Comments for Endodoc http://endodoc.org Potpourri of Pediatric Endocrinology Fri, 18 May 2012 01:52:26 +0000 hourly 1 http://wordpress.org/?v=3.3.2 Comment on Ordering Laboratory tests and Procedures: The Art, Science, Economics, and Politics Of The Process by endodoc http://endodoc.org/2012/04/23/ordering-laboratory-tests-and-procedures-the-art-science-economics-and-politics-of-the-process/comment-page-1/#comment-155951 endodoc Fri, 18 May 2012 01:52:26 +0000 http://endodoc.org/?p=598#comment-155951 I agree I agree

]]> Comment on Ordering Laboratory tests and Procedures: The Art, Science, Economics, and Politics Of The Process by Jeff Belden MD http://endodoc.org/2012/04/23/ordering-laboratory-tests-and-procedures-the-art-science-economics-and-politics-of-the-process/comment-page-1/#comment-155469 Jeff Belden MD Tue, 24 Apr 2012 23:29:33 +0000 http://endodoc.org/?p=598#comment-155469 I agree with your take that a lot of physicians order tests out of ignorance about the costs. Cost transparency is complicated by the crazy pricing and discounting in our current healthcare finance system. I advocate putting a few prices in front of physicians along with some clinical decision support guidance. For us family physicians, thyroid tests, CBC, BMP, and CMP would be a great place to start. I see a lot of over-ordering of thyroid tests beyond a simple TSH, which suffices most often. EHRs would be the ideal tool for that, but they are lagging in getting that kind of CDS (clinical decision support) into our hands. I agree with your take that a lot of physicians order tests out of ignorance about the costs. Cost transparency is complicated by the crazy pricing and discounting in our current healthcare finance system.

I advocate putting a few prices in front of physicians along with some clinical decision support guidance. For us family physicians, thyroid tests, CBC, BMP, and CMP would be a great place to start.

I see a lot of over-ordering of thyroid tests beyond a simple TSH, which suffices most often.

EHRs would be the ideal tool for that, but they are lagging in getting that kind of CDS (clinical decision support) into our hands.

]]> Comment on Treating Children With Growth Hormone: Moral, Ethical, And Other Considerations by endodoc http://endodoc.org/2010/05/14/treating-children-with-growth-hormone-moral-ethical-and-other-considerations/comment-page-1/#comment-154734 endodoc Wed, 21 Mar 2012 12:29:14 +0000 http://endodoc.org/?p=353#comment-154734 Thanks for your comment. What do you mean by "the bottom line?". If you mean, what do I think this all means, I think we need to use growth hormone (and all other medications and treatments) with great care and THINK about the risks and potential benefits and share those thoughts with our patients. Thanks for your comment. What do you mean by “the bottom line?”. If you mean, what do I think this all means, I think we need to use growth hormone (and all other medications and treatments) with great care and THINK about the risks and potential benefits and share those thoughts with our patients.

]]> Comment on Treating Children With Growth Hormone: Moral, Ethical, And Other Considerations by Harriet Policz http://endodoc.org/2010/05/14/treating-children-with-growth-hormone-moral-ethical-and-other-considerations/comment-page-1/#comment-154198 Harriet Policz Thu, 15 Mar 2012 09:57:09 +0000 http://endodoc.org/?p=353#comment-154198 Thank you, I have recently been looking for information approximately this topic for a long time and yours is the greatest I have discovered so far. But, what concerning the bottom line? Are you sure in regards to the supply? Best Escorts 4U, 5, 26 Store Street, London, WC1E 7BT, 020 3011 3203, 020 3011 6092 Thank you, I have recently been looking for information approximately this topic for a long time and yours is the greatest I have discovered so far. But, what concerning the bottom line? Are you sure in regards to the supply? Best Escorts 4U, 5, 26 Store Street, London, WC1E 7BT, 020 3011 3203, 020 3011 6092

]]> Comment on How Do You Tell If It’s Type 1 Or Type 2 Diabetes? by endodoc http://endodoc.org/2008/04/11/how-do-you-tell-if-its-type-1-or-type-2-diabetes/comment-page-1/#comment-143560 endodoc Sun, 30 Oct 2011 10:48:19 +0000 http://endodoc.org/2008/04/11/how-do-you-tell-if-its-type-1-or-type-2-diabetes/#comment-143560 I have no idea what type 2.5 is. MODY (maturity-onset diabetes of youth) is a group of disorders characterized as type 2 diabetes-like conditions inherited in autosomal dominant fashion. The disorder is frequently diagnosed in childhood or adolescence. There are several genetic variants. There was a recent excellent review on the subject (Fajans SS, Bell GI: MODY. Diabetes Care 2011;34:1878-84). Type 1.5 is not really a specific disorder but a clinical diagnosis to describe patients in whom one cannot be certain if they have type 1 or type 2 diabetes. So-called LATA or latent autoimmune diabetes in adults is really just type 1 diabetes with clinical onset in adulthood. The best way to tell if a person has autoimmune type 1 diabetes is to measure various autoimmune markers such as GAD antibodies, islet-cell antibodies, etc. It's worth knowing if a patient has autoimmune type 1 or not since monitoring for autoimmune diseases is important (e.g., celiac disease, chronic lymphocytic thyroiditis, pernicious anemia). Sometimes it is not possible to classify a patient's type of diabetes but remember- treatment goals are the same for all types of diabetes. I have no idea what type 2.5 is. MODY (maturity-onset diabetes of youth) is a group of disorders characterized as type 2 diabetes-like conditions inherited in autosomal dominant fashion. The disorder is frequently diagnosed in childhood or adolescence. There are several genetic variants. There was a recent excellent review on the subject (Fajans SS, Bell GI: MODY. Diabetes Care 2011;34:1878-84). Type 1.5 is not really a specific disorder but a clinical diagnosis to describe patients in whom one cannot be certain if they have type 1 or type 2 diabetes. So-called LATA or latent autoimmune diabetes in adults is really just type 1 diabetes with clinical onset in adulthood. The best way to tell if a person has autoimmune type 1 diabetes is to measure various autoimmune markers such as GAD antibodies, islet-cell antibodies, etc. It’s worth knowing if a patient has autoimmune type 1 or not since monitoring for autoimmune diseases is important (e.g., celiac disease, chronic lymphocytic thyroiditis, pernicious anemia). Sometimes it is not possible to classify a patient’s type of diabetes but remember- treatment goals are the same for all types of diabetes.

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