those visits amounted to about $1200.00 per hour going through his office and insurance.

huh? he might bill that if it ever happened but no insco would pay it.

Thank you Dr. John for your honest and brave response.

I've been checking everyday for a followup on this story (originally covered by the NY Times last week. )The lack of response from the medical and research community was deafening. According to Columbia it seems it was okay to put vulnerable patients at risk, ignnore FDA regulations, falsify data -- because they said no patients suffered any harm in the end. And are we to believe them?

Today the journal Nature ran a news story on this and not surprisingly the basic problem is a lack of enforceable regulations on scanning practices. The regs seem to be less strict when radioactive substances are used... Huh? And then the Columbia lab ignored even these minimal regs.

Article in Nature online: "Brain-imaging programme suspended after violations --
FDA investigation at Columbia University serves as warning to other centres, say experts"

Excerpt:
"Most experimental drugs in the United States are regulated through an Investigational New Drug (IND) application to the FDA. But radioactive drugs used in research pilot studies do not require an IND, and can rely instead on approval from the research institution's Radioactive Drug Research Committee (RDRC). Researchers are typically expected to file for IND status after 30 trial injections have allowed them to refine their procedure. Even when IND status has been granted, however, the FDA only audits research laboratories in response to complaints, and such complaints are exceedingly rare."

The full article, with new information on how the lab operated is online at:
http://www.nature.com/news/2010/1007...tml?s=news_rss

The major casualty from this incidents like this is patient trust. It also reinforces the need for stronger protections for all human trial participants

Soccertease,

Each time we saw him, we got billed X and our insurance company reduced it to Y, which we paid. His billing was typically $357.00 for anywhere from 10-15 minutes...if you multiply that by four (15 minutes x 4 = 60 minutes) you can see that an hour of his time, under our insurance plan, would be a little over $1200.00.....of course you would never get that much time, nor would any insurer probably pay it. I mentioned it because, to compare what we get under his private pay regime, an entire hour, for $300.00, well, you can see the difference.

I dont' know what you do about Rx. He's still a doc, and can prescribe anything any other doc can prescribe whether his patient has insurance or not...it's how one would pay for it that would matter, which doesn't really concern him. He never inquired how we would pay for our scripts before, anyway, and in fact, I think it was the hassles over having to continually re-justify scripts to the insurance companies that drove him over the edge. His nurse told us she was spending over four hours a DAY trying to get prescriptions patients had been taking for years re-approved by their insurers. If she couldnt' get it resolved, he had to step in, defending a prescription he'd already written....all the while a patient waiting in the wings, hoping to heaven they can get their drugs so they can function. Things like sinemet, mirapex, things no one abuses and would never take if they didn't absolutely have to. No wonder he threw in the towel.

As far as the electronic medical records, what I understand is that docs who don't have them get reduced medicare/medicaid reimbursements as a penalty. They can still practice, and of course, they can still decide to opt entirely out of medicare/medicaid and have only private pay patients....which we are seeing more and more of in our state. So the reduced medicare/medicaid reimbursement penalty would have no real impact in those situations.

And I hope this is wrong, but it's quoted, so probably and unfortunately true: the electronic medical record only has to contain what the doctor and patient agree on. Okey-dokey. I guess if we dont' want the dx of PD in our medical record, we can just inform our doc not to write that down anywhere in our file, right? How does that work, exactly? I'll try to find the article that talked about this because I know it's hard to believe!