I am smacking myself on the forehead and saying, “Why didn’t I think of this?” Dr. Richard Parker, Medical Director at Beth Israel Deaconess Medical Center, has sent out a list to his physician colleagues of 56 common medical tests and procedures. What is revolutionary is that there are prices next to each item. You non-physicians may be surprised to know that we doctors have no idea what the tests or drugs we order actually cost. Unless we get billed as a patient, we are as clueless as you are.
As I wrote before, the ostrich excuse just won’t fly any more. We all need to be aware of the cost of care and have skin in the game. Some will argue that price can’t be the only driver. I’ve heard physicians say you can’t compare one price to another because “quality” costs more. I say prove it. Read more »
*This blog post was originally published at EverythingHealth*
Over the long weekend I caught up on some reading. One article* stands out. It’s on informed consent, and the stunning disconnect between physicians’ and patients’ understanding of a procedure’s value.
The study, published in the Sept 7th Annals of Internal Medicine, used survey methods to evaluate 153 cardiology patients’ understanding of the potential benefit of percutaneous coronary intervention (PCI or angioplasty). The investigators, at Baystate Medical Center in Massachusetts, compared patients’ responses to those of cardiologists who obtained consent and who performed the procedure. As outlined in the article’s introduction, PCI reduces heart attacks in patients with acute coronary syndrome — a more unstable situation than is chronic stable angina, in which case PCI relieves pain and improves quality of life but has no benefit in terms of recurrent myocardial infarction (MI) or survival.
The main result was that, after discussing the procedure with a cardiologist and signing the form, 88 percent of the patients, who almost all had chronic stable angina, believed that PCI would reduce their personal risk for having a heart attack. Only 17 percent of the cardiologists, who completed surveys about these particular patients and the potential benefit of PCI for patients facing similar scenarios, indicated that PCI would reduce the likelihood of MI.
This striking difference in patients’ and doctors’ perceptions is all the more significant because 96 percent of the patients “felt that they knew why they might undergo PCI, and more than half stated that they were actively involved in the decision-making.” Read more »
*This blog post was originally published at Medical Lessons*
If it’s free, it’s for me. Especially if it’s an iPhone application to track medical procedures:
That’s why Dr. Shanti Bansal developed a free iPhone application — “app” in Apple-talk — that lets doctors keep a record of each case and which procedure, from a cardiac MRI to a biopsy, they perform. “The goal is to help physicians in training be the best physicians they can,” said Bansal, who practices at Yale-New Haven Hospital. “One of the reasons I came up with this is that I’m a cardiologist and in cardiology we do a lot of procedures. I lost track of hundreds of procedures during my first and second year” of residency. Now, in about 30 seconds, each procedure can be entered into the iPhone.
Here’s the link to ProcedureTracker.com.
-WesMusings of a cardiologist and cardiac electrophysiologist.
*This blog post was originally published at Dr. Wes*