Comments on: The cost of prevention: Bankruptcy http://www.kevinmd.com/blog/2007/01/cost-of-prevention-bankruptcy.html medical blog Sun, 22 Nov 2009 19:59:44 -0500 http://wordpress.org/?v=2.8.4 hourly 1 By: Rich, MD http://www.kevinmd.com/blog/2007/01/cost-of-prevention-bankruptcy.html/comment-page-1#comment-70891 Rich, MD Thu, 25 Jan 2007 20:00:00 +0000 http://clients.emmense.com/kevinmd/2007/01/the-cost-of-prevention-bankruptcy.html#comment-70891 Anon 7:24 - <br/><br/>Most (I would estimate 99%) of defensive testing does not profit the physician who is ordering it.<br/><br/>For example, radiologic studies are almost never ordered by the radiologist. Most primary care providers do not own MRI scanners, CT scanners, and fewer than ever own plain x-ray equipment (I used to, but got tired of eating the costs when insurers refused to pay for it). Most emergency room docs do not own nuclear stress test machines, or stakes in cath labs, and similarly do not own shars of CT scanners and MRI machines.<br/><br/>Most of us do not own laboratories (I used to, but again, the inifinitesimal margin made in unacceptable) so ordering blood work does not raise revenue.<br/><br/>When someone is hosp[italized, in most cases, the hospital is payed a flat rate, so they actually lose money when more tests are ordered.<br/><br/>While there are some specialties that can make large profits on testing, they are a minority, and the rest of the defensive testing is just defensive (if notmisguided). Anon 7:24 –

Most (I would estimate 99%) of defensive testing does not profit the physician who is ordering it.

For example, radiologic studies are almost never ordered by the radiologist. Most primary care providers do not own MRI scanners, CT scanners, and fewer than ever own plain x-ray equipment (I used to, but got tired of eating the costs when insurers refused to pay for it). Most emergency room docs do not own nuclear stress test machines, or stakes in cath labs, and similarly do not own shars of CT scanners and MRI machines.

Most of us do not own laboratories (I used to, but again, the inifinitesimal margin made in unacceptable) so ordering blood work does not raise revenue.

When someone is hosp[italized, in most cases, the hospital is payed a flat rate, so they actually lose money when more tests are ordered.

While there are some specialties that can make large profits on testing, they are a minority, and the rest of the defensive testing is just defensive (if notmisguided).

]]> By: Anonymous http://www.kevinmd.com/blog/2007/01/cost-of-prevention-bankruptcy.html/comment-page-1#comment-70853 Anonymous Thu, 25 Jan 2007 12:24:00 +0000 http://clients.emmense.com/kevinmd/2007/01/the-cost-of-prevention-bankruptcy.html#comment-70853 So what motivates unnecessary defensive testing more...lawsuit fears or the opportunity to increase revenue?<br/><br/>Not trying to be snide...just wondering if it isn't a little of both in some cases, perhaps. So what motivates unnecessary defensive testing more…lawsuit fears or the opportunity to increase revenue?

Not trying to be snide…just wondering if it isn’t a little of both in some cases, perhaps.

]]> By: Michael Rack, MD http://www.kevinmd.com/blog/2007/01/cost-of-prevention-bankruptcy.html/comment-page-1#comment-70851 Michael Rack, MD Thu, 25 Jan 2007 06:52:00 +0000 http://clients.emmense.com/kevinmd/2007/01/the-cost-of-prevention-bankruptcy.html#comment-70851 The article raises an important point:<br/>"It's important to note that the economic gains from preventive care are sometimes exaggerated. Sadly, the cheapest patients are often the ones who receive no care whatsoever, because many die before they reach their medically expensive golden years." <br/>Improving preventive care in this country is important for the nation's health, but it's not going to solve the financial problems of our health care system. The article raises an important point:
“It’s important to note that the economic gains from preventive care are sometimes exaggerated. Sadly, the cheapest patients are often the ones who receive no care whatsoever, because many die before they reach their medically expensive golden years.”
Improving preventive care in this country is important for the nation’s health, but it’s not going to solve the financial problems of our health care system.

]]> By: Anonymous http://www.kevinmd.com/blog/2007/01/cost-of-prevention-bankruptcy.html/comment-page-1#comment-70848 Anonymous Thu, 25 Jan 2007 04:19:00 +0000 http://clients.emmense.com/kevinmd/2007/01/the-cost-of-prevention-bankruptcy.html#comment-70848 I have to say, my husband's heart specialist was happy that he has lost weight, is exercising, and is eating right. When my husband gave me the credit (for keeping his diet right and making him exercise), the doctor asked (jokingly) if I would come and work with them, because they have patients who need motivating.<br/><br/>Maybe I should appreciate the heart specialist more than I have in the past? I have to say, my husband’s heart specialist was happy that he has lost weight, is exercising, and is eating right. When my husband gave me the credit (for keeping his diet right and making him exercise), the doctor asked (jokingly) if I would come and work with them, because they have patients who need motivating.

Maybe I should appreciate the heart specialist more than I have in the past?

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