Too much medicine

Any discussion of overtesting needs to be accompanied with the reasons why: the malpractice environment promoting defensive medicine and the flawed reimbursement system.

Any discussion of “doctors ordering too many tests” without mention of the aforementioned causes isn’t worth listening to.

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Anonymous
“the malpractice environment promoting defensive medicine and the flawed reimbursement system.”
Is this the only reason? Would demand based on constant promotion of executive physicals be another one? What about money?
The other day I received a pretty little flyer in the mail from a newly opened radiology center. They were offering a special on three imaging tests none of which is recommended. The flyer had a little paragraph under each test describing how they help to detect bad things early – if I remember correctly one test dealt with blocked arteries. Needless to say there was no mention of recommendations or any evidence that doing these tests on healthy individuals is not useful. I’d imagine quite a lot of people would believe these advertising and go asking for these tests.
Another case. During this year’s regular ObGyn exam, before I even got to see a doctor a nurse gave a little speach about HPV test and how they can run it. She also gave me a little form to say “yes” or “no” since the insurance might not pay for it. When I mentioned that I hadn’t had sex in 10 years and had normal paps in between, she said how long the virus could be there, etc. etc. Since I know what is recommended or not, not to mention my low-risk status, I marked “no” and that was it. But I’d imagine quite a lot of women said yes and even paid out of their own pocket even if there is no reason to believe this is needed unless the pap is abnormal.
Please explain to me how malpractice drove these two situations. Additionally, since in both of these cases the advertising failed to disclose the (lack of) evidence or “recommended” status of the promoted tests how this is not a fraud?

Too much medicine

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