Christopher J. Combs, Ph.D.

Friday, April 23rd

I Need This Like Another Hole in the Head

Remember when I told you about how they used to do studies of cardiac bypass graft surgery by performing sham surguries on those assigned to the control group? Well, here's a summary of an article looking at the effects of fetal tissue implants on Parkinson symptoms. It appears that much, if not all, of the improvement can be attributed to the placebo effect. But mainly, I thought you would like to hear about patients in the control condition:

"NEW YORK (Reuters Health) Apr 22 - In a double-blind, placebo-controlled trial of fetal tissue transplantation for the treatment of Parkinson's disease (PD), clinicians and patients both reported greater improvement when they believed the patients were in the active treatment arm of the study.

"The results of the first double-blind study of embryonic dopamine-neuron transplantation for PD suggested some improvement with active treatment. Both groups received four burr holes in the forehead. In the sham treatment group, however, needles did not penetrate the brain."

Its seems that almost all of the patients, having received the burr holes and needles, were convinced they were in the treatment condition. Also makes you wonder about the effectiveness of the informed consent.

P.S. To read the article, registration at Medscape may be required.

Christopher J. Combs, Ph.D. on 04.23.04 @ 06:42 AM EST [link] [No Comments]

Monday, April 5th

VIP Clients

Two items from the past week that discuss the benefits of disengaging from insurance and managed care for patients. Yesterday, the Associated Press published a story, Some Doctors Choosing Cash Over Insurance, describing a small number of doctors who have opted out of traditional insurance plans, letting them spend more time with patients and do medicine the way they always envisioned it. By dispensing with insurance, they argue, they are able to make roughly the same amount per office visit, because they save on the time it takes to fill out all the paperwork and the clerical time to file it and pursue reimbursement. The most interesting claim was that users of these cash-only doctors weren't restricted to the upper class; most clientele were from the middle class.

Lynn Grodzki, LCSW, the author of Building Your Ideal Private Practice, publishes a monthly newsletter on private practice issues. This month's lesson deals with Very Important Clients. She suggests converting some of your clients to full fee (i.e., no insurance), and by doing so, offering added benefits: no waiting for appointments, full attention from the therapist during sessions, and a therapist who is able to keep up with the last techniques because of extra time to engage in continuing education.

Here's how she presents it:

"Once you decide to have a VIC full-fee practice, you can educate
others, both new and existing clients about your service.

"When a new client calls asking, 'What do you charge? Will you take my
insurance? Do you offer a sliding scale?' let this person know that
you only accept clients who can pay your full fee.

"Then add a piece of education, by saying, 'My fee reflects the
special services that I provide. I keep my caseload small to give
extra attention and care to everyone I see. I also maintain a
dedicated level of expertise through continual training, so that my
clients get the advantage of the most recent research and techniques.
I offer a calm, healing environment, another benefit for my clients.'"

It's an appealing idea, for sure, but it begs the question (at least in my mind): Shouldn't all of our clients be VIP clients?

Christopher J. Combs, Ph.D. on 04.05.04 @ 06:26 AM EST [link] [No Comments]

Temple University Psychology Internship Program

La Salle Psy 792 Weblogs
Tara Andreoli
Mary Brownsberger
Denise Frost
Catherine Hillman
Joshua Houseman
Michele Koschin
Gabe Levin
Jennifer Musico
Casey O'Donnell
Jeff Palmer
Denise Paulson
Moran Shenkar
Jaime Spinell
Amy Wells
Katy Werner

Greymatter Forums

April 2004

Valid XHTML 1.0!

Powered By Greymatter