Musings of an Orthopedic Surgeon: Cost containment in health care... it is possible, and *WE* can make a difference! #hcr #hcsm
… via online.wsj.comGreat interview in the WSJ. Becker articulates in simple language why he believes the recent health care reform (health insurance reform) bill was a “bad bill.”
I think the final paragraph I highlighted speaks to the number one issue we face, cost. Costs will..
Amen. Patients have traded an education for the seemingly infallible MRI. Doctors “give the patient what they want (the MRI)” and there is no progress, no new understanding of their condition, no discusion that puts things into context.
Everyday I discuss MRI results with patients. Everyday I get patients that say “but doctor, the MRI report I read said I had a partial tear in my rotator cuff? Don’t I need surgery? What are you going to do about that? And everyday I labor to try to explain the report in context. I tell them about the sensitivity and specificity of the test (in the best lay language that I can). I tell them that if I operate on every patient with a reading like theirs I would literally be operating on everyone because just about every normal MRI I see in someone between age 35+ says “tendinosis, possibble partial thickness rotator cuff tear.”
Could I easily talk a patient into gettibg a surgery on this with those words so clearly in black and what? Sure. Should I? No way. But in some ways patients actually put more stock in the MRI than the professional opinion, than a discussion about the natural history of their condition or sensitivity and specificity of MRI’s. When it’s free and high tech, they want it and they deserve it. And why should doctors waste their precious time convincing them otherwise?
…because it’s the right thing to do.
