Health care secrets

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)