Have You Had Medical Care You Thought Was Unnecessary? Share Your Story
February 11th, 2010
One-third of Americans say they have received tests, treatment or medications they didn’t need, according to a survey conducted for the Commonwealth Fund of New York. Are you one of them?
Think about it. We live in a market-driven economy where businesses thrive on getting us to consume more than we need, whether it’s a house that’s too big, a mortgage that’s unaffordable, or an investment that promises more than it can deliver. Market-driven health care is motivated by the same imperative. In our highly-caffeinated health care system, the mantra is volume, volume, volume. That ‘volume’ is you and me, and the people we love.
Here’s a story about a colleague, a research scientist, who has a heart condition that she watches very carefully. She went for a nuclear stress test at a free-standing diagnostic testing center as part of her routine monitoring. After the test was complete, the cardiologist told her she had a very serious problem that required open-heart surgery. She was scared out of her wits and immediately thought of a family friend who had died recently during heart surgery. The cardiologist wanted to do a cardiac catheterization and prescribe medication. He also told her to stop jogging immediately.
My savvy friend knew she didn’t want to have more tests or treatment at that center. Here’s why. While on the treadmill, she overheard the doctor tell the nurse that the center had nine patients a day and needed to increase its census to fourteen a day to generate enough revenue to make it financially viable. It’s true. She walked out and never looked back. A second opinion from expert physicians recommended continued monitoring and she followed their advice.
About ten years ago, the Institute of Medicine of the National Academy of Sciences convened a group of experts who acknowledged a uniquely American phenomenon in health care: overuse. It occurs when the possibility of harm exceeds the possible benefit. Health care insiders say that overuse is an epidemic. Epidemics are not good for anyone.
To learn what you can do to avoid unnecessary medical treatment, check out my new book coming out next month, The Treatment Trap, which has twenty smart steps for consumers. Read the foreword by Jim Guest, president of Consumers Union. In the meantime, share your story. Together we can learn from – and empower – each other.
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February 11th, 2010 at 10:10 pm
As a patient with chronic back pain, I was treated for this chronic condition with prednisone and then three corticosteroid injections. During the last injection, it struck me that this was an assembly line production that would go on all day; a countless number of “patients” receiving anesthesia and a spinal injection of a steroid; the objective of which was to reduce or eliminate the back pain. I underwent this treatment while I was in an large urban center. Fast forward one year where I am living in a much smaller community. I still have that back pain. What is different now is that I no longer am living in a large urban center with competing hospital systems or physicians. In this somewhat rural area, the “solution” for chronic back pain is relatively simple and inexpensive….physical therapy. PT first, injections second or third on the list. Naturally, coming from that urban center where I had seen “specialists” for this pain, I seek out a second opinion from a neurologist as I can not trust such a direct and simple treatment. The neurologist assured me that in his opinion, physical therapy was preferred. It would meet the same objective, however it would take longer. It would take years. However, it was safer, and I would participate in the recovery. Well, it has been over a year since then, I do those exercises almost every day and the pain has diminished to a far greater degree than it had under the steroid injection therapy . However, I now, once again, live in an urban center. My daughter’s teacher has been felled by chronic back pain. She has been prescribed the prednisone and injection therapy. I urged her to explore with her physician using physical therapy as a first line of treatment.
February 13th, 2010 at 7:10 am
Rosemary,
I see your point, but I wonder about your friend. She now has two different medical opinions. One, she believes is informed by an economic interest. The other might be informed — or mis-informed — by some other factor.
Has she sought a third opinion? She might need a tie-breaker.
February 13th, 2010 at 2:22 pm
It is interesting about the amount of care prescribed that is knowingly unnecessary. It would also be fascinating to know how much care is prescribed in good faith and deemed wasteful after the fact. Correct me if I’m wrong, but I imagine there is a fine line in many cases.
February 13th, 2010 at 3:11 pm
Lisa,
Thanks very much for your comment. Yes, it can be a fine line in many cases. In other instances, the distinction could be much more visible. This morning I was reading the results of a survey of physician leaders as part of the health leaaders media survey that was released yesterday. In that survey, 30% of physican leaders say that reimbursement and revenue considerations are a major influence in ordering tests or procedures.
February 13th, 2010 at 3:21 pm
Glenna,
The second opinion that the research scientst received was from a much more experienced source, a team of physicians from different subspecialties who also had an economic interest to perform procedures and surgeries but recommended continued monitoring. She does not believe she was misiformed. It has been nearly four years since this event, and she continues watchful monitoring with the help of her new physicians.