SMRs and AMRs

Thursday, January 07, 2010

Treat Me, but No Tricks Please

By GINA KOLATA
NYT

I RECEIVED an e-mail message recently from an angry doctor. He’d torn his hamstring running on a beach and spent eight weeks — a total of 20 hours — in physical therapy. Then his insurer said the physical therapy was not covered.

He couldn’t understand it. The therapy cost $150 a session, and he said it was “clearly beneficial and cost-effective.” (He added, though, that after eight weeks he was not yet running again.)

Hmm. I also tore my hamstring running, but my doctor never mentioned physical therapy. Instead he referred me for platelet-rich plasma, an experimental treatment that involves having my own blood platelets injected into the torn tendon. The cost, including the radiologist’s fee, an ultrasound and the plasma injection, was $2,200.

My insurer would not pay, which made sense to me because the plasma treatment is considered experimental. It might work; then again, it might not.

(More here.)

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