I enjoyed reading this short article, and I think his suggestion of adding a new dimension-- "cost-conscious care and stewardship of resources"-- is definitely an important and increasingly relevant one. If this responsible stewardship of medical resources isn't taught and practiced during med school and residency, I suppose it isn't fair to expect MDs who complete their residency to suddenly just be able to shift gears and adopt a cost-conscious approach.
But I really wish the author would have made a better effort to recognize/address the conflict between being cost-conscious and practicing defensive medicine to avoid malpractice litigations. The example he cited was that residents are encouraged to order "thoroughly diagnostic work-ups," perhaps at times ordering more than what's actually necessary... I would submit that sometimes even if the providers wanted to be cost-conscious and cut back on the number of tests/procedures, the system doesn't recognize/reward that behavior. Instead, they may very well be penalized.
This article does point out how additional testing and the behavior of practitioners can impact overall healthcare costs. The article does not do a good job of explaining why practitioners order additional tests. We live in a very litigious society where not providing a test can result in a law suit. Anyone entering the field of medicine is aware of the dangers of malpractice and they become increasingly aware the longer they spend in the field.
Cost conscious care cannot exist in a vacuum, all of the factors that go into decision making must be addressed. It is easy to say that providers must be more responsible but, I feel that is just talk if the real fear is being sued and perhaps even losing your license if you don't order the right tests.
Beyond malpractice; or perhaps alongside it, are the patients who are utilizing many tools available to them in multimedia to be informed consumers. The advent of WebMD and Dr. Oz are also influential in patient-provider relationship and decision making.
I enjoyed reading this short article, and I think his suggestion of adding a new dimension-- "cost-conscious care and stewardship of resources"-- is definitely an important and increasingly relevant one. If this responsible stewardship of medical resources isn't taught and practiced during med school and residency, I suppose it isn't fair to expect MDs who complete their residency to suddenly just be able to shift gears and adopt a cost-conscious approach.
ReplyDeleteBut I really wish the author would have made a better effort to recognize/address the conflict between being cost-conscious and practicing defensive medicine to avoid malpractice litigations. The example he cited was that residents are encouraged to order "thoroughly diagnostic work-ups," perhaps at times ordering more than what's actually necessary... I would submit that sometimes even if the providers wanted to be cost-conscious and cut back on the number of tests/procedures, the system doesn't recognize/reward that behavior. Instead, they may very well be penalized.
Thoughts?
This article does point out how additional testing and the behavior of practitioners can impact overall healthcare costs. The article does not do a good job of explaining why practitioners order additional tests. We live in a very litigious society where not providing a test can result in a law suit. Anyone entering the field of medicine is aware of the dangers of malpractice and they become increasingly aware the longer they spend in the field.
ReplyDeleteCost conscious care cannot exist in a vacuum, all of the factors that go into decision making must be addressed. It is easy to say that providers must be more responsible but, I feel that is just talk if the real fear is being sued and perhaps even losing your license if you don't order the right tests.
Beyond malpractice; or perhaps alongside it, are the patients who are utilizing many tools available to them in multimedia to be informed consumers. The advent of WebMD and Dr. Oz are also influential in patient-provider relationship and decision making.