Wednesday, December 17, 2014

Oh, those spendy ultrasounds

Doctors love to order ultrasounds--they don't hurt, don't impart radiation, aren't noisy and cramped, don't require disgusting prep, and therefore people will do it (some people, read on) and they can charge some completely arbitrary and huge amount for a machine that is at the low end of cost for the hospital or office.

Elizabeth Rosenthal, NYT, Dec 15, 2014, wrote about a guy who had two echocardiograms--an ultrasound of the heart. One was at a community hospital, the other at a big-woo medical center in Boston. Weirdly, the Boston one, three times as long complete with cardiologist on call, was $1,400. The one in the little hospital was $5,500.

Whew. Crazy Time!

Testing is a profit center, the article stated. Boy howdy, do I agree.

I had an echo once in the doc's office--don't remember what the purported charge was--but it was no big deal. The guy in the story paid $80 on $500 (Medicare).

One doctor said the threshold for ordering an echocardiogram is for the patient to have a heart.

The guy also got the first echo because he was undergoing cataract surgery--that is not even advised--cataract surgery is not total anesthesia. He also had no heart symptoms and was given to long walks.

Another doc in the article said some docs think, I have paid for this machine, the patient is insured, might as well use it.

This is not to say that all ultrasounds are unnecessary--you have to bore in a little and see how dedicated the doctor is to this test. Certainly the ones of babies are exciting!

I was ordered to get an ultrasound of my kidneys recently--I had a cyst 20 yrs ago. When I called for the appt they asked my weight. I said why. They said their table had limits. I said what is the limit? They said 600 lbs. This irritated me so much--this has to be a routine question? I did not get it! Maybe I am endangering myself...but come on!

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