June 8th, 2010 by Davis Liu, M.D. in Better Health Network, Health Policy, News, Opinion
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The Associated Press recent article “Overtreated: More medical care isn’t always better” reiterated a commonly known fact which is not understood by the public. This problem of doing more and yet getting little in return is a common issue which plagues the U.S. healthcare system and was illustrated quite convincingly by Shannon Brownlee’s book. Americans get more procedures, interventions, imaging, and tests but aren’t any healthier.
In fact they are often worse off. Too many unnecessary back surgeries. Too many antibiotics for viral infections, which aren’t at all impacted by these anti-bacterial therapies. Too many heart stents which typically are best used when someone is actually having a heart attack. Research shows that those that are treated with medications do just as well. As all patients with cardiac stents know, they also need to be on the same medications as well.
Eliminating unnecessary treatments is a good thing, particularly when it is based on science. Read more »
*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*
April 18th, 2010 by DrWes in Better Health Network, News, Research
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Thanks to the wonders of magnetic resonance imaging (MRI), amazing images of “heart strings” — the muscle fiber orientation of the left ventricle of the heart — have been obtained. According to the University of Oxford:
The image was produced using a branch of magnetic resonance imaging (MRI) called diffusion tensor imaging (DTI). The technique tracks the diffusion of water throughout the myocardium (the heart’s muscular wall comprising interconnected sheets of muscle cells called myocytes). Due to the way the myocytes are organized, the movement of water is restricted, so tracking the location of water molecules can reveal valuable information about the structure of the heart in a non-invasive way.
Nice.
-WesMusings of a cardiologist and cardiac electrophysiologist.
*This blog post was originally published at Dr. Wes*
March 31st, 2010 by RyanDuBosar in Better Health Network, Health Policy, Opinion, Primary Care Wednesdays, True Stories
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Congress controls the nation’s purse strings. It can tell the Executive Branch how to spend money. It can regulate all commerce, and by the way, to Congress everything is “commerce.”
Congressional legislation can incent economic behavior–pay for this, but not for that–but it can’t change personal decisions. A case in point is Dr. Robert Cantor, ACP Member, of Boca Raton, Fla., who says he authorizes the tests that his patients demand. His opinion? “I do the damn test.”
He says there’s little incentive not to order tests and little in healthcare reform to make him and others change their habits. More likely is the idea that, once new medical technology is invented, it will find a use.
Another article compiles a wide spectrum of ideas on how to reduce healthcare spending. Tort reform was one, sure, but many doctors focused on changing patient behavior first.
*This blog post was originally published at ACP Internist*
March 25th, 2010 by KevinMD in Better Health Network, News, Opinion
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It’s well known that the use of imaging scans, like CTs, MRIs and PET scans, have been growing at an alarming rate. But a recent study provides some stark numbers. According to a recent CDC report, “MRI, CT or PET scans were done or ordered in 14 percent of ER visits in 2007.” That’s four times as often as in 1996. Although a physician called that growth “astounding,” it’s really no surprise.
Emergency departments are becoming more crowded, and with patient satisfaction scores becoming more influential in financial incentives for physicians, sometimes just ordering a test is the path of least resistance. Factor in the spector of defensive medicine which, according to a survey from the Massachusetts Medical Society, accounts for up to 28 percent of tests ordered, it’s a wonder that more scans weren’t ordered.
Imaging scans are a clear cost driver in healthcare, contributing $12 billion to Medicare’s bill. But costs won’t resonate with patients requesting the tests or the doctors ordering them. One encouraging sign is the recent trend of publicizing the harms of scans, like radiation from CTs. I’m finding that patients are becoming increasingly aware of the risk, and making a more informed decision after I explain it to them. It’s a small step forward.
*This blog post was originally published at KevinMD.com*
