This excellent investigative journalism from The Atlantic confirms my observations in a long medical career. Please take a few minutes and read it. Too much surgery is not based on evidence and greed often drives it. I hope you will think about this piece and comment.
I'm glad to see this article is a widely read outlet like The Atlantic. Excessive care and costs, an outgrowth of a fee-for-service reimbursement methodology that all but ignores health outcomes, are at the heart of the US health system's deep structural misalignment. In 2008, PwC issued a report estimating that more than half (54.5%) of everything we pay for in health care provides no value, and little has changed since then. A policy environment that has opened its arms to blatant bribery from industry interests has rendered this outrageous behavior acceptable and part of the norm. Health care industry practices now depend on performing inappropriate and unnecessary care to maintain their revenues and valuations. The only antidote is for purchasers - employer and unions - to circumvent the health plans, contracting directly with high performance providers who can measurably demonstrate superior health outcomes and/or lower cost than conventional providers within high value niches. And kudos to Dr. Bestermann for drawing his readers' attention to this important piece.
Having served as a medical director for decades I have had many discussions with and about doctors attempting to get paid for unnecessary procedures and tests. When markets fail, regulations often become necessary. Here are reasons 2106 doctors think other doctors do too many unnecessary services. Defensive medicine/ fear of malpractice suits- 85%; patient pressure/ requests- 59%; difficulty accessing prior medical records- 38%; ambiguous guidelines - 38%; time limitations with patients- 37%; missing information from prior patient history- 37%; organization pressures- 21%; financial security- 9%. And other excuses.
“Sorensen’s appetite for the PFO procedure raises a fundamental question about how surgical interventions, and thus how surgeons and other specialists, are regulated—a topic that’s often missing from the political debates about health care on Capitol Hill and in statehouses around the country. Those discussions tend to focus on two things: cost and access. Whether a person will benefit from any given treatment, so long as it’s affordable and accessible, is given much less consideration.” Wow!….just, wow!
I'm glad to see this article is a widely read outlet like The Atlantic. Excessive care and costs, an outgrowth of a fee-for-service reimbursement methodology that all but ignores health outcomes, are at the heart of the US health system's deep structural misalignment. In 2008, PwC issued a report estimating that more than half (54.5%) of everything we pay for in health care provides no value, and little has changed since then. A policy environment that has opened its arms to blatant bribery from industry interests has rendered this outrageous behavior acceptable and part of the norm. Health care industry practices now depend on performing inappropriate and unnecessary care to maintain their revenues and valuations. The only antidote is for purchasers - employer and unions - to circumvent the health plans, contracting directly with high performance providers who can measurably demonstrate superior health outcomes and/or lower cost than conventional providers within high value niches. And kudos to Dr. Bestermann for drawing his readers' attention to this important piece.
Having served as a medical director for decades I have had many discussions with and about doctors attempting to get paid for unnecessary procedures and tests. When markets fail, regulations often become necessary. Here are reasons 2106 doctors think other doctors do too many unnecessary services. Defensive medicine/ fear of malpractice suits- 85%; patient pressure/ requests- 59%; difficulty accessing prior medical records- 38%; ambiguous guidelines - 38%; time limitations with patients- 37%; missing information from prior patient history- 37%; organization pressures- 21%; financial security- 9%. And other excuses.
“Sorensen’s appetite for the PFO procedure raises a fundamental question about how surgical interventions, and thus how surgeons and other specialists, are regulated—a topic that’s often missing from the political debates about health care on Capitol Hill and in statehouses around the country. Those discussions tend to focus on two things: cost and access. Whether a person will benefit from any given treatment, so long as it’s affordable and accessible, is given much less consideration.” Wow!….just, wow!