Thursday, September 29, 2011

Docs may overdo it--they admit it

According to a survey of primary care physicians in Archives of Internal Med (Sept 26), many believe they provide too much medical care—and that malpractice reform and realignment of financial incentives would prevent this.

What the US pays per patient is twice that of the average industrialized country.

A large part of this is unnecessary.

Six hundred twenty-seven doctors were surveyed.

Nearly half—42%--said they were providing “too much” care.

Twenty-eight percent said they were more “aggressive” than they would like.

Why? Well, three-quarters said to protect themselves against lawsuits. Clinical performance measures, said 52%, made them do more than strictly necessary.

Doctors believe they are paid to do more and exposed to punishment if they do less.

You know what frosts me—when they do these big expensive things, such as MRIs, then don’t send the results to other specialists and these are repeated—and patients just go along, la-de-dah, my doctor must really care about me—ANOTHER MRI, my my.

A doctor asked to comment on this study said longer time with patients and increased communication could substitute for excessive testing. The patient would feel cared for at less expense.

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