Cutting costs under the guise of patient safety

Rationing is a very dirty word in America, evoking grim images of wartime Great Britain and, in the health care context, withholding of needed care from patients based on cost. But cut back on costs we must, and with magical thinking about the deficit becoming every more popular, we’ll have to find other ways to convince folks to do it.

Patient safety is a promising guise under which to achieve cutbacks, especially in costly areas where the dangers are real. The new radiation protection bill signed into law in California recently is a great example.

AuntMinnie recently ran a story, “Calif. governor signs medical radiation bill into law”:

The bill requires that radiation dose be recorded on the scanned image and in a patient’s health records, and that radiation overdoses be reported to patients, treating physicians, and the state Department of Public Health (DPH).

The law is clearly focused on overdoses, but once patients realize how much radiation they’re being exposed to — especially by repeated CT scans — many will start cutting back on what they request or accept. Over time, perhaps this attitude will spread to other areas of medicine such as surgical procedures and prescription drugs, where the risks are not always recognized today.

The federal government has done a great job whipping people into a sustained frenzy about airport security. All the time I hear people say they’ll put up with whatever hassles it takes at the airport in the name of security, and it almost seems the greater the hassle, the more satisfied people are to be subjected to it.

I don’t admire this approach in airport security, but if the same zeal were devoted to patient safety (with the idea of reducing health care costs) I think it could succeed.

David E. Williams is co-founder of MedPharma Partners and blogs at the Health Business Blog.

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  • http://advocateyourself.blogspot.com Cheryl Handy

    I am all for patient safety. But I doubt any law or mandate will even motivate a significant number of people towards creating an environment for patient safety. Patient safety is about people.

    The law itself requires that which would promote patient safety but which is idealistic in itself – proper charting.

    Even if there was proper charting at medical institute number 1 and number 2, what about the tests performed in other states? Do not even get me started on the emr mess.

    This law is not even a start for patient safety. I’d be curious to know what the sanctions or fines are for breaking the law.

  • doc99

    Regarding those CT Scans, more attention needs to be focused on the main cause of the reflexive CT requests, mostly in the ER. I don’t need to name it – we all know what that is and little to do with medicine and nothing to do with profit.

  • http://www.twitter.com/alicearobertson Alice

    Rationing is a very dirty word in America, evoking grim images of wartime Great Britain and, in the health care context, withholding of needed care from patients based on cos [end quote]

    Wartime? I think of NOW in the UK…….and there were just more cuts because that island is ready to sink into the ocean. Rationing is still alive, well, and kicking in Britain, but some people aren’t.

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