Bingo, David:
It is not surprising that doctors will order more tests if they profit from testing. However, even if doctors get no profits from tests a huge problem remains – doctors are ordering tests using “other people’s money” and have little incentive to economize. Spending due to tests being seen as costless is likely to be much greater than spending due to doctors profiting from testing.
Even if there were no financial incentives, the advantages (including lessening the threat of malpractice and patient satisfaction) greatly outweighs the downside.
Related posts:
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- The decision not to test is often the more difficult choice
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- "Do I really need that?"
- Is the test that finds the most cancers the best?
- Healthcare Diseasecare
- How much radiation am I getting with my X-ray, CT scan, or nuclear medicine test?
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In the ER, the difference between a 99283 and 99284 or a 99285 is the ordering of more tests. So I can see a patient with epigastric pain and order no tests, give them a GI cocktail and a Nexium prescription and charge a 99283. Or I can do an ECG and charge a 99284. Or add a chest X-ray, CBC, LFTs and cardiac enzymes and charge a 99285 (lessening my risk in the process).
Where is the incentive to control costs?
” So I can see a patient with epigastric pain and order no tests, give them a GI cocktail”
GI Cocktail?? Do they still have those in ERs? I never EVER Do that. I call the GI cocktail “the Plaintiff’s sodomites best friend”. I’ll admit the patient with a tummy ache and call it “epigastric pain, r/o MI”. Screw the economy. I agree with you scalpel. There’s no place for tummy aches in the ER. They’re all ischemia.
Good luck getting someone to admit that.
So goes another 4 BILLION dollars per year in defensive medicine. No wonder there’s millions of uninsured Americans.
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