September 9th, 2010 by KevinMD in Better Health Network, Health Policy, News, Opinion, Research
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Nothing polarizes the heath care debate more than defensive medicine. A recent study from Health Affairs will only add more fuel to the fire.
Here’s what I wrote a couple of years ago in USA Today: “When you consider that rampant testing is a major driver of escalating health care dollars, addressing defensive medicine should be a primary goal of cost containment.”
Is that still true? Well, yes and no. Read more »
*This blog post was originally published at KevinMD.com*
August 3rd, 2010 by Dr. Val Jones in News, Opinion
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I received this press release and was depressed by the prevalence of lawsuits filed against doctors in this country. More than 40% of physicians are sued at some point in their careers, and the vast majority of these suits are found to be meritless. If that doesn’t make you want to quit practicing medicine, I don’t know what does.
This kind of litigious climate definitely adds to my stress levels — and makes me fearful of caring for very sick and fragile patients who are likely to have poor outcomes, regardless of what I do. Many of my colleagues practice medicine with one eye always looking over their shoulder, wondering when that one bad apple will take them to court in an attempt at a financial windfall.
In Canada, those who bring frivolous lawsuits to court are responsible for all legal costs. Read more »
July 5th, 2010 by KevinMD in Better Health Network, Health Policy, News, Opinion, Research
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Emergency physicians are in a dilemma. Risk missing a diagnosis and be sued, or be criticized for overtesting.
Regular readers of this blog, along with many other physicians’ blogs, are familiar with the difficult choices facing doctors in the emergency department.
The Associated Press, continuing its excellent series on overtesting, discusses how lawsuit fears is a leading driver of unnecessary tests. Consider chest pain, one of the most common presenting symptoms in the ER:
Patients with suspected heart attacks often get the range of what the ER offers, from multiple blood tests that can quickly add up in cost, to X-rays and EKGs, to costly CT scans, which are becoming routine in some hospital ERs for diagnosing heart attacks …
… and the battery of testing may be paying off: A few decades ago insurance statistics showed that about 5 percent of heart attacks were missed in the emergency room. Now it’s well under 1 percent, said Dr. Robert Bitterman, head of the American College of Emergency Physicians’ medical-legal committee.
“But you still get sued if you miss them,” Bitterman added.
The American Medical Association’s idea of providing malpractice protection if doctors follow standardized, evidence-based guidelines makes sense in these cases. Furthermore, it can also help reduce the significant practice variation that health reformers continually focus on. Read more »
*This blog post was originally published at KevinMD.com*
June 14th, 2010 by EvanFalchukJD in Better Health Network, Health Policy, Opinion, Quackery Exposed
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Some things are just part of the problem in healthcare. The company Medical Justice is one such thing. I’ve written about them before. Medical Justice sees the medical malpractice crisis and devised a solution: Muzzle the patients. It’s as misguided as it is ridiculous.
Medical Justice says doctors need to stop their patients from saying bad things about them. They charge doctors hundreds — even thousands — of dollars a year to help do this.
Under one of their programs, they give doctors contracts to use with their patients. The doctor tells the patient that they must agree to the terms of the contract before the doctor agrees to see them. Okay, so there are lots of forms that patients need to sign when they go to the doctor. What makes these so different? Read more »
*This blog post was originally published at See First Blog*
June 7th, 2010 by DrWes in Better Health Network, Health Policy, Opinion
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When I started medical school, if someone had told me that providing healthcare to my patients would be grounds for a Department of Justice inquiry into the care I delivered, I would have laughed in their face. But the government’s desperate financial times require desperate measures. From the Report on Medicare Compliance:
Both the Department of Justice (DOJ) and the Recovery Audit Contractors (RAC) are focusing investigations on Medicare billing for implantable cardiac defibrillator (ICD) surgery. The reimbursement rate for ICD surgery is one of the higher dollar Medicare Severity Diagnosis Related Groupings (MS-DRG). The DOJ’s investigation is focusing on both medical necessity and MS-DRG coding validation issues, while the RACs are currently only conducting MS-DRG validation reviews. According to the CMS national coverage determination (NCD), Medicare pays for ICD implantation for eight specific conditions. However, there are many circumstantial limitations to coverage in these conditions that often lead to CMS not covering the implantation. Read more »
*This blog post was originally published at Dr. Wes*
