Dr. Krakow, salesman extraordinaire? UPDATED

[Mike6977]

PREAMBLE:

Thirty rough years of dealing with my wife's cancer, my own cardiovascular disease, etc. etc., has left me more knowledgeable on those subjects than I ever wanted to be . . . and a lot more skeptical about doctors motives.

Motive wise, I'd have to say that the majority of doctors I've met were businessmen first, and clinicians a distant second.

Thus, when faced with an important medical decision, I feel obligated to read the medical literature in detail, and get the best 2nd, 3rd, or even 4th expert opinions I can.

Then, I repeat the process if necessary, going back and forth to each doctor, and resolving conflicting opinions, gaps in the literature, and so forth.

Yes, I have to trust . . . but I also damn sure verify.

Then I cross my fingers and hope I made the right decision.



___________________________________________________________________________________________________________

DR. KRAKOW

That brings me to Dr. Barry Krakow.

Dr. Krakow has posted here 58 times.

I've searched his posts, and was impressed with his writing skills, his depth of knowledge, and the progress he was reporting with ASV.



THE INTERVIEW

Recently, someone here posted an audio link, an interview with Dr. Krakow, conducted by Dr. Park, whom I've had the pleasure of meeting in person.

Listening to that interview, I grew increasing excited.

If I understood Dr. Krakow correctly, in the past 24 months he has used ASV, titrated with his specialized techs, to get spectacular results

I got the impression that his ASV therapy goes well beyond greatly reducing already treated OBAs and CTAs

It would seem to include fixing any partial obstruction of the airway, so that the flow curve appears completely normal.

Like you were born again.



I WAS STOKED

Nearing the end of his audio interview, I was sold.

I wanted to fly out to New Mexico and have a consultation, followed by a sleep study, a titration and a back rub.

As I listened, one of his call-in listeners seemed just as amped as I was. The caller excitedly concluded his questions by asking Dr. Krakow what kind of insurance he took.

Dr. Krakow flatly said: "Every kind".

That sealed the deal. All I had to do was cover my airfare from NYC, and stay at a reasonably priced hotel.

My GHI co-pay of $15 per procedure would be chicken feed.


A LITTLE SLASH OF COLD WATER

Then I went to Dr Krakow's website and was slapped back to reality a bit.

He expects full payment by credit card, before any consultation or sleep study. Then he'll file with your insurance company, and you'll get reimbursed what ever they reimburse.

That is miles away from accepting as payment whatever your insurance will pay.

Dr Krakow could have been honest during his interview . . . but choose not to be.


NOBODY'S PERFECT

Now, I've certainly seen worse misrepresentations.

A month ago, I made an appointment with a highly credentialed doctor at Columbia University.

He promised me over the phone that he was a GHI preferred provider.

At his office, I double-checked with his staff, yes, he was a preferred provider. They even accepted my two GHI co-payments of $15: one for his consultation and one for a femoral ultrasound.

Yesterday, I received a letter from GHI. He's not a PP, the ultrasound isn't covered . . . and I owe him around $1500.

I sure hope GHI is mistaken. Cause I don't plan to pay the good doctor a dime.



MEANWHILE, BACK AT THE KRAKOW RANCH

These two "events" put me in a bit more contemplative mood about Dr. Krakow.

In the literature, I've seen some other doctors report good results with ASV, but nothing like the panacea Dr. Krakow seems to feel it is.

In the Dr. Park interview, he didn't mention any studies he was planning to publish about his results with ASV.

He didn't mention his number of patients, or even give general statistics, like, say, 90% of patients reduced their VPAP AHI scores from "X" to "Y" while under his specialized ASV titration.

He spoke a lot about of his personal success with Auto BiPap, followed by his even greater personal success with ASV.

He may be a great doctor, and perhaps he's on the cutting edge of a revolution in SDB therapy.

Only time will tell. But for right now, all I can say with confidence is that he's a damn good salesman.

And that's said with true respect for good salesmen.


IF YOU'VE GOT THE SKINNY . . .

We have a lot of members at cpaptalk.

I'm guess some of you must have consulted with Dr. Krakow, or even made the trip to his practice in New Mexico.

If you have, could you please post about it here? If possible, please be specific about the results you achieved.

Again, no disrespect to Dr. Krakow, I know being a good salesman is an important part of having a successful medical practice.

But I'd like some more information before I'm, uh, sold.



Cheers and love to my fellow SDB compadres,

Mike

[ozij]

Dr. Krakow has posted here 58 times.

ASV was mentioned in 7 of them.

[Mike6977]

Dr. Krakow has posted here 58 times.

ASV was mentioned in 7 of them.

Hi ozij. I'm not sure how that is relevant to my post. Can you please explain further?

Thanks, Mike

[NightMonkey]

Motive wise, I'd have to say that the majority of doctors I've met were businessmen first, and clinicians a distant second.

Well you know the doctors you have met and I don't, but even if you claim this as a general premise, I disagree with it.

My GHI co-pay of $15 per procedure would be chicken feed.

This is the consumer expecting the very best products/services and expecting to get them for "chicken feed". No wonder doctors have to pay close attention to the business side.

It took me two years to learn to winnow those customers out of my active customer list.

But I do wish you the very best in working your way through the system and getting top notch help at a reasonable price. As you state, we are comrades in this, but we need to find doctors who will be comrades with us.

[ameriken]

Dr. Krakow has posted here 58 times.

ASV was mentioned in 7 of them.

Great first post Mike, I envy your style of writing, I read every word of it, and being an ASV user, it heightened my interest. I'd be skeptical as well before spending a ton of money to fly to NM (though for me it would be a long days drive). You raised my own curiosity about him and his research and whether or not he is serious or a Krakpot.

So, the way I took ozij's remark, is if Krakow is such an expert in ASV, then why out of 58 posts he only makes 7 posts on the subject? Maybe that doesn't mean much of anything at all, but for me, it just increases my own skepticism and makes me raise my eyebrows go 'Hmmph'.

[VVV]

Dr. Krakow is a very serious and straightforward sleep doctor.

Sorry I can't provide any links now, but he has criticized advice coming from cpaptalk (haven't we all?). He has his own publications, website, and videos. I don't think he is interested in posting on cpaptalk, whether about ASV or any other subject. It has been 3.5 years since he posted here.

If I needed specialized help, I would first have a consultation and examination with Dr. Park. Depending on the outcome, I would next go to Dr. Krakow's lab.

Of course I have no idea whether he could prescribe any improvements for Mike6977.

BTW, I would expect him to receive substantial compensation for his work.

[Otter]

As I listened, one of his call-in listeners seemed just as amped as I was. The caller excitedly concluded his questions by asking Dr. Krakow what kind of insurance he took.

Dr. Krakow flatly said: "Every kind".

That sealed the deal. All I had to do was cover my airfare from NYC, and stay at a reasonably priced hotel.

My GHI co-pay of $15 per procedure would be chicken feed.


A LITTLE SLASH OF COLD WATER

Then I went to Dr Krakow's website and was slapped back to reality a bit.

He expects full payment by credit card, before any consultation or sleep study. Then he'll file with your insurance company, and you'll get reimbursed what ever they reimburse.

That is miles away from accepting as payment whatever your insurance will pay.

Dr Krakow could have been honest during his interview . . . but choose not to be.

I don't see this as dishonest. At worst, it's incomplete. The question was not "what insurance will pay for your services?" It was, "what insurance do you accept?" What he's probably saying is that he's willing to have his people bill medicare, etc. Many doctors won't because it's too much of a hassle. Will medicare pay for what he's doing? Maybe not, but he's at least willing to file the paperwork.

[Otter]

So, the way I took ozij's remark, is if Krakow is such an expert in ASV, then why out of 58 posts he only makes 7 posts on the subject? Maybe that doesn't mean much of anything at all, but for me, it just increases my own skepticism and makes me raise my eyebrows go 'Hmmph'.

It doesn't mean anything at all. Just because he knows about something other than ASV doesn't mean his knowledge of ASV is lacking. Trying to measure a doctor's knowledge (or anyone's knowledge) of a subject by the percentage of his posts that deal with that subject is extremely silly.

[ameriken]

So, the way I took ozij's remark, is if Krakow is such an expert in ASV, then why out of 58 posts he only makes 7 posts on the subject? Maybe that doesn't mean much of anything at all, but for me, it just increases my own skepticism and makes me raise my eyebrows go 'Hmmph'.

It doesn't mean anything at all. Just because he knows about something other than ASV doesn't mean his knowledge of ASV is lacking. Trying to measure a doctor's knowledge (or anyone's knowledge) of a subject by the percentage of his posts that deal with that subject is extremely silly.

And trying to say I was measuring a doctors knowledge by a percentage of his posts is also extremely silly.

I was very clear in saying that maybe it means nothing, but just increases my skepticism.

[Otter]

And trying to say I was measuring a doctors knowledge by a percentage of his posts is also extremely silly.

I was very clear in saying that maybe it means nothing, but just increases my skepticism.

Yes, we partially agree. You think it may mean nothing, and I'm certain that it means nothing. But if you don't think the percentage of the doctor's posts about ASV is a measure of his knowledge of ASV, then why does it raise your skepticism? Maybe it's not so much the post statistics as an underlying distrust of flamboyant experts, which IMO, is not entirely unjustified.

Don't get me wrong, being skeptical of doctors is very healthy. I just don't see how you can tell anything from the subjects of 58 forum posts. The quality of the content, OTOH, might be useful.

[ameriken]

And trying to say I was measuring a doctors knowledge by a percentage of his posts is also extremely silly.

I was very clear in saying that maybe it means nothing, but just increases my skepticism.

Yes, we partially agree. You think it may mean nothing, and I'm certain that it means nothing. But if you don't think the percentage of the doctor's posts about ASV is a measure of his knowledge of ASV, then why does it raise your skepticism? Maybe it's not so much the post statistics as an underlying distrust of flamboyant experts, which IMO, is not entirely unjustified.

Don't get me wrong, being skeptical of doctors is very healthy. I just don't see how you can tell anything from the subjects of 58 forum posts. The quality of the content, OTOH, might be useful.

Wow man, chill out, you're really making this into something bigger than it is. Have you ever had a reaction to anything? I read ozij's post and had a simple human reaction. I didnt sit for the next hour doing calculations and try to 'tell anything from the subjects of 58 forum posts'. It was just a simple skeptical reaction.

I don't know about you, but everyday I see and hear things that make me smile, make me cringe, make me go 'hmmph', makes me happy, bring a tear, or whatever. They're all just reactions, I was not doing research and writing an essay on "An Analytical Study of Doctors Credibility Based on Numbers and Percentages of Forum Posts, Part 1" with references.

If you don't want anyone to make too much out of his 58 posts and come to any conclusions, then please don't come to any conclusions and make too much out of that one single post I made.

[So Well]

If you don't want anyone to make too much out of his 58 posts and come to any conclusions, then please don't come to any conclusions and make too much out of that one single post I made.

But Dr. Krakow won't argue with us in the forum and you will. A guy's gotta have fun some way.

I go with the earlier post that Krakow hasn't posted here in three years. Krakow is learning every day and I am sure his experience with, knowledge of, and opinion of ASV has evolved a great deal in 3.5 years.

Debating Krakow in this forum is like chasing a spirit. Now ameriken there we can get a good rise out of.

[ameriken]

If you don't want anyone to make too much out of his 58 posts and come to any conclusions, then please don't come to any conclusions and make too much out of that one single post I made.

But Dr. Krakow won't argue with us in the forum and you will. A guy's gotta have fun some way.

I go with the earlier post that Krakow hasn't posted here in three years. Krakow is learning every day and I am sure his experience with, knowledge of, and opinion of ASV has evolved a great deal in 3.5 years.

Debating Krakow in this forum is like chasing a spirit. Now ameriken there we can get a good rise out of.

Only my wife can get a good rise out of me.

[Otter]

If you don't want anyone to make too much out of his 58 posts and come to any conclusions, then please don't come to any conclusions and make too much out of that one single post I made.

I'm not drawing any conclusions about you. You did say that the subject ratio might mean nothing, and I was agreeing with that possibility. Sorry if I ruffled your feathers. That wasn't my intent.

I don't think the post ratio is cause for alarm, and I doubt you really do now that you've thought about it a bit. However, I wouldn't discard that gut reaction. You may have been responding to something else and hanging that on the ratio. Some people dismiss emotional reactions as illogical noise, but we use a lot more of our brains for emotion than logic. Logic, OTOH, gets less processing power but can be more focused. The two together are much more powerful than either one alone. If you still have the reaction after considering the weakness of the post ratio as evidence, it might be useful to try figure out what your gut is really trying to tell you. Or not. It's just a suggestion.

I wonder what Doc Krakow will think of the 7/58 ratio if he ever reads this thread.

[Guest]

PREAMBLE:

Thirty rough years of dealing with my wife's cancer, my own cardiovascular disease, etc. etc., has left me more knowledgeable on those subjects than I ever wanted to be . . . and a lot more skeptical about doctors motives.

Motive wise, I'd have to say that the majority of doctors I've met were businessmen first, and clinicians a distant second.

Thus, when faced with an important medical decision, I feel obligated to read the medical literature in detail, and get the best 2nd, 3rd, or even 4th expert opinions I can.

Then, I repeat the process if necessary, going back and forth to each doctor, and resolving conflicting opinions, gaps in the literature, and so forth.


I will like to know your opinion of Dr. Park. I was thinking of making an appointment to see him.
It will be a expensive for me since I have to fly to NY, but if he is good it will be worth it. Thank you



Yes, I have to trust . . . but I also damn sure verify.

Then I cross my fingers and hope I made the right decision.



___________________________________________________________________________________________________________

DR. KRAKOW

That brings me to Dr. Barry Krakow.

Dr. Krakow has posted here 58 times.

I've searched his posts, and was impressed with his writing skills, his depth of knowledge, and the progress he was reporting with ASV.



THE INTERVIEW

Recently, someone here posted an audio link, an interview with Dr. Krakow, conducted by Dr. Park, whom I've had the pleasure of meeting in person.

Listening to that interview, I grew increasing excited.

If I understood Dr. Krakow correctly, in the past 24 months he has used ASV, titrated with his specialized techs, to get spectacular results

I got the impression that his ASV therapy goes well beyond greatly reducing already treated OBAs and CTAs

It would seem to include fixing any partial obstruction of the airway, so that the flow curve appears completely normal.

Like you were born again.



I WAS STOKED

Nearing the end of his audio interview, I was sold.

I wanted to fly out to New Mexico and have a consultation, followed by a sleep study, a titration and a back rub.

As I listened, one of his call-in listeners seemed just as amped as I was. The caller excitedly concluded his questions by asking Dr. Krakow what kind of insurance he took.

Dr. Krakow flatly said: "Every kind".

That sealed the deal. All I had to do was cover my airfare from NYC, and stay at a reasonably priced hotel.

My GHI co-pay of $15 per procedure would be chicken feed.


A LITTLE SLASH OF COLD WATER

Then I went to Dr Krakow's website and was slapped back to reality a bit.

He expects full payment by credit card, before any consultation or sleep study. Then he'll file with your insurance company, and you'll get reimbursed what ever they reimburse.

That is miles away from accepting as payment whatever your insurance will pay.

Dr Krakow could have been honest during his interview . . . but choose not to be.


NOBODY'S PERFECT

Now, I've certainly seen worse misrepresentations.

A month ago, I made an appointment with a highly credentialed doctor at Columbia University.

He promised me over the phone that he was a GHI preferred provider.

At his office, I double-checked with his staff, yes, he was a preferred provider. They even accepted my two GHI co-payments of $15: one for his consultation and one for a femoral ultrasound.

Yesterday, I received a letter from GHI. He's not a PP, the ultrasound isn't covered . . . and I owe him around $1500.

I sure hope GHI is mistaken. Cause I don't plan to pay the good doctor a dime.



MEANWHILE, BACK AT THE KRAKOW RANCH

These two "events" put me in a bit more contemplative mood about Dr. Krakow.

In the literature, I've seen some other doctors report good results with ASV, but nothing like the panacea Dr. Krakow seems to feel it is.

In the Dr. Park interview, he didn't mention any studies he was planning to publish about his results with ASV.

He didn't mention his number of patients, or even give general statistics, like, say, 90% of patients reduced their VPAP AHI scores from "X" to "Y" while under his specialized ASV titration.

He spoke a lot about of his personal success with Auto BiPap, followed by his even greater personal success with ASV.

He may be a great doctor, and perhaps he's on the cutting edge of a revolution in SDB therapy.

Only time will tell. But for right now, all I can say with confidence is that he's a damn good salesman.

And that's said with true respect for good salesmen.


IF YOU'VE GOT THE SKINNY . . .

We have a lot of members at cpaptalk.

I'm guess some of you must have consulted with Dr. Krakow, or even made the trip to his practice in New Mexico.

If you have, could you please post about it here? If possible, please be specific about the results you achieved.

Again, no disrespect to Dr. Krakow, I know being a good salesman is an important part of having a successful medical practice.

But I'd like some more information before I'm, uh, sold.



Cheers and love to my fellow SDB compadres,

Mike