When I can't even order what are considered "reasonably priced" procedures and tests for my patients, without being told by their insurance companies, that the tests and procedures aren't medically necessary, what makes anyone think ordering seemingly superfluous tests would be acceptable?
Please elaborate on the tests. Be specific. I once had an insurance company tell my provider to have an ESR blood test. We both laughed hysterically. Uuuuuuhhhhhhmmmmm why though? The patient has a confirmed diagnosis of fibromyalgia psoriatic arthritis ankylosing spondylitis osteoarthritis. WTH?
I ordered MRI for a patient who'd had an ischemic stroke. Her insurance denied it was necessary. I was livid. I've faced this and similar situations on a regular basis. Insurance companies are a modern day equivalent to robber barons.
I hate hearing this, but knowing that they will NOT approve the basic tests needed to confirm types of damage from a stroke.... that's really the kind of thing y'all need to go public on. Set up a GoFundMe, I think PATIENTS would support you. ANd please keep telling these true stories!
CRP and ESR show how things are going. CRP is more sensitive and better for my case.
When you already know that a person has a diagnosis of fibromyalgia psoriatic arthritis ankylosing spondylitis osteoarthritis, an ESR, is a huge waste of time and money. Since I don't have any type of Rheumatoid arthritis a CRP, is also a waste.
You don’t need to have Rheumatoid. When my PA flares my CRP skyrockets. I have had it for 45 years!
A rheumatoid factor test is used as a diagnostic tool. It's more accurate. Symptoms tell you and your provider when you're in a flare up. No need for a blood test.
If you are treated by a good rheumy at a major med school affiliated hospital you will find that if you have a high rheumatoid arthritis. CRP is a sensitive
After factor it means you have rheumatoid arthritis I bet.
Who told you that you can only have a CRP with RA- wrong. Also, with me, in the early years, these inflammatory markers were not reflective at all. I call this my“fibromyalgia phase”. When I finally wised up I made a 60 minute trip once a month to see a great Rheumy, I got the proper diagnosis.
Nobody had to tell me. I did the research for myself.
medlineplus.gov/lab-tests/rh...
The Rheumatoid Factor blood test is more accurate than a CRP. www.mayoclinic.org/diseases-con...
Have you read the Mayo info? It is very clear about blood tests.
My rheumatoid factor has never been positive. For me ESR and CRP are extremely accurate in tracking the #psoriatic arthritis.
Ps for me anyway, the fibromyalgia I was told I had by local docs turned out to be part of the psoriatic arthritis.
I have Psoriatis too and my Columbia Pres Rheumy does use ESR and CRP every month. It has been a great gauge of disease activity which in combination with my pain level told us which DMARD is working.
But Jenna, it is DOCS who must fight this system on the rational basis that *doctors* know it gives crap care
I fully agree. We need to continue to raise awareness and advocate for our patients. They need to know, nurses aren't their only advocates.
I appreciate your response :). As you know, nurses are disparaged in the medical world, patients are assumed to be complaining druggies (or just hysterical women STILL) - only doctors are in a position to say what is true: Americans get crap care from our medical system. Can't docs all withdraw?
My mom was a nurse (retired now). She told me there were very few doctors that treated the nurses with respect. It doesn't cost us anything to treat coworkers and patients with respect. More of us need to work to change the system. We just have to keep at it.
Tests may mean finding things they don't want to pay for.
Absolutely!