Yet when MDs and the insurance lobby speak to the public, its just all the LAWSUITS that are responsible.

The fact is that the excessive testing and overutilization that is grouped under “defensive” medicine is a problem that is PRIMARILY due to financial incentives within the medical profession, not to mention outright billing fraud (e.g. Medicaid fraud) that is a huge burden on the system.

But without “defensive medicine” costs (which are mostly non-lawyer/lawsuit related) the medical lobby has to confront the actual numbers that all costs of the US Legal system/malpractice law are 2% or less of US health care spending, per the Congressional Budget Office and every reputable study.

So I ask you, when you admit that the “defensive medicine problem” is mostly MD created, will you acknowledge, at least as an economic matter (psychological reactions/stress issues aside) that medical malpractice cases are a miniscule part of the overall economics of US health care spending?

Or will you just continue to bash “the lawyers.”

And yes, I am a lawyer, and proud of the work that I do. I take on cases where real people need real help to make up for problems caused by real malpractice. And I’m truly sick of how, when MDs speak to each other, they acknowledge that most of the major problems in an otherwise excellent system of care are self-created, or due to structural/financial issues, and yet when they speak to the public, the “message” is: if only people had no right to bring a civil case for malpractice, then every patient would get the medical care the President has, at half the cost, and you’ll be taller and better looking.

Just my reaction.

In light of the COURAGE trial and the pre-op eval studies, I am surprised that there has not been any significant decline in the number of Pre-op and non pre-op Caths and stents and tests. Some of this is related to Medical Mal concerns, but still, the cardiologists near me are going all out to do lucrative procedures with little clinical benefit. I do not live near McAllen Texas, but can certainly see similarities.

It’s good to see that we agree that (a) the system is inept, (b) patient inconvenience should be avoided at all costs but is sometimes necessary– at least in the current environment– to make informed medical decisions, and (c) access to all medical information (as in a computerized EHR system) is essential for efficient medical care.

I can’t help but wonder, though, why your posts seem to accuse me of resisting the “government option”. I’m not defending the status quo one bit. The AMA does not speak for me, I’m not in it just to make money, and I fully support a nationalized system, as it would make my job more rewarding and my patients would clearly benefit.

(BTW, Melben, re “every doctor who sends a patient to get lab tests done does receive a commission for each one“. This is patently not true. I’ve received ZERO for any tests I’ve ordered.)

Still, there are ways to improve both the quality and efficiency of diagnostic imaging, while lessening the financial strain they place on our health care system. At the American College of Cardiology, we are working to reduce the rate of inappropriate imaging by creating evidence-based guidelines that facilitate the proper and judicious use of imaging services. These appropriate use criteria are crucial to helping physicians determine when imaging should occur, while appreciating the patient’s clinical situation, scientific evidence and the local health care setting.

To learn more about the ACC’s efforts to establish appropriate use criteria and reduce unnecessary imaging, visit the Lewin Report at http://lewinreport.acc.org.

“1) The patient: The patient receives more appropriate, efficient, and convenient care” …..

Convenient for whom? Many medical tests require pre-authorization from private insurance companies. A simple blood draw requires the patient to travel to a lab and wait his or her turn of anywhere between 10 and 45 minutes; a procedure such as an MRI can have a wait of up to two hours (even with an appointment) plus the time it takes to conduct the MRI. Of course, once the new medical tests results are returned to you, the patient must reschedule another appointment with you so that (after waiting in in your reception room) you and the patient “have the data & information up front”.

“rather than waiting the days or weeks to get results of previous tests (if the prior provider even returns my phone calls).” …..

Then, there would be no difference between the private health insurance system and the purported inefficient government option (or single payer system) as it is the prior provider, another physician, that is creating the log jam?

“2) Cost: The point of my initial argument (apparently lost on you, so quick to vilify the physician) was that it actually costs MORE on personnel, phone calls, paperwork, HIPAA compliance, and overall red tape, to get the results of prior studies, than to repeat the study. It’s unfortunate, but that’s our “system.” ” …..

No, the argument that the present system is completely inept is not lost on me. Your statement is an excellent argument for the president’s suggestion that all medical records be computerized for easy access.

As for vilification of the physician, I have not vilified physicians, just one who orders duplicative medical tests for patients that are coping with an illness, long waits, and medical bills.