Word: boning
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Dates: during 1990-1999
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YOUR STORY OMITTED MANY RELEVANT points, but one stands out. TIME painted bone-marrow transplantation as a managed-care issue. It is not. It was and is an issue for everyone in health care. Our response to this issue, which we gave to you but which failed to make it into the article, is as follows: A panel of transplant physicians, drawn from California's finest medical centers, created and continuously reviews guidelines for bone-marrow transplants. Since 1994, any case that does not meet criteria for approval and is appealed is automatically referred for outside review to the Medical...
...Christy underwent a bone scan, which showed her cancer had spread; her disease was now classified as Stage IV metastatic breast cancer. Given the standard therapies available, it was a death sentence, but her oncologist, Dr. Mahesh Gupta, warmly assured her there was hope. He recommended she consider a bone-marrow transplant and, in a breach of Health Net procedure, skipped the usual channels for making referrals and arranged a consultation with a physician he knew, Dr. Robert McMillan, an oncologist at the Scripps Clinic in La Jolla. Christy's sister, living in Colorado, had urged...
...Gupta, reviewing his notes on the case, says Dr. McMillan agreed Christy was a candidate for a transplant but said she would first have to undergo several cycles of chemotherapy to demonstrate that her tumor would respond to the potent drugs used in bone-marrow therapy. In the deMeurerses' eyes, however, it was a deeply troubling encounter. Dr. McMillan declined even to describe what was involved in a bone-marrow transplant or give the family a tour of the Scripps facilities, according to Alan deMeurers and Christy's mother, Joyce Nesmith. "I believe he was told to send us away...
When Dr. Jones examined Christy deMeurers, he believed a transplant could help her. "The available proof for its efficacy in breast cancer was at least equivalent to many other procedures that we do every day," he says. As early as 1990, even Health Net had found evidence that bone-marrow transplants might become a standard weapon against breast cancer. That year the company's then chief medical officer, Dr. Leonard Knapp, ordered a study by Technology Assessment Group of San Francisco to evaluate the treatment. The report, however, didn't reach the conclusion he had hoped for. It found that...
...Schinke examined Christy and agreed she ought to consider a bone-marrow transplant. At the least it might provide a period free of disease and debilitating chemotherapy. He suggested she get an evaluation at the UCLA Medical Center. To Dr. Schinke, whether Health Net would pay was a side issue. "When the patient comes to me, I'm still going to tell them about what I think may help," he says. "That's the ethical thing...