Wednesday, July 7, 2010
Healthcare Dollars: Part 1 of 2
Here are a couple of interesting MSNBC articles....one about over-testing, and the other about over-treating. Both articles claim that we waste billions of dollars every year by over-testing and over-treating patients. Well....no shit Sherlock! Here are my takes on the subjects.
Part 1 OVER-TESTING:
Yes....we over-test a lot. It is called defensive medicine. But it is not JUST because we are afraid of getting sued. Nobody wants to get sued. I am sure it totally screws with your head. Just having to present in M&M conference in residency would fuck up my head for weeks. No doctor, especially ER doctors, want to miss something. In the ER you margin of error is supposed to be zero in the few minutes you have with a patient.
I am in a tort reform state, and lawsuits being capped has not slowed me or any of my colleagues down in our testing. We don't think..."Oh well, now I can only get sued 200k for this patient so I might as well send him home and risk it." No....its that WE DON'T WANT TO GET SUED PERIOD. We don't want to screw up. We don't want to miss things. There has to be a balance in the testing. But it seems as soon as we don't order that "unnecessary" test...we get screwed.
---side note...why do other docs (not me b/c I don't), order so many damn UAs??? You don't have to order a urine test for every ER patient guys).
Patients want to be tested. I don't know how many times I have heard, "But you aren't going to test my blood?" from a patient. No genius, I don't need to order blood work to see that you have cellulitis. I don't need a CXR or blood work to see that a 35 year old patient with no fever and who looks good has bronchitis. But try explaining that to a patient. They will either doubt you, or you will explain it soooooo many times throughout your practice that you will get so sick of explaining it and just order the damn tests.
So if you want to lower costs...don't just give us tort reform BUT protect us from being sued period (unless it involves complete breaching what a reasonable physician would do or if we act outright dangerously). THEN we can practice evidence based medicine. But you are going to have to protect us first.
Posted by SerenityNow at 9:06 PM