Comments on: Almost half of physicians order tests to avoid lawsuits http://www.kevinmd.com/blog/2006/06/almost-half-of-physicians-order-tests.html Wed, 15 Feb 2012 00:27:00 +0000 hourly 1 By: Anonymoushttp://www.kevinmd.com/blog/2006/06/almost-half-of-physicians-order-tests.html#comment-78526 Anonymous Thu, 02 Aug 2007 16:34:00 +0000 http://clients.emmense.com/kevinmd/2006/06/almost-half-of-physicians-order-tests-to-avoid-lawsuits.html#comment-78526 Can a Physician "86" a patient if the patient refuses un-needed medical tests. Sort of like you can afford it why not! Can a Physician “86″ a patient if the patient refuses un-needed medical tests. Sort of like you can afford it why not!

]]> By: Anonymoushttp://www.kevinmd.com/blog/2006/06/almost-half-of-physicians-order-tests.html#comment-64429 Anonymous Sun, 25 Jun 2006 17:52:00 +0000 http://clients.emmense.com/kevinmd/2006/06/almost-half-of-physicians-order-tests-to-avoid-lawsuits.html#comment-64429 Anon at 1:24 - this is really tragic. How did these kids got HIV? Could it still end up a false positive?<br/><br/>Their mother was in a car accident in Haiti, went to the hospital and got a blood transfusion. Then got married to the kids father, unkowingly infected him, and they started a family and unknowingly infected both fetuses (or through breastfeeding) Really makes me grateful fo what little I have in life. Anon at 1:24 – this is really tragic. How did these kids got HIV? Could it still end up a false positive?

Their mother was in a car accident in Haiti, went to the hospital and got a blood transfusion. Then got married to the kids father, unkowingly infected him, and they started a family and unknowingly infected both fetuses (or through breastfeeding) Really makes me grateful fo what little I have in life.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2006/06/almost-half-of-physicians-order-tests.html#comment-64427 Anonymous Sun, 25 Jun 2006 17:46:00 +0000 http://clients.emmense.com/kevinmd/2006/06/almost-half-of-physicians-order-tests-to-avoid-lawsuits.html#comment-64427 11:23,<br/><br/>I'm not sure but I think it might be Bush's fault. 11:23,

I’m not sure but I think it might be Bush’s fault.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2006/06/almost-half-of-physicians-order-tests.html#comment-64424 Anonymous Sun, 25 Jun 2006 15:23:00 +0000 http://clients.emmense.com/kevinmd/2006/06/almost-half-of-physicians-order-tests-to-avoid-lawsuits.html#comment-64424 Anon at 1:24 - this is really tragic. How did these kids got HIV? Could it still end up a false positive?<br/><br/>I think another harm of overtesting is that it takes time and resources from the cases where there is a real need. <br/><br/>I have an off-topic question about this topic. Last couple of days it was inaccessible - whenever I click to see it, I got a blank page. Same with statin thread. It happened some time before with other topics. Anybody knows why it happens? Server problems? Powers that be didn't like something posted? Hackers attack? Anon at 1:24 – this is really tragic. How did these kids got HIV? Could it still end up a false positive?

I think another harm of overtesting is that it takes time and resources from the cases where there is a real need.

I have an off-topic question about this topic. Last couple of days it was inaccessible – whenever I click to see it, I got a blank page. Same with statin thread. It happened some time before with other topics. Anybody knows why it happens? Server problems? Powers that be didn’t like something posted? Hackers attack?

]]> By: Anonymoushttp://www.kevinmd.com/blog/2006/06/almost-half-of-physicians-order-tests.html#comment-64421 Anonymous Sun, 25 Jun 2006 05:43:00 +0000 http://clients.emmense.com/kevinmd/2006/06/almost-half-of-physicians-order-tests-to-avoid-lawsuits.html#comment-64421 I had to tell a father today that his two children, age 2 and 6, both had tested positive for HIV. All he could say to me was "but I prayed every day this week that the tests would be negative". I couldn't help him, and i died inside knowing there's so little I can do. Then I had to move on to the next patient. And to think I have to spend much of my week ordering defensive tests to keep away the maggots that are attorney's when instead I could be using my time helping families in need like this. No-one seems to understand (or care) what the maggots are doing to our time and our health care system. This family (poor immigrants) can't get the health care they need, but I can order an MRI on a mild headache "just in case". It just isn't right. I had to tell a father today that his two children, age 2 and 6, both had tested positive for HIV. All he could say to me was “but I prayed every day this week that the tests would be negative”. I couldn’t help him, and i died inside knowing there’s so little I can do. Then I had to move on to the next patient. And to think I have to spend much of my week ordering defensive tests to keep away the maggots that are attorney’s when instead I could be using my time helping families in need like this. No-one seems to understand (or care) what the maggots are doing to our time and our health care system. This family (poor immigrants) can’t get the health care they need, but I can order an MRI on a mild headache “just in case”. It just isn’t right.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2006/06/almost-half-of-physicians-order-tests.html#comment-64392 Anonymous Fri, 23 Jun 2006 17:28:00 +0000 http://clients.emmense.com/kevinmd/2006/06/almost-half-of-physicians-order-tests-to-avoid-lawsuits.html#comment-64392 if you order the test, even if they don't get it , you are still somewhat protected. Also, ANA is a reasonable screening test for SLE most times if they have polyarthralgia, swelling, etc. ; as opposed to a defensive measure if you order the test, even if they don’t get it , you are still somewhat protected. Also, ANA is a reasonable screening test for SLE most times if they have polyarthralgia, swelling, etc. ; as opposed to a defensive measure

]]> By: Anonymoushttp://www.kevinmd.com/blog/2006/06/almost-half-of-physicians-order-tests.html#comment-64390 Anonymous Fri, 23 Jun 2006 16:56:00 +0000 http://clients.emmense.com/kevinmd/2006/06/almost-half-of-physicians-order-tests-to-avoid-lawsuits.html#comment-64390 I think the 50% number is way low. I'd say more like 95-99% of physicians order defensive tests based on my 20+ years as a practicing radiologist. I don't blame them for doing it and it has made me a ton of money. It's a win-win situation for everybody but the patient. I think the 50% number is way low. I’d say more like 95-99% of physicians order defensive tests based on my 20+ years as a practicing radiologist. I don’t blame them for doing it and it has made me a ton of money. It’s a win-win situation for everybody but the patient.

]]> By: LRhttp://www.kevinmd.com/blog/2006/06/almost-half-of-physicians-order-tests.html#comment-64385 LR Fri, 23 Jun 2006 13:23:00 +0000 http://clients.emmense.com/kevinmd/2006/06/almost-half-of-physicians-order-tests-to-avoid-lawsuits.html#comment-64385 It does cost patients more than just the waste of time in getting unneeded tests, or extra worry, or being sent to specialists when it's not truly warrented, or being subjected to possibly risky tests or biopsys. All this testing drives up health care costs big time. The tests cost money, and there's no way around it. Expensive tests like CT scans and MRI's cost a lot of money. And for what benefit, if they are only done for defensive reasons? <br/><br/>My insurance premiums went up 12% last year. The year before they went up 10%. When people (lawyers, health care consultants) come on these blogs and say that defensive medicine doesn't contribute to increased costs, I believe they are wrong, and burying their heads in the sand. I believe that are not looking at the whole picture.<br/><br/>The only entities who benefit from all this extra testing are the places that perform the tests, like Quest Diagnostics or Labcorp. Check out their websites, and check out the profits those companies rake in. It does cost patients more than just the waste of time in getting unneeded tests, or extra worry, or being sent to specialists when it’s not truly warrented, or being subjected to possibly risky tests or biopsys. All this testing drives up health care costs big time. The tests cost money, and there’s no way around it. Expensive tests like CT scans and MRI’s cost a lot of money. And for what benefit, if they are only done for defensive reasons?

My insurance premiums went up 12% last year. The year before they went up 10%. When people (lawyers, health care consultants) come on these blogs and say that defensive medicine doesn’t contribute to increased costs, I believe they are wrong, and burying their heads in the sand. I believe that are not looking at the whole picture.

The only entities who benefit from all this extra testing are the places that perform the tests, like Quest Diagnostics or Labcorp. Check out their websites, and check out the profits those companies rake in.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2006/06/almost-half-of-physicians-order-tests.html#comment-64381 Anonymous Fri, 23 Jun 2006 12:44:00 +0000 http://clients.emmense.com/kevinmd/2006/06/almost-half-of-physicians-order-tests-to-avoid-lawsuits.html#comment-64381 Suppose a patient presents with a lesion but denies any risk-enhancing behaviors (smoking, drinking, etc.) You do a surgical biopsy, send the results to the lab, and they come back benign. But the lesion recurs within months, you don't know why, so you do another surgical biopsy. Same results, and again, recurrence within months.<br/><br/>How many times do you repeat the surgical biopsy as a defensive measure? If you elect to discontinue treatment at some point, how do you handle it -- considering that you've already done multiple biopsies and have probably scared the bejeesus out of the patient by now? <br/><br/>And if the patient begins to suspect that s/he is on the receiving end of defensive medicine and wants to discuss it with you, then what? Do you have that talk? Do malpractice fears skyrocket, causing you to act in some other defensive fashion? Suppose a patient presents with a lesion but denies any risk-enhancing behaviors (smoking, drinking, etc.) You do a surgical biopsy, send the results to the lab, and they come back benign. But the lesion recurs within months, you don’t know why, so you do another surgical biopsy. Same results, and again, recurrence within months.

How many times do you repeat the surgical biopsy as a defensive measure? If you elect to discontinue treatment at some point, how do you handle it — considering that you’ve already done multiple biopsies and have probably scared the bejeesus out of the patient by now?

And if the patient begins to suspect that s/he is on the receiving end of defensive medicine and wants to discuss it with you, then what? Do you have that talk? Do malpractice fears skyrocket, causing you to act in some other defensive fashion?

]]> By: Anonymoushttp://www.kevinmd.com/blog/2006/06/almost-half-of-physicians-order-tests.html#comment-64378 Anonymous Fri, 23 Jun 2006 12:08:00 +0000 http://clients.emmense.com/kevinmd/2006/06/almost-half-of-physicians-order-tests-to-avoid-lawsuits.html#comment-64378 "You couldn't sleep at night if you relied on your professional judgment solely?<br/><br/>If you're not sure it works, isn't your confidence a false confidence?"<br/><br/>No, not at all. My clinical judgement gets me to 99+% certainty. The CT, referal, etc... makes the chart lawyer proof. “You couldn’t sleep at night if you relied on your professional judgment solely?

If you’re not sure it works, isn’t your confidence a false confidence?”

No, not at all. My clinical judgement gets me to 99+% certainty. The CT, referal, etc… makes the chart lawyer proof.

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