Yes. Our Toronto docs know alot of your Vancouver docs and your volume is
massive.
And our Retina doc said each vial of fluorescein is $50 Cdn. The price
went up about 6 yrs ago. We don't have easy access to the cost of
consumables cos we don't bill patients or insurance companies for every
procedure or consumable we use.
$50 a vial is the cost doing business in Canada. I don't know if the $50
price is the price before our dollar dropped or after. Ie if the 50 dollar
cost was based on the increase 6yrs ago. Then easily that same vial is
close to 70 now...
So yeah I can see why the bean counters are wondering if you can use less
dye....
Cynthia VandenHoven
Medical Imaging Specialist, Hospital for Sick Children, Toronto Canada
On Mar 11, 2016 12:49 PM, "CPMC Ophthalmic Diagnostic Center" <
cpmceyelab@xxxxxxxxxxxxxxxx> wrote:
That would explain it!
*Denice Barsness, CRA, COMT, ROUB, CDOS, FOPS*
*Ophthalmic Diagnostic Center*
*CPMC Department of Ophthalmology*
*2100 Webster Street Suite 212*
*San Francisco CA 94115*
*(415) 600-3937 <%28415%29%20600-3937> FAX (415) 600-6563
<%28415%29%20600-6563>*
*From:* optimal-bounce@xxxxxxxxxxxxx [mailto:optimal-bounce@xxxxxxxxxxxxx]
*On Behalf Of *Krista Peters
*Sent:* Friday, March 11, 2016 9:22 AM
*To:* optimal@xxxxxxxxxxxxx
*Subject:* [optimal] Re: FA dye dosage
We have 6 OCT's between 4 satellite offices and 5 retina specialists. A
huge diabetic population and common practice to do angiograms on every new
WetAMD/RVO patient.
Krista
On Mar 11, 2016, at 8:30 AM, CPMC Ophthalmic Diagnostic Center <
cpmceyelab@xxxxxxxxxxxxxxxx> wrote:
Wow! 100 angiograms a week! Sounds like the old days. Either you have
a huge diabetic population or don’t own an OCT?
*Denice Barsness, CRA, COMT, ROUB, CDOS, FOPS*
*Ophthalmic Diagnostic Center*
*CPMC Department of Ophthalmology*
*2100 Webster Street Suite 212*
*San Francisco CA 94115*
*(415) 600-3937 <%28415%29%20600-3937> FAX (415) 600-6563
<%28415%29%20600-6563>*
*From:* optimal-bounce@xxxxxxxxxxxxx [mailto:optimal-bounce@xxxxxxxxxxxxx
<optimal-bounce@xxxxxxxxxxxxx>] *On Behalf Of *Krista Peters
*Sent:* Thursday, March 10, 2016 5:43 PM
*To:* optimal@xxxxxxxxxxxxx
*Subject:* [optimal] Re: FA dye dosage
Thanks for your input Denise et al
I'm not involved in the purchasing of the dye (although maybe I need to
be) but our accountant is saying we're spending close to 25k every 3
months. We do about 75-100 angiograms per week. We're in Vancouver Canada
and I hear it's been difficult for us to find a company to ship to Canada.
Then there's added custom charges etc...
I'm thinking we need to investigate a cheaper company that ships to Canada
instead of compromising quality images.
Krista
On Mar 10, 2016, at 4:45 PM, CPMC Ophthalmic Diagnostic Center <
cpmceyelab@xxxxxxxxxxxxxxxx> wrote:
Costs? I think a vial is up to a whopping 8.00 at the present time
Isn’t that splitting hairs a bit? Like shorting on the GenTeal when doing
a biometry
Cost of doing business
I cannot see the point of cutting anything in half to save money
The term “Allergic” reaction is sure thrown around lightly. You have to
really ratchet up a normal reaction to the procedure ( vasovagal) or even
mild hives to begin to fill the criteria of a compromised airway, aka
“Allergic”
One hears that term thrown around from everything from gluten to the color
pink. Check out the references and you will see that the peer reviewed
literature on reactions to sodium fluorescein for ophthalmic use are mighty
Slim indeed. Nausea is not an allergic reaction. It’s a contraction
of the large smooth muscle of the stomach more often or not caused by
nerves, clenching, lack of breathing.
Ana, do a literature search on the OPS Website. You will see a number of
articles discussing these issues that have been discussed for four decades
now. AAO’s OMIC group also has a few well worded missives on the subject.
Us old dogs in the field will tell you that PATIENT MANAGEMENT goes a long
way to lessening reactions, not cutting your vial in half.
Respectfully,
Denice
*Denice Barsness, CRA, COMT, ROUB, CDOS, FOPS*
*Ophthalmic Diagnostic Center*
*CPMC Department of Ophthalmology*
*2100 Webster Street Suite 212*
*San Francisco CA 94115*
*(415) 600-3937 <%28415%29%20600-3937> FAX (415) 600-6563
<%28415%29%20600-6563>*
*From:* optimal-bounce@xxxxxxxxxxxxx [mailto:optimal-bounce@xxxxxxxxxxxxx
<optimal-bounce@xxxxxxxxxxxxx>] *On Behalf Of *Ana Mills
*Sent:* Thursday, March 10, 2016 2:40 PM
*To:* optimal@xxxxxxxxxxxxx
*Subject:* [optimal] Re: FA dye dosage
Hi Krista,
Ana here, how does your office manager feel about using the 10%
fluorescein? I use the 10% and I always only use 2.5cc for every patient,
to cut costs, and to cut down on the likelihood of an allergic reaction for
the patient. With that combo, I've noticed that it is very rare that I have
patients with nausea/vomiting or itching, etc., which is nice for everyone.
My images very typically still end up being of very high quality, and we
don't blow through our fluorescein supply too quickly. I'm not sure what
the price difference is between the 5% and 10%, but I think you should try
to get your office to start just buying the 10% and always only using 2.5cc
per patient. I've been in the field for five years now, and so far this is
definitely my preferred way of administering the fluorescein injections.
I'm curious to see if they let you switch!
Ana A. Mills
Ophthalmic Photographer/Technician
DC Retina, Dr. Neal Adams, M.D.
2101 Medical Park Drive, Suite 303
Silver Spring, MD 20902
Business phone: (301) 754-1200
On Mar 10, 2016, at 5:27 PM, Krista Peters <krista_81@xxxxxxxxxxx> wrote:
My office manager is wanting to cut costs by lowering the dosage of FA dye
from 5cc to 2.5cc. We are using a 5% dye and currently cut the dosage for
people with renal issues and those images are rarely as good as when using
the full 5cc. My manager is claiming that lots of clinics are doing this.
Do any of you only use 2.5cc with 5%?? I'd be curious to know your thoughts
so I can try to convince the doctors otherwise.
Krista
