How much healthcare is too much?
When you’re feeling ill, what's the first piece of advice you get from a friend, co-worker or spouse? I bet I have a pretty good guess – "You need to go to the doctor [insert name here]!" We all rely on physicians for their healthcare knowledge – far beyond what the regular Joe has – and turn to them for any and every ailment in the book. While the internet can be a useful health resource, it can also lead to misdiagnoses and even depression. Most people regard their doctor as the ultimate trusted resource, but the cost of face-to-face healthcare is outrageous. In the end, is going to your physician always worth it?
I recently read a disheartening article from The New York Times illuminating the fact that doctors have absolutely no clue what tests, scans, surgeries, etc., actually cost the patient and insurance company. This one quote made it ever so clear "…Most physicians enter practice with little sense of how to make the most cost-effective choices for patients, or how their own decisions affect the patient's – and the nation's – medical bills." Since 2007, the AAMC has required residency programs to teach doctors cost considerations and risks, but in a recent survey only 60 percent of medical schools are doing so.
On top of that, tests that doctors commonly order to diagnose a problem could be extremely harmful when overused. Radiation from the CT scans done just in the year 2007 will eventually cause 15,000 extra deaths, researchers reported in The Archives of Internal Medicine.
To me, one of the key steps to healthcare reform starts with the doctor. It starts with education on costs, risks and benefits of various health procedures. After all, we rely on (and pay) our doctor to make a decision that's in our best interest so we aren't subject to superfluous care. But when, how and ultimately who will hold doctors accountable?
Comments
I read the NY Times article as well, and while I agree that doctors are hugely responsible for understanding the costs, risks and benefits of these tests, it a lot of cases, these physicians are practicing defensive medicine. Defensive medicine is one of the largest contributors to wasteful spending in the healthcare system. Why? Because doctors don't want to be sued. The fear of a malpractice suit is hovering over these physicians every single day. In a 2009 Gallup poll, 73% of physicians agreed that they had practiced some form of defensive medicine in the past 12 months. In the same poll, physicians estimated that 26% of healthcare costs are directly tied to defensive medicine...if that's accurate, that means that between $650 billion and $850 billion is spent a year on unnecessary tests, procedures and treatments simply because doctors need to protect themselves from frivolous lawsuits.
If we want to look at cutting back these costs, we all need to play our part. Physicians need to better understand the costs and risks of these procedures, but there also needs to be some protection so if they decide they are unnecessary, they're not going to be sued six months down the road. Patients need to ask questions and understand why a test or procedure is being ordered. And we all need to lay off the lawsuits. Yes, there are cases of medical malpractice. And yes, these doctors deserve to face grave consequences. But when 40% of malpractice cases don't even involve a medical error (according to the New England Journal of Medicine), we're all accountable.
Lesley,
All very good points. Doctors seem to always be fearful of malpractice suits. And they pay out of their own pocket a heck of a lot of money for malpractice insurance. It's unfortunate and I agree 100% that people need to layoff the lawsuits when it's not tied to medical error. The most shocking thing to me was the simple lack of knowledge that doctors have when it comes to the cost of procedures. I'd hope medical schools do a much more thorough job in the future to educate physicians on the cost of procedures - so they realize how much it actually ends up costing. I feel like that should be weighed in the decisions just as heavily as health risks and benefits so they can make the right decision. In the perfect world, doctors shouldn't feel like they must practice defensive medicine because that can be costly to the patient's wallet and health in the long term. I think accountability should start with medical schools and physicians, but patients should also be more aware so they know to ask the right questions (and know when lawsuits are actually appropriate!)
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