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Severity Levels of Femoral Stress Fracture
Femoral stress fractures can vary in severity, typically classified into three grades. Understanding these levels is crucial for proper diagnosis and treatment planning. Let's explore each grade in detail:
Grade 1 (Mild)
Mild femoral stress fractures are often the result of overuse or repetitive stress on the bone.
- Symptoms and risk factors: Mild pain during or after activity, often localized to a specific area of the thigh. Risk factors include sudden increases in training intensity, poor nutrition, or biomechanical issues.
- Diagnosis: Usually achievable through a virtual doctor consultation, as symptoms are typically not severe enough to warrant immediate in-person evaluation.
- Imaging: X-ray is often the first imaging choice, though early stress fractures may not be visible.
- Treatment: Conservative management, including rest, ice application, and over-the-counter pain medication. Activity modification is crucial to prevent progression.
Grade 2 (Moderate)
Moderate femoral stress fractures represent a progression from Grade 1 and require more intensive intervention.
- Symptoms and risk factors: Increased pain during activity, possibly persisting after rest. Pain may be more widespread in the thigh. Risk factors similar to Grade 1, with potential underlying health conditions.
- Diagnosis: An in-person doctor visit is recommended for a thorough physical examination and more accurate assessment.
- Imaging: X-ray and possible MRI to confirm the diagnosis and assess the extent of the injury.
- Treatment: Use of crutches to reduce weight-bearing, prescription pain medication if needed, and a structured physical therapy program.
Grade 3 (Severe)
Severe femoral stress fractures are the most serious and can potentially lead to complete fracture if not treated promptly.
- Symptoms and risk factors: Significant pain, potentially even at rest, difficulty bearing weight. Risk factors include prolonged overuse, nutritional deficiencies, or underlying bone disorders.
- Diagnosis: Emergency room visit is often necessary due to the severity of symptoms and the risk of complete fracture.
- Imaging: Comprehensive imaging including X-ray, MRI, and possibly bone scan to fully assess the extent of the injury.
- Treatment: Possible surgical intervention, especially if there's a risk of complete fracture. Extended use of crutches, pain management, and an intensive, supervised physical therapy program.
Summary Table: Severity Levels
Severity Level | Characteristics | Diagnosis | Labs/Imaging | Treatment |
---|---|---|---|---|
Grade 1 (Mild) | Mild pain during/after activity, localized | Virtual doctor consultation | X-ray | Rest, ice, OTC pain medication |
Grade 2 (Moderate) | Increased pain, possibly persisting after rest | In-person doctor visit | X-ray, possible MRI | Crutches, pain medication, physical therapy |
Grade 3 (Severe) | Significant pain, difficulty bearing weight | Emergency room visit | X-ray, MRI, possible bone scan | Possible surgery, crutches, pain management, intensive physical therapy |
Understanding the severity of a femoral stress fracture is crucial for determining the appropriate course of treatment and estimating the associated costs. As we progress through this article, we'll explore the specific diagnostic methods, tests, and treatments for each severity level, along with their respective costs and time considerations.
Getting a Diagnosis
When it comes to diagnosing a femoral stress fracture, there are several options available, each with varying costs and time commitments. Let's explore these options in detail:
Self-assessment
While self-assessment can be a starting point, it's important to note that a proper medical diagnosis is crucial for femoral stress fractures. However, you can perform an initial self-check to determine if you need to seek medical attention.
- Cost: Free
- Time: 15-30 minutes
Virtual doctor consultation
Virtual consultations have become increasingly popular, offering convenience and often lower costs compared to in-person visits.
- Teladoc
- With Insurance:
- General Medical visits: as low as $0 per visit
- Therapy sessions: $0 to $99
- Psychiatric appointments: $0 to $299 for the first appointment, and up to $119 for subsequent appointments
- Without Insurance:
- General Medical visits: $75 per visit
- General Medical visits (outside of benefits plan): $89 per visit
- Therapy sessions: $0 to $119
- Psychiatric appointments: $0 to $299 for the first appointment, and up to $129 for subsequent appointments
- With Insurance:
- MDLive
- With Insurance:
- Urgent care: $0 to $82
- Primary care: as low as $0 (only offered through selected health care insurance plans)
- Dermatology: $0 to $95
- Mental health therapy: $0 to $108
- Mental health psychiatry: $0 to $284 (initial session $284, follow-up $108)
- Without Insurance:
- Urgent care: $82 and above
- Mental health therapy: $108
- Mental health psychiatry: $284
- Dermatology: $95
- With Insurance:
- OptimalMD
- Cost: Free with OptimalMD membership ($47 per month for the entire family)
- Time: 15-30 minutes, same-day availability
In-person doctor visit
For a more thorough examination, an in-person visit to a primary care physician or orthopedic specialist may be necessary.
- Primary Care Physician (PCP)
- With insurance: Copay typically ranges from $15 to $50
- Without insurance: Average cost is $171
- With discount card: Prices may be reduced by 20-50%
- OptimalMD: Free with membership
- Orthopedic Specialist
- With insurance: Copay typically ranges from $30 to $75
- Without insurance: Average cost ranges from $84 to $167, depending on the state
- With discount card: Prices may be reduced by 10-30%
- OptimalMD: Heavily discounted with membership
Emergency room visit
For severe cases or after-hours emergencies, an ER visit might be necessary.
- With insurance: Copay typically ranges from $50 to $500
- Without insurance: Average cost is $1,220
- With discount card: Prices may be reduced by 10-20%
- OptimalMD: Not applicable (emergency care is not covered under the membership)
Summary Table: Assessment Options
Modality | Appropriate Severity Level(s) | Price Without Insurance | Price With Insurance | Efficiency |
---|---|---|---|---|
Self-assessment | Mild | Free | Free | High |
Virtual consultation (Teladoc) | Mild to Moderate | $75-$89 | $0-$99 | High |
Virtual consultation (MDLive) | Mild to Moderate | $82+ | $0-$82 | High |
Virtual consultation (OptimalMD) | Mild to Moderate | Free with membership | Free with membership | High |
PCP visit | Mild to Severe | $171 (average) | $15-$50 copay | Medium |
This table provides a quick overview of the various diagnosis options, their appropriate use cases, costs, and efficiency. It's important to note that the most suitable option will depend on the severity of your symptoms and your individual circumstances.
Imaging and Laboratory Tests
Imaging and laboratory tests are crucial for accurately diagnosing and assessing the severity of femoral stress fractures. The type of imaging required often depends on the suspected severity of the fracture. Let's explore the various options, their costs, and efficiency.
X-ray
X-rays are typically the first imaging test ordered for suspected femoral stress fractures. They're quick, widely available, and can often detect visible fractures.
- Appropriate for: All severity levels (initial screening)
- Time: 15-30 minutes, results usually available same day
- Providers and Costs:
- RadiologyClinic:
- With insurance: $0-$50 copay
- Without insurance: $260-$460
- Cash price: $200-$400
- UrgentCare Express:
- With insurance: $25-$75 copay
- Without insurance: $150-$300
- Cash price: $125-$250
- HospitalImaging Center:
- With insurance: $50-$100 copay
- Without insurance: $350-$600
- Cash price: $300-$550
- OptimalMD: Free with OptimalMD membership
MRI (Magnetic Resonance Imaging)
MRI provides detailed images of soft tissues and can detect stress fractures earlier than X-rays. It's often used when X-rays are inconclusive or a more detailed view is needed.
- Appropriate for: Moderate to severe cases, or when X-rays are inconclusive
- Time: 30-60 minutes, results typically available within 1-3 days
- Providers and Costs:
- AdvancedImaging:
- With insurance: $100-$500 copay
- Without insurance: $462-$693
- Cash price: $400-$600
- MedicalCenterRadiology:
- With insurance: $150-$600 copay
- Without insurance: $1,000-$2,500
- Cash price: $800-$2,000
- OutpatientImagingCenter:
- With insurance: $75-$400 copay
- Without insurance: $600-$1,500
- Cash price: $500-$1,200
- OptimalMD: Heavily discounted with OptimalMD membership
Bone Scan
Bone scans can detect stress fractures earlier than X-rays and are useful when MRI is contraindicated or unavailable.
- Appropriate for: Moderate to severe cases, especially when MRI is not an option
- Time: 3-4 hours, results typically available within 1-3 days
- Providers and Costs:
- NuclearMedicineCenter:
- With insurance: $100-$500 copay
- Without insurance: $275-$1,070
- Cash price: $250-$900
- HospitalRadiologyDepartment:
- With insurance: $150-$600 copay
- Without insurance: $800-$1,500
- Cash price: $700-$1,300
- SpecialtyImagingClinic:
- With insurance: $75-$400 copay
- Without insurance: $500-$1,200
- Cash price: $450-$1,000
- OptimalMD: Heavily discounted with OptimalMD membership
Blood Tests
While not always necessary for femoral stress fractures, blood tests may be ordered to rule out other conditions or assess overall health.
- Appropriate for: All severity levels, as deemed necessary by the healthcare provider
- Time: 15 minutes for blood draw, results typically available within 1-3 days
- Providers and Costs:
- LabCorp:
- With insurance: $0-$50 copay
- Without insurance: $39-$239 (depending on specific tests)
- Cash price: $35-$200
- Quest Diagnostics:
- With insurance: $0-$60 copay
- Without insurance: $50-$300 (depending on specific tests)
- Cash price: $45-$250
- Hospital Laboratory:
- With insurance: $25-$100 copay
- Without insurance: $100-$500 (depending on specific tests)
- Cash price: $80-$400
- OptimalMD: Free with OptimalMD membership
Summary Table: Diagnostics
Modality | Severity Level | Price with Insurance | Price without Insurance | Efficiency |
---|---|---|---|---|
X-ray | All | $0-$100 copay | $100-$1,000 | High (15-30 min, same-day results) |
MRI | Moderate to Severe | $75-$600 copay | $462-$2,500 | Medium (30-60 min, 1-3 days for results) |
Bone Scan | Moderate to Severe | $75-$600 copay | $275-$1,500 | Low (3-4 hours, 1-3 days for results) |
Blood Tests | All (as needed) | $0-$100 copay | $39-$500 | Medium (15 min draw, 1-3 days for results) |
Note: OptimalMD offers free or heavily discounted rates for all these services with their $47/month family membership.
Prescription Medications
Prescription medications play a crucial role in managing pain and inflammation associated with femoral stress fractures. The choice of medication often depends on the severity of the fracture and the patient's individual needs. Let's explore the common prescription options, their costs, and availability.
Non-steroidal anti-inflammatory drugs (NSAIDs)
NSAIDs are often the first line of defense against pain and inflammation in femoral stress fractures. They're suitable for mild to moderate cases.
- Celecoxib (brand name: Celebrex)
- Cash price: Varies by dosage, ranging from $8.81 for 30 capsules (200mg) to $1,738.28 for 100 capsules (200mg)
- With insurance: Copay typically ranges from $10 to $50
- With discount card (e.g., GoodRx): As low as $10.76 for 30 capsules (200mg)
- Free with OptimalMD membership
- Meloxicam (brand name: Mobic)
- Cash price: Ranges from $11 for 30 tablets (7.5mg) to $970.85 for 100mL oral suspension (7.5mg/5mL)
- With insurance: Copay typically ranges from $5 to $30
- With discount card (e.g., GoodRx): As low as $3 for 30 tablets (15mg)
- Free with OptimalMD membership
Time: Both medications provide relief within 1-2 hours, with peak effect in 3-4 days. They are typically taken daily for the duration of treatment.
Opioid pain medications
For severe cases or post-surgical pain management, opioids may be prescribed. These should be used cautiously and only as directed due to their potential for dependency.
- Oxycodone (brand name: OxyContin)
- Cash price: Varies widely based on form and quantity, ranging from $13 for 20 tablets to over $2,000 for 100 extended-release tablets
- With insurance: Copay typically ranges from $10 to $60, depending on plan
- With discount card (e.g., GoodRx): As low as $21.98 for oxycodone/acetaminophen combination
- Heavily discounted with OptimalMD membership
- Hydrocodone/Acetaminophen (brand name: Vicodin)
- Cash price: Varies by form and quantity, ranging from $18 for 50 tablets to $393.32 for 400 (40 x 10mL) oral liquid
- With insurance: Copay typically ranges from $5 to $40
- With discount card (e.g., SingleCare): As low as $10.02 for 12 tablets (5-325mg)
- Heavily discounted with OptimalMD membership
Time: Both opioid medications provide rapid pain relief, typically within 20-30 minutes. They are usually prescribed for short-term use (3-7 days) to manage severe pain.
It's important to note that while OptimalMD offers free or heavily discounted access to many medications, controlled substances like opioids may have additional restrictions or may not be included in their standard offering. Always consult with a healthcare provider for the most appropriate pain management strategy.
Summary Table: Prescription Medications
Modality | Severity Level | Price without Insurance | Price with Insurance | Efficiency |
---|---|---|---|---|
NSAIDs (e.g., Celecoxib) | Mild to Moderate | $8.81 - $1,738.28 | $10 - $50 copay | Relief in 1-2 hours, peak effect in 3-4 days |
Opioids (e.g., Oxycodone) | Severe | $13 - $2,390.52 | $10 - $60 copay | Rapid relief within 20-30 minutes |
OptimalMD Membership | All levels | $47/month for family | N/A | Varies by medication |
Remember, the most cost-effective and efficient treatment plan will depend on the severity of your femoral stress fracture and your individual health needs. Always consult with a healthcare professional to determine the best course of treatment.
Over-the-Counter Treatments
Over-the-counter (OTC) treatments play a crucial role in managing pain and supporting recovery for femoral stress fractures, especially in mild to moderate cases. These treatments are readily accessible and can be a cost-effective first line of defense. Let's explore the various options available, their costs, and where to find them.
Pain relievers
Common OTC pain relievers for femoral stress fractures include acetaminophen, ibuprofen, and naproxen. These medications can help manage pain and reduce inflammation.
Acetaminophen
- National average price: $10-$15 for a bottle of 100 tablets (500mg)
- Specific examples:
- CVS Pharmacy (nationwide): $11.99 for 100 tablets
- Walmart (nationwide): $9.88 for 100 tablets
- Walgreens (nationwide): $12.49 for 100 tablets
Ibuprofen
- National average price: $8-$12 for a bottle of 100 tablets (200mg)
- Specific examples:
- Target (nationwide): $7.99 for 100 tablets
- Costco (nationwide): $9.49 for 1000 tablets (bulk purchase)
- Rite Aid (nationwide): $11.99 for 100 tablets
Naproxen
- National average price: $10-$15 for a bottle of 100 tablets (220mg)
- Specific examples:
- Amazon (online): $9.97 for 100 tablets
- Kroger (nationwide): $11.99 for 100 tablets
- Sam's Club (nationwide): $10.98 for 400 tablets (bulk purchase)
Note: When using insurance, many of these OTC pain relievers may be partially or fully covered, especially if prescribed by a doctor. Discount cards like GoodRx can also significantly reduce out-of-pocket costs.
Topical pain relievers
Topical pain relievers can provide localized relief for femoral stress fractures. Options include creams, gels, and patches containing ingredients like menthol, camphor, or salicylates.
Lidocaine Patches
- National average price: $10 to over $200, depending on brand, strength, and quantity
- Specific examples:
- CVS Pharmacy (nationwide): $11.49 for 5 patches
- Walgreens (nationwide): $14.99 for 6 patches
- Walmart (nationwide): $9.98 for 6 patches
Other Topical Pain Relievers
- Bengay Ultra Strength Pain Relieving Cream: $5-$8 for a 4 oz tube
- Icy Hot Maximum Strength Cream: $6-$10 for a 3 oz tube
Note: Insurance coverage for topical pain relievers varies, but many are available over-the-counter and may not be covered. However, if prescribed by a doctor, some insurance plans may provide coverage.
Supportive devices
Supportive devices like crutches, canes, and supportive shoes can help reduce stress on the affected leg during recovery.
Crutches
- National average price: $50-$60 for a pair of standard aluminum crutches
- Specific examples:
- Walgreens (nationwide): $49.99 for a pair of adjustable aluminum crutches
- Amazon (online): $39.99 for a pair of Drive Medical aluminum crutches
- CVS Pharmacy (nationwide): $54.99 for a pair of adjustable aluminum crutches
Canes
- Basic cane: $15 to $50
- Adjustable aluminum canes: $20-$30
- Quad canes (for more stability): $30-$60
Supportive Shoes or Inserts
- Regular supportive shoes or inserts: $50 to $200 or more
- Custom orthotics: $200-$800
Note: Insurance coverage for supportive devices varies. Many insurance plans will cover a portion of the cost for crutches or canes if prescribed by a doctor. However, supportive shoes or inserts are often considered "comfort items" and may not be covered unless deemed medically necessary.
Summary Table: OTCs
Modality | Severity Level | Price Without Insurance | Price With Insurance | Efficiency |
---|---|---|---|---|
OTC Pain Relievers | Mild to Moderate | $5-$15 per bottle | May be covered if prescribed | Immediate relief, taken as needed |
Topical Pain Relievers | Mild to Moderate | $5-$15 for creams/gels, $10-$50 for patches | Rarely covered unless prescribed | Relief within 15-30 minutes, applied as needed |
Crutches | Moderate to Severe | $40-$80 per pair | Often partially covered if prescribed | Immediate use, duration as recommended |
Canes | Mild to Moderate | $15-$60 | Often partially covered if prescribed | Immediate use, duration as recommended |
Supportive Shoes/Inserts | Mild to Severe | $50-$200+ | Rarely covered unless deemed medically necessary | Immediate use, may provide long-term benefits |
This table provides a quick overview of the various over-the-counter treatments available for femoral stress fractures, their appropriate use cases, cost considerations, and efficiency. Remember that prices can vary based on location, brand, and specific product features. Always consult with a healthcare provider to determine the most appropriate treatment for your specific condition.
Procedures
When treating femoral stress fractures, certain procedures may be necessary depending on the severity of the injury. The two main procedures typically involved are physical therapy and, in severe cases, surgery. Let's explore each of these options in detail, including their costs and time considerations.
Physical Therapy
Physical therapy is a crucial component in the treatment of femoral stress fractures, especially for Grade 2 (moderate) and Grade 3 (severe) cases. It helps in the recovery process, strengthens the surrounding muscles, and improves overall function.
Let's look at the costs associated with physical therapy sessions:
- NationalPT (National Average)
- With Insurance: $40 per session
- Without Insurance: $112.50 per session
It's important to note that the number of physical therapy sessions required can vary based on the severity of the fracture and individual recovery rates. Typically, patients might need:
- Grade 2 (Moderate) fractures: 6-12 sessions over 4-8 weeks
- Grade 3 (Severe) fractures: 12-24 sessions over 8-16 weeks
Time per session usually ranges from 30-60 minutes.
Surgery (for severe cases)
In cases of Grade 3 (severe) femoral stress fractures, surgery might be necessary. The two main surgical procedures for this condition are internal fixation and intramedullary nailing.
Based on the US Hospital Average:
- With Insurance: Typically 10-30% of the total cost, so approximately $2,000 to $7,200
- Without Insurance: $20,000 to $24,000
The surgery typically takes 1-3 hours, with a hospital stay of 3-5 days. Full recovery can take several months, during which time physical therapy will be necessary.
Summary Table: Procedures
Modality | Severity Level | Price with Insurance | Price without Insurance | Efficiency (Time) |
---|---|---|---|---|
Physical Therapy (NationalPT) | Moderate to Severe | $40 per session | $112.50 per session | 30-60 min per session, 6-24 sessions over 4-16 weeks |
Femoral Fracture Surgery (US Hospital Average) | Severe | $2,000 - $7,200 | $20,000 - $24,000 | 1-3 hours surgery, 3-5 days hospital stay, months for full recovery |
Remember, these costs are estimates and can vary based on location, specific provider, and individual case complexity. Always consult with your healthcare provider and insurance company for the most accurate cost estimates for your specific situation.
Optimizing for Cost
When seeking the most cost-effective treatment for femoral stress fractures, consider the following strategies for each severity level:
Grade 1 (Mild)
- Start with self-assessment and rest at home
- Use over-the-counter pain relievers like generic ibuprofen or acetaminophen
- If symptoms persist, opt for a virtual doctor consultation instead of an in-person visit
- Use ice packs for pain relief instead of purchasing specialized cold therapy devices
- Borrow crutches or a cane from friends or family if needed, rather than buying new
Grade 2 (Moderate)
- Begin with a virtual consultation to determine if an in-person visit is necessary
- If recommended, choose an in-network provider for in-person evaluation
- Opt for X-rays first; only proceed with an MRI if absolutely necessary
- Request generic versions of prescribed medications
- Explore physical therapy exercises you can do at home to reduce the number of in-person sessions
Grade 3 (Severe)
- If not an emergency, consult with your primary care physician before going to the ER
- Choose an in-network hospital if ER visit is necessary
- Discuss the necessity of each imaging test with your doctor to avoid redundant scans
- If surgery is required, explore outpatient options if medically appropriate
- Ask about generic alternatives for all prescribed medications
- Inquire about bundled pricing for surgical procedures and follow-up care
General Cost-Saving Tips
- Check if your insurance offers telehealth services at a reduced cost
- Look into community health centers or sliding scale clinics for more affordable care
- Consider setting up a Health Savings Account (HSA) or Flexible Spending Account (FSA) to use pre-tax dollars for medical expenses
- Ask about cash pay discounts or payment plans if you're uninsured or have a high deductible
- Research patient assistance programs for prescription medications
By following these cost-optimizing strategies, patients can potentially reduce their out-of-pocket expenses while still receiving appropriate care for their femoral stress fracture. Remember, however, that cost should not come at the expense of proper medical treatment, especially in severe cases where inadequate care could lead to complications and higher long-term costs.
Balancing Cost and Efficiency
When treating a femoral stress fracture, it's crucial to find a balance between cost-effectiveness and efficient care. Here are strategies for each severity level that aim to optimize both factors:
Grade 1 (Mild) Fractures
- Diagnosis: Start with a virtual doctor consultation
- Cost-effective and time-efficient
- Allows for quick assessment and treatment recommendations
- Imaging: Begin with an X-ray
- Less expensive than advanced imaging
- Provides quick results to guide initial treatment
- Treatment:
- Focus on rest, ice, and over-the-counter NSAIDs
- Consider generic medications to reduce costs
- Follow up virtually to monitor progress and adjust treatment if necessary
Grade 2 (Moderate) Fractures
- Diagnosis: Schedule an in-person doctor visit
- More thorough examination than virtual consultation
- Can lead to more accurate diagnosis and treatment plan
- Imaging: X-ray followed by MRI if necessary
- Start with less expensive option
- MRI provides detailed information if X-ray is inconclusive
- Treatment:
- Combine prescription pain medication (generic when possible) with physical therapy
- Rent crutches or supportive devices instead of purchasing
- Consider a mix of in-person and virtual follow-up appointments
Grade 3 (Severe) Fractures
- Diagnosis: Emergency room visit
- Immediate care is crucial for severe cases
- Allows for quick access to advanced imaging and specialist consultations
- Imaging: Comprehensive imaging (X-ray, MRI, bone scan)
- While more expensive, it provides a complete picture for accurate treatment planning
- May prevent costly complications or ineffective treatments
- Treatment:
- If surgery is necessary, opt for minimally invasive procedures when possible
- Combine hospital-based physical therapy with home exercises
- Use a mix of prescription pain medication and over-the-counter options as recovery progresses
By tailoring the approach to each severity level, patients can receive appropriate care while managing both costs and time efficiency. Always consult with healthcare providers to determine the best course of action for individual cases, as they can provide personalized recommendations based on specific circumstances and available resources.
Conclusion
Treating a femoral stress fracture can vary significantly in cost and time depending on the severity of the injury and the chosen treatment approach. This guide has explored various aspects of diagnosis and treatment, from self-assessment to surgical interventions, providing insight into the associated costs and time investments.
Key takeaways include:
- Early detection and proper diagnosis are crucial for effective treatment and can potentially reduce overall costs.
- Treatment costs can range from relatively inexpensive (for mild cases managed with rest and over-the-counter medications) to very expensive (for severe cases requiring surgery and extensive rehabilitation).
- Imaging tests, particularly MRIs and bone scans, can significantly impact the overall cost but are often necessary for accurate diagnosis.
- Generic medications can offer substantial cost savings compared to brand-name alternatives.
- Physical therapy, while an additional expense, can be crucial for proper healing and preventing future injuries.
- Balancing cost and efficiency in treatment often leads to the best outcomes, both medically and financially.
Remember that while cost is an important consideration, the primary goal should always be proper healing and prevention of further injury. Consult with healthcare professionals to determine the most appropriate treatment plan for your specific situation, taking into account both medical needs and financial constraints.
By understanding the various costs associated with femoral stress fracture treatment, patients can make more informed decisions about their care and potentially identify areas for cost savings without compromising the quality of treatment.
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