June 16th, 2010 by Davis Liu, M.D. in Better Health Network, Health Policy, Health Tips, News, Opinion, Research
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The Associated Press has been running a fantastic series of must reads with the latest article highlighting the consequence of too many imaging studies, like X-rays and CT scans, which are the biggest contributor to an individual’s total radiation exposure in a lifetime. Americans get more imaging radiation exposure and testing than people from other industrialized countries.
Reasons for doing too many tests include malpractice fear, patient demands for imaging, the difficulty in obtaining imaging results from other doctors or hospitals, as well as advanced technologies, like coronary angioplasty, which have increased radiation but avoid a far more invasive surgery like heart bypass. Read more »
*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*
June 14th, 2010 by StevenWilkinsMPH in Better Health Network, Health Policy, News, Opinion, Research
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In a recent article, the editors of the Archives of Internal Medicine make the case that too much unneeded care is being delivered in physician’s offices these days. According to the authors, “patient expectations” are a leading cause of this costly problem.
Their solution? Get physicians to share with patients the “evidence” for why their requests are crazy, wrong, ill-informed or just plain stupid. But getting patients to buy into the “less is more” argument is a daunting task as most physicians already know. The problem is complicated by the fact that patients have a lot good reasons for not buying it. Read more »
*This blog post was originally published at Mind The Gap*
May 25th, 2010 by Davis Liu, M.D. in Better Health Network, Health Policy, Health Tips, Opinion, Quackery Exposed, Research
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A patient brought in a flyer for Life Line Screening, where for $129 an individual can have their carotid (neck) and peripheral (leg) arteries screened for blockage, their abdominal aorta screened for aneurysm (swelling), and be tested for osteoporosis. The advertisement claims that “we can help you avoid a stroke,” and their logo notes “Life Line Screening: The Power of Prevention.”
Are these tests worth your money? Short answer: No.
Although the flyer correctly indicates that 80 percent of stokes can be prevented, the National Stroke Assocation does not recommend ultrasound as a screening test. Preventing stroke includes quitting smoking, knowing your blood pressure and cholesterol numbers, drinking alcohol in moderation (if already doing so), exercising regularly, and eating a low-sodium diet. Their is no mention of an ultrasound test. Why? Because there is NO evidence that it helps save lives in individuals who are healthy and have no symptoms (except for the following situations). Read more »
*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*
May 17th, 2010 by KevinMD in Better Health Network, Health Policy, Opinion, Research
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Let’s face it, the best way to cut healthcare costs is to say “no.” That means denying unnecessary tests that most patients in the United States are accustomed to having.
The New York Times‘ David Leonhardt has the best take on this issue that I’ve read. He acknowledges the difficulty of telling the American public “no,” and cites examples ranging from the breast cancer screening controversy to the managed care backlash in the 1990s:
This try-anything-and-everything instinct is ingrained in our culture, and it has some big benefits. But it also has big downsides, including the side effects and risks that come with unnecessary treatment. Consider that a recent study found that 15,000 people were projected to die eventually from the radiation they received from CT scans given in just a single year — and that there was “significant overuse” of such scans. Read more »
*This blog post was originally published at KevinMD.com*
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*
