A major obstacle to reforming health care is altering patient expectations. Convincing American patients that the latest, greatest and most isn’t necessarily beneficial will be a tough sell:
Economic incentives for doctors (including their paychecks and their fear of lawsuits) to choose the most aggressive treatment certainly play a big role. At Kaiser, where doctors tend to be paid a set salary regardless of which procedures they do, angioplasty rates are lower.But we patients deserve some of the blame, too. We’ve come to believe that aggressive treatment somehow offers us the best chance to stay healthy, even when the evidence says otherwise. “This is a society that demands that everything that can conceivably be tested or done or fixed should be,” Dr. Hochman said. “Other cultures are not like that.”
