessary treatments, further tests, etc. The general medical guidance is to only test when there's a legitimate suspicion that a patient has the illness. In this case, these patients wouldn't have been tested for a wide range of respiratory issues anyway, and given the pandemic it's much more likely that they've got coronavirus, so they really shouldn't be tested for the other things, especially if asymptomatic.

deleted 6y ago
[deleted]

nitrogen 6y ago

Was this a modern machine-based test where testing for one disease is just as easy as testing for 20 at a time? There's been a lot of false information and insurance screwups in the news about such tests. A single lab test that the machine vendor charges $200 for, and thus costs the hospital probably $50 or less if they own the machine, gets coded by insurance as 20 separate tests. We 100% should be using these kinds of tests way more often. If this was such a rapid multi-test, the villain here is the billing department and insurance.

renewiltord 6y ago

Sure, on a forum like this you can talk like that. Go anywhere else and you'll be instantly shut down with "Oh, so you're supposed to know better than a guy who went to school for 15 years?!" It's a beautiful rhetorical technique. Very effective.