To: wlheatmoon who wrote (1455 ) 3/18/1998 6:03:00 PM From: Dan Packer Read Replies (1) | Respond to of 5736
Mike - I congratulate you. You deftly caught my joke on Rotor's syndrome recognizing that I was describing an intrahepatic obstructive-like cause rather than an overproduction of pigment, some functional block of excretion coupled with a fetal protein system that lacks binding sites. I'm not really sure that you can really follow the course of really high bilirubins with this indirect measurement. It all depends on clinical comfort levels. I would think that you would want exact measurements. "Close" may be good enough in government work and hand grenades, but may not be good enough for babies. I recognize that you'd like to bill for $3 tylenol tablets, but gee. Frankly I would suspect that the actual use for this device would be as a screening tool. A neonatal unit might buy it, and then use it to corroborate clinical eyeballing. The cost would be bundled with the global unit fee. Ethical places would do that. That's the problem with fee-for-service, there's an incentive for "one more test". In this case, the Colormate 3 might simply give you more reliable care, with zero marginal charge to the patient. The billing would be the same as for a tympanic temperature measurement, zero. Hepatitis is a big problem in Asia. Does regular global bilirubin measurement help? With an alcoholic, does the colorimeter test rule in, or rule out surgically correctible obstructive disease? You're right about the market size, you could break into song: "Oh, you wonder where the yellow went, if you brush your folks with Pepsodent?" Something like that. Dan the Rotorman - Consider the lilies of the field: They toil not, neither do they spin.