Rick,

An additional issue then is to find out how many of these types of PFO tests
the Doc has done and read or how many his referral group has done.  This is
to ensure competency in performing the procedure as well as reading the
results correct?

-----Original Message-----
From: Gatto, Richard RG SCC [mailto:RG982309@MS*.SH*.CO*]
Sent: Thursday, April 20, 2000 7:52 AM
To: 'Kevin Connell'; Sean M.Cary; quest@gu*.co*; techdiver@aquanaut.com
Subject: RE: Pictures of PFO's


	Incorrect info... My wife does this (Echocardiograms, Doppler,
Stress tests, etc) for a living at one of the largest heart
centers/hospitals in Houston. The correct info would be that a good
cardiologist could do it. My wife helps teach cardiac fellows the technique
and procedures, many will never be worth a shit at scanning. The idea is to
make them familiar with the technique. They are mainly taught to read the
echo not perform it. While some excel and practice enough to stay
proficient, most farm out the work to the people who do it every day.
	Why were you given a TEE instead? This is normally a secondary move
after failing to get good images through the chest. That is common with
mainly two groups of people, the very thin and the very fat. You can also
throw some of the short stocky guys in with that group.
	And to answer your next question, Yes, I do get my tests when ever I
want them. 

Thanks,
             Rick

rggatto@sh*.co*           

	"The game consists of figuring out what the game is..." 

> -----Original Message-----
> From:	Kevin Connell [SMTP:kevin@nw*.co*]
> Sent:	Wednesday, April 19, 2000 11:13 PM
> To:	Sean M.Cary; Quest Tech List
> Subject:	Re: Pictures of PFO's
> 
> As you've probably heard me complain before, When i got mine done, I got 
> suckered into getting a trans-esophageal echo cardiogram w/ bubble 
> contrast, which is done by a cardiologist, while you are an outpatient on 
> demerol, and costs about $1100.00.  My insurance at that time did not
> cover 
> it, but I had really cheap blue cross at the time....  I think decent HMO 
> covereage would cover it.
> 
> I have since found out that any knowledgeable md can do it with an 
> ultrasound like machine for only a couple hundred.  In the HMO situation, 
> it is *key* to have a good working relationship with your MD so that
> he/she 
> will be more than happy to refer you to a diving specialist .  Since I 
> never see the doctor, I just made the local diving doc my PCP, so that 
> works out good despite the fact he is more than an hour away. It all comes
> 
> down to the referral.
> 
> Besided, didn't you read business week about a month ago?  Managed Care is
> 
> dead.
> 
> 

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