A panel of anonymous doctors tells all:
How can a patient get a doctor to really pay attention?Dr. Heart2: You say, “You know, I’ve heard a lot about you, I’ve heard you’re a great doctor, and I’m really glad that I finally got a chance to come see you.” Something like that. That sets things up extremely nicely. Even if it’s a white lie.
Dr. Baby: The truth is, we’ll spend more time with patients we like. We’ll joke with them, we’ll laugh with them. You have fun with patients you like. People who are obnoxious and pushy, we get the business done and get on with it.
Here is what they say about overtesting, one of the larger drivers of health care cost:
What’s the most common mistake doctors make?Dr. Heart2: One of the issues that I see frequently is overtesting. Someone I know was complaining of arm numbness, so he went to the emergency room and a neurologist there ordered a series of tests: a CAT scan, a carotid ultrasound, an MRI, a transcranial Doppler study, and then a transthoracic echocardiogram. Thousands and thousands of dollars later, there was nothing. He was put on medication, and he was told he was at an impending risk for another stroke. So he went home, and about three days later, the tingling returned and he thought he was having a stroke. So he went back to the emergency room, and the neurologist ordered more tests. It turned out a nurse diagnosed him with a slipped disk, which didn’t require any workup””just Motrin and rest.
Dr. Virus: But patients want the CAT scans. They only think they want Marcus Welby.
Dr. Lung: Would the patient be happy if the person was seen and sent home without a cat scan? They would not be happy.
Dr. Heart2: Patients are coming in and they got on the Internet and they’ve read about some valve problem. So they come in and they say, “Doctor, is it possible I have this valve problem?” How am I going to say, “No, you don’t have this valve problem” without giving all these tests? And if I don’t do the tests, they go down the block to Mr. X cardiologist, who is more than happy to do them. And then they go around telling people, “I went to this cardiologist who didn’t order the tests, and this other guy was so thorough!”
(via WSJ Health Blog)
Related posts:
- Can you reform health care before reforming malpractice?
- Value of primary care
- "Secret shoppers" in the emergency department
- Secrets of the pharmaceutical industry
- Patient perceptions and defensive medicine
- Will electronic records actually increase health costs?
- My take: Pre-certification, mandating good behavior, Power 8
{ 9 comments }
Nowhere in that article is the statement made that overtesting is one of the largest drivers of health care costs.
I didn’t say it was the largest, but “one of the larger” drivers of health care cost.
Thanks,
Kevin
That claim isn’t in there either. In fact, if you were going to talk about cost drivers based on that article, you would have attributed it to the pharmaceutical industry and doctors’ susceptibility to their marketing.
Kevin is certainly entitled to editorialize.
Gimme a break.
He certainly is. Just as, presumably, his commenters are entitled to point out the shortcomings in his editorials.
Gimme a break.
When people come in gushing over the doctor from the outset, one’s borderline alarm should go off, especially if it accompanied by criticisms of all who have come before.
But is certainly true that, up to the point where perspective is lost, liked patients get better care than disliked patients. It is easier to relax, to think, and communication is better. Somewhere between “like” and “infatuation”, objectivity is impaired, the doctor begins doing “special favors” for the patient, and quality medical care doesn’t happen. What does happen may still be healing but can also be very destructive.
I think a poor doctor-patient relationship tends to fuel overtesting. The lack of confidence in the doctors assurances and even lack of faith in his good intentions prompt the patient to seek more. The doctor’s uneasiness with the quality of the trust prompts him to practice more defensively.
“liked patients get better care than disliked patients”.
I always wondered why the hot female red heads in skin- tight mini-skirts got better treatment than the 300+ pound
65 yr old males with their
size 65 beer bellies!
When people come into the ER gushing with compliments, 99% of the time they are looking for their narcotic fix. When they don’t get it they suddenly turn into the nastiest people you have ever seen.
People should not be coming into the ER gushing with compliments. More like they should be gushing with blood or pain, something significant that warrants a trip to the Er. If you are well enough to gush compliments then why would you need an ER?
Comments on this entry are closed.