How we spend the most money on futile care

A 90-year old man with a pancreatic mass, almost definitely pancreatic cancer, was admitted to a hospital.

Surgeon Jeffrey Parks does the initial surgery consult on this terminal case, and recommends hospice care.

The next evening, he’s shocked by the “astounding amount of medicine [that] had been practiced” during the day:

Consults had gone out to GI, oncology, and nephrology. The GI guy had ordered an MRCP and, based on some mild distal narrowing of the common bile duct, had scheduled the patient for a possible ERCP in the morning. A stat CT guided biopsy of the liver lesions had also been done. The oncologist had written a long note about palliative chemotherapy options and indicated he would contact the son about starting as soon as possible. The nephrologist had sent off a barrage of blood and urinary tests.

It’s often said that we spend the most money in the world on futile care, often with little benefit to the patient. The preceding account was that phenomenon in action, replicated thousands of times on a daily basis.

A microcosm of what’s wrong with American medicine indeed.

View 31 Comments >

Most Popular

Get KevinMD's 5 most popular stories.