July 27th, 2010 by GarySchwitzer in Better Health Network, Health Policy, News, Opinion, Quackery Exposed, Research
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Kudos to Christopher Snowbeck and the St. Paul Pioneer Press for digging into new Medicare data to report that the state the newspaper serves is out of whack with the rest of the country in how many expensive MRI scans are done on Minnesotans’ bad backs.
Snowbeck artfully captures the predictable rationalization and defensive responses coming from locals who don’t like what the data suggest. Because what they suggest is overuse leading to overtreatment. So here’s one attempt a provider makes to deflect the data:
“The Medicare billing/claims data, which this report is generated from, would not capture conversations between a patient and provider that may have addressed alternative therapies for lower back pain,” said Robert Prevost, a spokesman for North Memorial Health Care. “It’s important to recognize the limitations of this data.”
No, data don’t capture conversations. But wouldn’t it be fascinating to be a fly on the wall during those many patient-physician encounters that led to an MRI to see what level of truly informed shared decision-making (if any) took place? Read more »
*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*
June 22nd, 2010 by Davis Liu, M.D. in Better Health Network, Health Policy, News, Opinion
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Boston Celtics basketball player Kendrick Perkins injured his knee during the NBA Finals against the Lakers when he landed awkwardly. Unable to weightbear, he left Game 6 not to return for the following pivotal Game 7.
Based on his mechanism of injury and his physical examination, his trainer reported that he tore his medial collateral ligament (MCL) as well as the posterior cruciate ligament (PCL). More amazingly, this was done without the help of a MRI. Since Perkins was unable to play the final game, there was no urgent medical need to expedite the test, as regardless of the result his season was already done.
How do doctors know what’s wrong without X-ray vision or an imaging test? (Note that Perkins did get a X-ray, but X-rays generally don’t show ligament injuries.) Is it guessing? Read more »
*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*
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*