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ESWT worked for me

Posted by Henry on 11/29/04 at 19:06 (164894)

Four years of pain gone after 12 weeks thanks to ESWT. It was $750 for 3 treatments at about 20 minutes a piece. The doc used the Sonocur so I needed no painful shots.

Great site. So, so board. This board needs a moderator. Its hard for patients to get a word in edgewise with all the acrimony, arguments, obvious shills. Thanks to Dr. Z, Dr. Ed, Sunny, Dr. Rompe for keeping good information here. Vince, take you bitterness elsewhere. Lets here more from the patients. Get the shills out of here as they are confusing us.
Henry

Re: ESWT worked for me

Tina H on 11/29/04 at 20:36 (164916)

Thanks Henry for taking the time to post. Glad it went so well for you! Did you have this done in the US or Canada? Thanks, Tina H

Re: ESWT worked for me, calling all lurkers

Henry on 11/29/04 at 22:16 (164924)

Thank you Tina. I had it done in the US. It would of been a bit cheaper in Canada but the drive and hotel would have wiped out any savings.

Also, I felt that my doctor seemed very knowledgeable about the treatment and emphasized that the ESWT was part of my treatment plan, not the whole treatment. I think that is where I see some go wrong in that people take the treatments step by step but not combining the treatments in an effective way.

Any more lurkers out there, please come forward and lets here your story. it is time for the patients to take this board back.
Henry

Re: ESWT worked for me

Scott R on 11/30/04 at 02:03 (164931)

'Henry', those web sites that try to hide your identity do not work as well as you think and using them diminishes your credibility.

Re: ESWT worked for me

vince on 11/30/04 at 05:04 (164933)

Come clean 'Henry' or is it John?

Re: ESWT worked for me

Julie on 11/30/04 at 06:45 (164939)

Henry, who did your ESWT, and where? That's a very good price, so I'm sure others here would be glad to have that information.

Good to see your post -a pleasant change from acrimony.
.

Re: ESWT worked for me

Ed Davis, DPM on 11/30/04 at 11:51 (164957)

Julie:

I appreciated the post. For some reason, Scott did not. Anonymity bothers Scott sometimes but other times it is okay.

We had a poster lower on the page post a low of $680, I believe for one high energy which is very low. From the Sonorex/Sonocur perspective, I would place $750 in the low average for such treatments. If one goes to http://www.Sonorex.com , one can look at the various providers in the US and survey fees you will find that $750 is a good price but not out of the range for typical low energy application (3 sessions). I believe Sunny Jacob is at $1050 Canadian which, with the exchange rate is a bit less than $750 (I have not checked the exchange rate in a while). Sonorex in Vancouver was $750 Canadian, 3 years ago, so with the exchange rate (again I may be off) about $550 for the 3 low energy apps. They may have rasied their rates a bit since.
Ed

Re: ESWT worked for me. ps.

Ed Davis, DPM on 11/30/04 at 12:02 (164962)

Julie:
I should mention that Sunny includes, I beleive, a low energy laser type treatment in the price -- he may be available for more details.
Ed

Re: ESWT worked for me

Scott R on 11/30/04 at 13:20 (164964)

Ed, I am ok with anonymity when someone keeps the same identity and obeys the be nice rule. It's not OK when someone uses multiple identities to manipulate the message board for their own purposes. When they have a financial interest, the 3 elements of fraud are satisfied.

Re: ESWT worked for me

john on 11/30/04 at 15:19 (164971)

Scott,

Just curious, what are the names that have been used as multiple identities?

Re: ESWT worked for me

Julie on 11/30/04 at 16:18 (164977)

Right on, Scott.
.

Re: ESWT worked for me

Ed Davis, DPM on 11/30/04 at 16:19 (164979)

ScottR:
You cannot make such determinations consistently. Anyone can go to a local library, an airport, an internet cafe and get online anonymously. For example, today, I am posting from my local hospital's system between cases. Considering that, you need to have ground rules for ALL to follow consistently. First and foremost, most patients here want to know who is giving them advice. We have posters here who obviously are shills for organizations and it is not difficult to figure out who they are. They are confusing patients and are disruptive to the board. I have no problem with corporate reps coming here but they must admit to who or what they represent even if they want to remain anonymous by name. Post and keep a consistent set of rules that everyone can follow and live with, keeping the board open to patients.
Ed

Re: ESWT worked for me

Scott R on 11/30/04 at 16:58 (164981)

I try to apply the be nice rule very consistently. I didn't see any posts from John that seemed out of order except some of his lasts posts that seemed to be getting more directed at individual companies or people, so i said he needed to disclose his identity if his comments might encourage legal action. I didn't see any posts from him that made me think he was trying to mislead people. He seemed consistent and honest. He never switched identities. It seemed obvious he is in the ESWT business and he never denied that he might be a biased opinion. So his identity was disclosed as far as it needed to be: we all know he's a biased opinion. What more do we need to know about him? His physical address so we can stalk him? The company he works for so his boss can make him to stop posting?

Re: ESWT worked for me

scott r on 11/30/04 at 17:07 (164983)

John, for several reasons i don't/can't discuss message board security.

Re: ESWT worked for me

john on 11/30/04 at 17:17 (164984)

Understood. I just wanted to make sure that you knew that I was not the person posting under multiple names.

Re: ESWT worked for me

Ed Davis, DPM on 11/30/04 at 18:10 (164985)

ScottR:

You, I and several other know enough to understand John's bias. That is not true for readers. Yes, readers should know if he is representing a company or organization -- he can do so and remain anonymous. He can even remain anonymous to his employer if he is not on a monitored network. His employer may be encouraging him to post if he represents the interest of a specific company. Should readers do not know if that is the case. They should -- it is plain old honesty.

I don't thing John has ever switched identities but there is no way you nor I can tell as there are too many ways to reamin anonymous considering the various means of public access to the net of which I have just listed some.

John is usually courteous but routinely omits information. I don't want to get into a long string here, dissecting every post. Nevertheless, if readers know which organization he is with, his bias will be understood. It is okay to have a bias as long as it is disclosed. One can even maintain such a bias, anonymously.
Ed

Re: ESWT worked for me

Ed Davis, DPM on 11/30/04 at 18:22 (164989)

ScottR:
Take a look at this post:

Posted by john on 11/30/04 at 15:20 View Thread
Robert,

Has United Healthcare agreed to pay the physician's fee yet?
Posted in Category: ESWT . . View All Heel Pain Categories

Yes, it is couteous. But it implies that United is to do something illegal, that is, fee splitting. Readers may not see this subtlety but it is something that you, I and the 'regulars' understand VERY well.
Ed

Re: ESWT worked for me

john on 11/30/04 at 18:45 (164994)

Dr Davis,

In your effort to attack everything I post you have made a fundamental mistake. You have confused United Healthcare with United Shockwave Therapies. Just for the record, one is an insurance company and the other is an ESWT equipment provider!

My question regarded a post by Robert who was having trouble getting United Healthcare to pay for the professional component, even though, United Healthcare had paid for the technical component. It had nothing to do with the other company.

Please stop the personal attacks. Just because you disagree with my position on FDA approved, high energy ESWT, doesn't mean that my posts are less than honest.

Re: ESWT worked for me

Ed Davis, DPM on 11/30/04 at 18:56 (164996)

john:
You have my sincere apologies on this one as I did confuse the two. You have a great deal of knowledge in this field but have very strong opinions. I have strong opinions too but am willing to tell you )and readers) where those opinions are derived from. Why will you not do the same? Readers are looking for advice and if you are providing that from a standpoint of some expertise, why would you be so adamant about not revealing the derivation of your opinions? We obviously don't know who you are and are not asking for you to reveal any personal details, just what your involvement with the industry is.
Ed

Re: ESWT worked for me

Dr. Z on 11/30/04 at 19:34 (164998)

Ed,
I will try to make this simple for the board. Maybe this could be added to all of John's post so that readers know who he is.

My name is John, I have expereince in the ESWT business. I only support ESWT treatments/ equipment that has FDA approval. I don't support Low energy ESWT treatments/Equipment due to the lack of FDA approval. I feel it is important when making your decision regarding where, when who to have ESWT with that FDA approval is one of the most important criteria to understand.
This can be taken two ways either it is great or you are laughting and think Dr. Z is a fool . Take your pick.

Re: ESWT worked for me

Dr. Z on 11/30/04 at 20:28 (165002)

Ok here goes Sorry but I can't help this . This will illustrate my opinion of the no thrills no charge United Policy.

If its weren't for United Healthcare's very fair and lucrative professional ANd Techical payments for ESWT I doubt whether United Shockwave would have a no thrills no payment plan
What do I mean?. Well you go into an area where there is alot of United Healthcare subcriber( patients) you tell Dr. Podiatrist or Dr. Orthpodic surgeon hey dude look we will not charge your patients that don't have insurance . Buy some stock in our company if you want just use our company cause we know that good old United HEALTHCARE will pay big bucko's for the Technical fees so who cares if we give away tech fees for patients that don't have insurance we will double,triple our payments from just United Healthcare.
Ok so what is the big deal. It is my understanding that in the state of New Jersey and maybe other states, are a regualations that are based on stark regulations that referrals to an equipment vendor for any type of reward is considered a knickback.
Dr Z would love to be involved in this win win win situation except it is a knickback Knickback, knickback . So how does an insurance company such as United Healthcare protect itself and avoid this . They stop ESWT coverage period why should they have to be involved or deal with stupid petty plan.

Ok so what's new. Dr. Z always go off on this topic. Well today it is different I will commit myself to stopping companies such as United Shockwave from doing this. Its wrong and will destroy ESWT coverage now and in the future. I put too much of my profesional life to have a company show up in 2002 and decide that hey this is what we are going to do.

Now Vince will come back with hey its competition and you are etc etc. Well Vince I started a company many years before United Showed up without insurance and did well. My company is growing faster and bigger then I could every dream . United has had no effect on my company now and in the future. Did you know that over 168,000 patients per year will be an ESWT candidate every year in areas such as NYC,Phila, Baltimore. That's each city. That is alot of patients that need ESWT treament. We are only talking about the foot. So if insurance is dropped alot of these patients will not be able to afford ESWT treatment. This is my motivation to keep and expand insurnce so that more patients can get ESWT treatment. The no thrills plan will NOT increase insurance coverage n the long run. So who am my to say this I have 25 years of experience in the insurance industry and in podiatry. Trust me this will end insurance coverage. Use common sense. I am mr. united healthcare . I see that there is a no thrill plan. Best way to stop it is to use the Blue Shield Tech report to get out of this maddness. In the short term the no thrill plans will look great but in the long term it will destroy ESWT insurance coverage.
Believe what you want but this is just plan truth. Remember when what Dr. Z told you when down the road patients are talking about how to handle out of pocket only ESWT payments.

Re: ESWT worked for me

Ed Davis,DPM on 11/30/04 at 23:00 (165004)

Dr. Z:
I suspect a somewhat different scenario in which a critical mass of cured patients comes to exist and as such insurers have to extend coverage. Therein lies the 'double edge sword' effect in which insurers cover the services but do so at low contracted rates telling providers to 'take it or leave it.' This has been part of the larger pattern of insurers controlling access to treatment and payment rates. The 'high cost' providers will need to rethink their treatment models. Healthtronics was 'first' through the door but will need to rethink their delivery system -- they are currently fighting to keep their current delivery system but eventually will realize that insurors won't accept the costs and they will need to change. The current Healthtronics model has something for the anesthesiologist, surgicenter and hope to politically enjoy the support of the hospital industry. They also may not be fully cognizant that their model is changeable and don't need to fight to keep it. More docs have to be comfortable with office based application via ankle blocks and/or nitrous oxide and Healthtronics could be proactive in offering courses to help those not familiar with the aforementioned techniques.
Ed

Re: ESWT worked for me

Ed Davis,DPM on 11/30/04 at 23:07 (165005)

Dr. Z:
Keep in mind, that behind the scenes, United is fighting hard to get paid for the services. They are providing the patients 'insulation' from the battle but are not taking a 'no' from the insurers, at least not without a big battle...
Ed

Re: ESWT worked for me

Dr. Z on 12/01/04 at 00:01 (165006)

Ed,
I will keep an open mind. Can you help me out with an example of the United Model that provided your scenario. I do know exactly how some insurance coverage happened with the Blues in my area. Patients came to see me and the same group of providers we had. The patients paid a fair fee and then submitted to their insurance company a paid bill. We helped along with the patient ( very important since they were subscribers) get their billed paid. The key was that the service was rendered and the patient had paid, in addition to paying insurance premiums. The demand increased to the point that the medical directors started to call us about ESWT and a relationship started. So here is what I leared. First you need a demand. Seoond you need support from the patient. Third insurance companies come on board because of the demand from the subscriber.

I just don't see this with the No Thrills model. There is no paid bill. The insurance has no relationship with the equipment vendor. So therefore the insurance Co. has no pressure to satisfy anyone but themselves.
All I see is an equipment vendor placing presure on an insurance company that sees no reason to agree to anything.
How is the insurance company to believe that the fees are fair and reasonable. I will tell you how. When alot of patients start paying a fee and submitting it to their insurance company and are praising ESWT it makes the point of what is fair. The market just set the fee. Healthronis is another issue which I agee wit you.
It is my opinion that one of the reasons that there is a no thrills program is to get the doctor to do these procedures. For some reason there is a fear that if you must explain to the patient that there is a fee and your insurance company won't pay the doctor becomes fearful. When you have to explain and charge a fee you have to understand, study, and believe in your treatment. It is amazing to me how many doctors just won't do ESWT unless insurance covers the procedure. Sad but true. I say if you don't understand the procedure take the time to learn the procedure. If you don't believe in a procedure don't do it. If you charge a fair fee, understand the procedure and believe in its benefits patients will pay.
ESWT is an effective procedure that will stay whether insurance is present or not. The real question will be which companies will be around when insurance ends due to the no thrill model. Its tough to try and point out something that you know is true because you have experienced this. My feeling is that the no thrill model will stay and only be talked about as the cause why this is little to know insurance coverag AFTER it happens I hope I am wrong. I wish that there was more foresight in our profession and less short term thinking.

Re: ESWT worked for me

Ed Davis, DPM on 12/01/04 at 10:25 (165020)

Dr. Z:
You are looking at a more ideal situation. I think that there is a bit of a difference between the East and West coast in patient thinking. I don't like to generalize, but having been on both sides of the US, the difference is 'palpable' to me. Patients on the East coast generally are more medically pro-active, apt to go directly to specialists and seek out specific care for their conditions. Patients on the West coast, for some reason, are a lot more influenced by the decisions made by their primary care physicians and insurance companies. I really cannot explain this phenomenon but it definitely does exist. Managed care had a much easier time 'taking over' the West Coast because of the attitude differential -- look at the managed care penetration in California. Some feel that due to the more transient nature of the population in California, long term relationships between providers and patients are less likely to exist and thus third parties have been able to gain more influence. I think that United Shockwave is looking at the West coast 'attitude' of going after the third parties as opposed to the 'ideal' of consumers being the drivers of demand for the service. Imagine having a patient make a statement like, 'it cannot be a good service if my insurance does not cover it.' I remind that person that many individual plans don't cover maternity and that places an end to that discussion....
Ed
Ed

Re: ESWT worked for me

Dr. Z on 12/01/04 at 11:04 (165022)

Dr. Ed,
Interesting. I believe that the largest penetration for managed care has been my area- Philadelphia, I read this somewhere. Aetna US Healthcare largest base is in Philadelphia. If I though that the United Plan would work I would have an open mind. I see it as an excuse by the insurance companies to close down ESWT coverage. I know that the path that I followed works ( patient demand creating insurance coverage, driven by patients and not equipment venders) and I am just not understanding how United no tech fee is ever going to create insurance demand. It will create increased Doctor useage for ESWT due to the fear doctor have about talking finanical details. So I guess that is positive.
Anyway. I don't see any one including patients speaking up about this to insurance companies. As Forrest Gump once said. That's all I have to say about that.

Re: ESWT worked for me

Ed Davis, DPM on 12/01/04 at 17:14 (165037)

Dr. Z:
The insurers obviously may not appreciate United's strategy. It is one more way to build the 'critical mass' I speak of at times. I look at demand as a hyperbolic curve, low for a long time and suddenly having an upswing. The upswing in the curve is caused on a sudden increase in demand volume. To use stockbrokers language, we are 'forming a base' from which the upswing will occur. There just need be a certain level of public recognition in order for demand to take off.
Ed