Funny thing about things that are “free”:
Now let’s say that a federal law required Circuit City to give away plasma screen TVs free of charge to anyone who showed up in the store requesting one, regardless of their ability or inclination to pay for it and regardless of their plasma TV insurance status. Some of these folks would try to pay for their TV anyway, because they are honorable people, but many more would just ignore the bills and stock up on TVs at the expense of the company.I suggest that if we were to create a plasma screen TV utilization chart, it would look strikingly similar to the CDC ED Utilization Chart.
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{ 9 comments }
Not entirely apt:
How many colonoscopies do you really want?
Medical treatment is not anything that sane people actually WANT.
I know some people that would want one every 2-3 years instead of every three years. Let’s face it; the risk (however small) of cancer really can scare people.
How many shots of Demerol do you want? How many Z-paks? How many vicodin? How many MRIs?
In response that “medical treatment is not anything that sane people actually want”. I hope that the author of this will consider his statement when he has deep substernal chest pain that radiates to his left arm and neck. As for colonoscopies, I want one and had one. You see colon cancer has killed two uncles and one aunt.
“Medical treatment is not anything sane people want.”
You haven’t taken care of any workers compensation patients have you?
Anon 2:37, the risk of cancer can indeed scare people. But most people avoid necessary, paid for screening unless pushed.
Scalpel, None, none, none, none.
Throckmorton (are you usually on the left?) again, when someone has LSSSCP they are not going to comparison shop. Thus … there is no market for the care of LSSSCP, there are only regional care plans. There may be a market for screening colonscopies, but ones done for emergent bleeding are again decided by non-market externalities.
Anon 3:45, Dunno if 2:26 had done any WC work before, but I have. And yes, most people don’t malinger. If you think a majority of your WC cases are malingering you should probably take that up with someone. I’m pretty sure the standards of occupational medicine don’t suggest that a majority of those cases are malingering.
Evan:
I do workman’s comp consultation as a surgical specialist, and at least half of the cases, no kidding, are fraud. There is more than malingering, there are patients who make up ridiculous stories about how a clearly non-work-related problem was a result of something on the job. Then there are the others who have fooled a bunch of less specialized folks, claiming a persistent disability when no reliable evidence supports their claim. (Electrophysiology can be your friend).
And I have been at this a decade.
Let us make the analogy a bit more accurate. First we would close over 50% of all Circuit City Stores because they don’t meet the “Standard.” We would make sure that the stores that were closed were in minority communities. We would then outlaw Costco, Sam’s, Wal-Mart and Best Buy from selling plasma televisions secondary to “scope of sales requirements.” We would then create special legal protections for stores that sell plasma televisions. For example, if your local store should drop a plasma television on your head and maim you… good luck getting restitution. Now… continue.
Anon 5:51, I assume you are aware of referral bias. If half the cases referred to you are malingerers, that does not mean that 1/2 of WC cases are malingerers. The only way they could be equal was if there were a 100% referral rate to you.
Obviously in most WC systems a lower level of care would be offered initially and if that care were effective your services would not be necessary.
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