Comments on: Patients believe we overtreat and/or overtest

By: Steve Lucas

Steve Lucas — Thu, 15 Sep 2005 09:58:38 +0000

I like gbrown’s idea. This may make people look at the medical resources they are consuming and think twice about the phrase “Don’t worry, your insurance will pay for it.”

By: John Di Saia MD

John Di Saia MD — Thu, 15 Sep 2005 03:22:56 +0000

Well all we need is tort reform and may be we won’t feel like every chart is up for legal review. I feel sorry for the Emergency and Internal Medicine docs. I have arbitration agreements to scare away the litigious. The ER docs don’t (at least in my state).

By: tina

tina — Wed, 14 Sep 2005 22:50:45 +0000

Do you think there is something inherent psychologically that might cause this? Drs want to help thier patients. What I’ve noticed over the last few weeks is that when they can’t help me or don’t know what to do they get either angry or confused. The poor ER docs are the most lost. However if the opportunity arises where they can help, they get this perky excited look. My endo doesn’t really want to understand what is causing the problem, just that the proper mix of meds have resolved the problem. Perhaps sometimes docs don’t know how to solve a problem so pass out a script instead. My GP hands out scripts and samples like candy. It is an easy solution and perhaps it makes the patient “feel” like youv’e done something even though you don’t know what to do.

I have found rather than too much testing they actually rely on far too little testing and at times don’t really understand the limitations of the tests they are running. If you even try and mention that you get treated like you don’t understand what you are talking about. It feeds into the idea you guys have that patients are really incapable of understanding thier own condition. I told the first ER doc it was an adrenal problem. I told the first endo it was an adrenal problem. I told the second and third ER docs it was an adrenal problem. I told the GP it was an adrenal problem. I told the fourth ER doc it was an adrenal problem. I told the second endo it was an adrenal problem. They all treated me like a hypochondriac and an idiot for reading information on the internet. Guess what? It was an adrenal problem. You are all conspiring to kill me.

By: m

Wed, 14 Sep 2005 22:01:35 +0000

is this unusual?

do we blindly accept the repair reccommendations that our household plumber or electrician suggest? do we always listen to the advice of elders? do we not frequently ignore even sound advice to exercise and eat regularly? just because a doc suggests a plan of action, many of us (docs included) do not do it.

By: gbrown

gbrown — Wed, 14 Sep 2005 21:57:43 +0000

As a pathologist I may have a skewed perspective but I have often thought that even physicians have little understanding of the cost/benefit trade-offs of their recomendations. With the increase in patient directed care and HSA’s it seems to me that it would be extremely useful for the public to have available objective numeric data on incidence of diseases, diagnostic testing strategies, and treatment effectiveness, along with, eg, relevant medicare fees. This would surely cut down on more egregious waste such as cranial imaging for headache.

By: elliottg

elliottg — Tue, 13 Sep 2005 16:34:59 +0000

Just ran across this at balkin.blogspot.com and thought it had some relevance. It’s a discussion of the weighing of risk.

http://balkin.blogspot.com/2005/09/secret-ambition-of-cass-sunstein_13.html