Monday, February 27, 2006

If your doctor seems puzzled or therapy doesn’t work, forge on

….According to a story by David Leonhardt in the NYT (Feb 22, 2006), autopsies show docs are wrong about 1 time out of 5 when it comes to what ails ya.

…This 20% error rate is unchanged since the 1930s and apparently all the MRIs, CT scans, PET scans and lab tests developed in that time have not cut the rate.

…The NYT speculates that this is because there is no bonus for a correct diagnosis. Medical personnel get paid right along to run the tests, do the surgery, and talk to the patients.

…There is also no penalty for failure. Docs don’t go down with their planes like pilots do. Understandably pilots have demanded more studies of crashes and more programs to eliminate them.

…HA thinks the hassled and scattered nature of the medical system is also to blame. Tests may be run, but the results sit around in piles for weeks. Many docs don’t seem to have a spare sec to really focus on the individual patient; think about that patient’s history, symptoms, and test results; and really brainstorm—if only for 5 minutes—what might be wrong. It might be more than one thing!

…In addition, at least out here in AZ, primaries and specialists don’t seem to get their heads together and discuss a patient.

…It’s not an intention problem or education problem, so much as a procedures and overload problem.

….What do you think?

…A friend of HA’s who read this story told her that she decided to dump the dermatologist who had not helped a rash for two years and try another one.

…It’s your body, not the doctor’s. Has HA mentioned this before?


Bill Thomasson said...

HA says, "…In addition, at least out here in AZ, primaries and specialists don’t seem to get their heads together and discuss a patient. ...

... What do you think?"

I think that this is one of the unrecognized advantages of HMOs. The referral system at least means the primary always gets a report of the specialist visit. That was more the exception than the rule in the days when I had fee-for-service insurance.

Star said...

I remember doctors calling each other and saying I am sending over Mrs. Jones, etc. Now they don't even know each other. When you need a specialist, they stick a pin in the list. I had one guy refer my sister to an orthopod because that doctor had once wrapped his own ankle in an ER. We checked on the guy and he had a claim against him for operating the wrong leg on someone. Our doctor didn't know this! Didn't docs used to get referral fees--at least they knew each other enough and sucked up enough to get the fee.