Specialists and zebras

Nicely put:

The dark secret of specialists is that they are trained to see the bizarre. In order to adequately train a specialist in diseases and illnesses that rarely occur, they must train at large, academic medical centers. In such places, where doctors throughout the region send their difficult cases, they do end up seeing quite a few bizarre cases. To deal with the bizarre, they do lots of tests and perform lots of procedures. Because they are trained this way, they carry these habits out into the real world. Thus, when they see rather simple cases they are more likely to overtreat them or try to make the bizarre out of the ordinary.

This especially frightening when you consider how specialist-based our health care system is, with the average Medicare patient seeing five or more specialists annually.

That’s a lot of testing and explains the excessive practice variation that drives up health care spending.

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