Defensive Medicine Elevating Health Care Costs


I’m one of those people who tries not to go near a doctor unless I’m bleeding or broken in some way. I was raised in the day when house calls were normal and I detest with a passion beyond purple the bureaucracy and indifference typical of the “modern” physician’s office. At the same time, however, I do realize that these people really can’t practice medicine as they might choose to because they’re too frightened of legal action, namely malpractice suits.

I also realize that the more of that kind of thing that goes on, the higher the cost of health care and the higher the cost of our health care insurance premiums. This opinion has only been bolstered by the results of a study released earlier this month by the Children’s Hospital of Philadelphia that convincingly proves the prevalence of what is now being termed “defensive medicine.”

Seventy-two orthopedic surgeons agreed to participate in the study and rate the reasoning behind the tests they ordered for 2,068 mainly adult patients. They worked with these people in a range of medical settings from emergency rooms to regular office visits. When the numbers were crunched, 20 percent of the total tests ordered were done so because in some way the patient seemed to want them or otherwise raised a red flag of potential “trouble” with the doctor.

It gets a little scarier when it’s broken down by individual test. Eleven percent of x-rays weren’t necessary, 39 percent of MRIs, 33 percent of CAT scans, 57 percent of bone scans, and 57 percent of ultrasounds. And never mind the cost on the MRIs and CAT scans. Those suckers come with a nice hefty dose of radiation as an added bonus. So what I want to subject myself to because I’m not sure the doctor who has seen 10,000 torn ligaments knows what he’s talking about when he looks at my knee and makes a diagnosis.

Now, understand, I am the original medical skeptic. But this problem is so potentially out of hand, the Obama administration has proposed alterations to state laws to in some way put a cap on malpractice suits. There has to be a decent balance between policing bad doctors and scaring the good ones to death. These are the kinds of studies that really reveal the complexity of health care reform in the United States. There is no on single problem, but a myriad of inter-related problems that all have to be addressed before the whole is going to get better.

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