Medical costs and unnecessary medical procedures and tests

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Thursday, May 7. 2015

Medical costs and unnecessary medical procedures and tests

It's an excellent article by a physician: Overkill -An avalanche of unnecessary medical care is harming patients physically and financially. What can we do about it?

A major omission, however, is the topic of lawsuits. No physician wants to be asked on the stand something like this: "Doctor, you have testified that in your opinion Mrs. Jones had the symptoms of ordinary migraine headache and did not need an MRI. We have an expert witness who says he always orders an MRI for headaches...."

This topic gives me a headache. The fact is that rigid "best practices" combined with lawsuit avoidance diminish physicians' use of their judgement, flexibility, experience, and more.

Posted by Dr. Joy Bliss in Medical at 15:06 | Comments (11) | Trackbacks (0)

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Unnecessary hospitalizations could be another addition to the list. Doctors dump patients on hospitals to cover their butts (I don't blame them with the lawsuits-gone-crazy)...even if this patient has no insurance or medicaid.

This adds to the growing cost of medical care, too.

#1 MissT on 2015-05-07 15:38 (Reply)

control the debate by controlling the parameters. here we are to assume that docs don't make mistakes and / or that negative results are indicia of unnecessary tests.

order the MRI.

that expert testifying against you is an MD, one of your own.

#2 Donny "The Bear Jew" Donowitz on 2015-05-07 17:17 (Reply)

Such are the fruits of a profession that's been crowing for far too long that it's god's gift to mankind and only it has the very special gift to cure all that ills man. You know, its "...judgement, experience and more." Too many physicians see themselves as and present themselves to the public as demigods. Note that Joy Bliss can't be simply Joy Bliss: she's DR. Joy Bliss. The medical profession is currently, and for far too long, nothing more than a cabal of quacks relying on best guess. "Modern, scientific medicine" ... what a cruel joke. There's a reason it's called "practice."

The public has awakened to the fraud. If a physician's judgement, experience and more cause harm to the patient then the first thing to happen is that he lose his license and banned from ever practicing again. Secondly, he should seek employment stacking cans in a grocery 'cause that's all his judgement, experience and more is good for.

#3 Sven Svenson on 2015-05-07 22:10 (Reply)

Are there unnecessary procedures being done? Of course there are but all this new concern about it is because of the government takeover of healthcare. This is how it works in all those "free" healthcare countries...you just don't get treated if they decide they don't want to treat what you have. They have to pull this bullshit with us because we're not use to being denied things...yet.

#4 Robert Sendler on 2015-05-07 22:20 (Reply)

"Such are the fruits of a profession that's been crowing for far too long that it's god's gift to mankind "

I was sitting at my desk a hour ago when I got a call from a woman I had operated on for melanoma 30 years ago. She found my number on Google and was amazed I answered the phone. The fact that I am 78 and long retired did not seem to affect her. She had a recent breast biopsy and wanted my opinion on what she should do. I told her and we had a nice visit on the phone.

I don't know if she thinks I am "god's gift to mankind" but I wonder if you have ever gotten a call like that. I spent the morning with my medical student group that I drive to Los Angeles every week to meet with. Do you do anything like that ?

Just wondering. I gave up the god complex decades ago.

#5 Mike K (Link) on 2015-05-07 22:43 (Reply)

Since I'm not in the business of medical practice, of course I don't advise former patients. But I have gone to extra ordinary lengths to help friends and strangers. Such actions require no special recognition. They're simply being civil.

Of course, since you gave up the "god complex" proves my point as you confess you did, at one time, posses it. Welcome back to the human race.

#5.1 Sven Svenson on 2015-05-08 08:46 (Reply)

I suspect that on the legal issue involving costly law suits that there is more fraud then there is legitimate medically caused harm. It would be a good thing to replace the current system of expensive lawsuits and often punishing judgements that only hurt our health care system. Instead cases should be decided by a panel of experts and legitimate victims should receive actual costs and reasonable awards without the expense of lawyers.

A patient should be able to decide along with their doctors what tests and treatments are appropriate. Also a insurance company should be able to set the payment limits and types of treatments that their insurance covers. The legal system and the government should not enter into this process.

#6 GoneWithTheWind on 2015-05-07 23:06 (Reply)

Malpractice law suits do not require error, just unwanted result. Of course there is always error too, in life.

#6.1 Bird Dog on 2015-05-08 06:58 (Reply)

as someone who has tried and defended medmal cases, I know that docs lie and cover up and will always see themselves as Deputy God (Lance-God?) until the day they die; and I know that plaintiffs lie and lie and lie when they're not merely exaggerating.

there are two answers here. to win a case a trial, you have to show the doc or other medical professional was negligent or somewhere in the proximate causal chain.

but anyone can sue anyone for anything. I have contemplated a federal suit against this website for failure to provide software that automatically capitalizes initial words in sentence. the ability write and file a complaint doesn't guarantee either a settlement or trial win.

in medmal cases, whether a case settles or not depends on how each side evaluates the merits. evaluation consists of, among many things, exposure vs likelihood of winning/losing. up until the jury decides (if it ever does), there is only the potential of malpractice, the concept is like Schrödinger's cat, liable / not-liable is a state in superposition, you don't know until the jury decides.

of course the docs are going to say they aren't liable. of course the plaintiff is going to say they are. because liability is a legal determination, and because the jury decides the facts, a case settles because neither side wants to roll the dice. so they negotiate a deal.

pure American capitalism.

#6.1.1 Donny "The Bear Jew" Donowitz on 2015-05-08 12:30 (Reply)

After decades of health I have in the last ten years undergone numerous surgeries some of them serious surgeries. My wife holds the medical power of attorney/medical directive. I told her if I am in a coma or worse to give it a chance but in the end I don't wwant to live like that. BUT I also told her no matter what I do not want her to sue the surgeon or hospital. I simply do not believe that doctors and other health professionals go into this to cause harm. I do believe humans can make mistakes. I certainly hope a doctor does not make a mistake while he has his hands inside my chest. But if he does and I die or live with problems caused by his mistake I do not want to sue. I love my doctors and nurses, I would prefer to forgive their mistakes and do what ever must be done to fix it.

#7 GoneWithTheWind on 2015-05-09 17:21 (Reply)

I told my pulmonologist that I was not having a bronoscopy. He'd already scheduled it and I'd arranged for time off work. He argued with me about it last visit and even sent me a registered letter telling me all sorts of dire things, up to lung transplants would happen if I didn't do this.

I have bird fanciers syndrome. I had some things stored in my home office that had been in the garage with the birds, but were moved in before I was diagnosed. I had a reaction to the bird dander, when I moved some things around. I told him all of this but he wanted more testing because the ground glass effect showed up in my lungs again.

I convinced him to treat it the same way we originally did. (Prednisone is the only treatment for this stuff). And this time, he wanted me to take calcium. He didn't talk about adrenal support, which I am doing on my own. My O2 levels are good and I'm tapering off the steroids again. I am going to refuse to have the CT scan with dye injected into my lungs too.

The recent visit and CT scan cost me a thousand over what my insurance paid. The bronoscopy would have been much more expensive. He's a good doctor but this has confirmed my belief that doctors and clinics want procedures to confirm what they already know.

#8 Teri pittman on 2015-05-09 17:26 (Reply)

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Thursday, May 7. 2015

Medical costs and unnecessary medical procedures and tests