Tuesday, October 6, 2009

Selective Interpretation

Peter Orszag (OMB chief) comments on the recently released report from the Institute of Medicine averring that over $800 billion is wasted on health care spending. This particular sentence stood out:
Unnecessary services, such as using more expensive brand name drugs when generics are just as good and overusing tests and treatments compared to professional guidelines, account for another $200 billion or so.

Hmm. Doctors are overusing tests and providing unnecessary services, to the tune of $200 billion per year. That sounds a lot like....defensive medicine. But in the subsequent paragraph of his blog post, while delineating possible solutions to the waste problem, not one mention of tort reform from Orszag. Because doctors are greedy bastards, you see. If they are ordering unnecessary tests and procedures(tonsils anyone?) then it must be solely due to financial motivations. Right?


Kellie said...

I am clearly practicing in the wrong part of the country. I don't get 70,000 to do a leg amputation nor do I get any reimbursement for ordering tests. I wanna go there....

Anonymous said...

Well, had another mismanaged patient today. Never should have even been an admit. $$,$$$ spent - it's a UTI stupid. OMG.

Anonymous said...

Why shouldn't doctors be required to follow best practice? (They are after all funded in large part by the taxpayer!)

Why shouldn't doctors be held accountable when they fuck up?

Jeffrey Parks MD FACS said...

Reasonable point you make. But completely unrelated to the blogpost at hand. Thanks for the random comment though!

Andrew_M_Garland said...

School systems across the country forbid children to run at recess, because they are afraid of lawsuits.

But, the government wants doctors to not do tests that might find something, then ignore the fear of being involved in those same lawsuits, in much more emotional circumstances.

I haven't seen any solution to the litigation problem. It can't be more lawsuits against doctors.

Anonymous said...

Orzag's term of "overuse" ticks me off!
Correct me if I'm wrong- What about those Medicare HHS protocols that interfere with the way a physician normally practices?

For example, if you are a patient in the early stage of an MI-(you've done the EKG) sweaty, dizzy, pass out, hit head. Do you give him the clotbuster and potentially cause worse bleeding in the brain, or do you do the CT which might waste your thirty minute window for the clot drugs? HHS says if you miss the window it puts the doc on the Shit list and drops the hospital rating as I understand it. This kind of interference forces 'defensive' medicine because it's damned if you do, damned if you don't! This causes the overuse in testing, does it not?

I don't like Orzag or the idiots ignoring the tort reforms so they can pay off the cronies. If they give in to TR, they lose the power. How sick is that? Really representing the constituents who elected them, hmmm?

They should get out the mirror, instead of accusing physicians of being the greedy bastards. We know who's on the right side of this argument and it isn't them.

Can't get comment thing to do it's thing...