HealthCareDive considers a recent survey of physicians that found that they believed that 20% of care is unnecessary. Here’s the quick summary:
- A survey of 2,106 U.S. physicians found that, on average, they believe 20.6% of medical care is unnecessary, including 22% of prescriptions, 24.9% of tests and 11.1% of procedures.
- An overwhelming majority (84.7%) attributed overtreatment to fear of malpractice, according to the study in Plos One. Other oft-cited reasons were patient pressure (59%) and difficulty accessing medical records (38.2%).
- More than seven in 10 respondents said there is a chance profit encourages overtreatment, and most believed less fee-for-service reimbursement would reduce overutilization.
Maybe it’s time to start asking the ancient question about our system: cui bono? Who benefits? Hint: if you perform an analysis of our system based on marginal costs and marginal benefits, the primary beneficiaries of our system are not patients.
I have participated off and on at a number of medical blogs. It still amazes me how many physicians believe that neither they nor other physicians are influenced by money. It is not hard to see if they just look around. I may be a little more sensitive to it since we have taken over several smaller hospitals and made them functional again. Very disappointing to see how many of these small places are run for the benefit of the staff and to maximize their own incomes.
Steve
What, they think they would have gone into medicine if it had paid $50,000 a year?
IMO our health care system is organized so as to benefit politicians, lawyers, insurers, providers, and patients, pretty much in that order.
50k and trying to pay backing 300k in loans would be tough. The thing is, there have always been people who chose medicine to safely make a good income, but there have always been some who saw it as a career or calling and didn’t have much idea about what they would really make. If you paid attention, you figured that out in the first few months of med school. You have to be in denial to not acknowledge that both types existed.
Steve
In my experience most career pursuits involve a healthy motivational distribution among financial reward, intellectual stimulation, calling and self worth. Not so in, say, fast food work or sorting tomatoes. But most pursuits. Otherwise you have the also-rans and time servers.
I have a pertinent story.
At 55, I had my first mammogram. The mammogram showed small abnormalities — really tiny calcifications layed under the skin of the nipples. The doctors said those calcifications could be evidence of developing cancer. I checked with a surgeon and learned that a biopsy would entail slicing under the nipples, scooping tissue out, then reattaching the nipples.
That called for a second opinion. I called a doctor in Baton Rouge. That doctor didn’t do biopsies, and directing me to who she thought was the best practitioner in that area. He happened to be a man and a surgeon. He explained almost exactly the same procedure as the first. My question was, since this was a first mammogram, why din’t we wait and observe for a year or two to see if there was further development of these spicules.
That wouldn’t do. No, the risk was too great that Paget’s Disease might develop quickly. So I scheduled and underwent surgery. Excision of both nipples. The biopsy was negative. There was some suspicion that I had had something called Ziska’s disease. Which, if he had told me the symptoms of, I could have confirmed.
So tell me that’s not money.
The procedure itself was painless, and the surgeon did an excellent job. The surgery was just unnecessary at that particular time.