March 12, 2010

IF ONLY THE DEMOCRATS' PLAN WERE GOING TO RATION "HEALTH CARE":

Experts say US doctors overtesting, overtreating (LINDSEY TANNER, 3/12/10, AP)

The colon exam exposed him to radiation "while likely providing no benefit to his care," Dr. Rita Redberg, editor of Archives of Internal Medicine, wrote in an online editorial. Obama's experience "is multiplied many times over" at a huge financial cost to society, and to patients exposed to potential harms but no benefits.

She also took issue with another test Obama had which uses radiation — a heart scan to look for calcium deposits in his arteries. She said the test isn't recommended for low-risk men like Obama.

"People have come to equate tests with good care and prevention," Redberg, a cardiologist with the University of California at San Francisco, said in an interview Thursday. "Prevention is all the things your mother told you — eat right, exercise, get enough sleep, don't smoke — and we've made it into getting a new test." [...]

Doctors also often order tests or procedures to protect themselves against lawsuits — so-called defensive medicine — and also because the fee-for-service system compensates them for it, said Dr. Gilbert Welch, a Dartmouth University internist and health outcomes researcher.

Some doctors think "it's always a good thing to look for things to be wrong," Welch said. It also has become much easier to order tests — with the click of a mouse instead of filling out forms, and both can lead to overuse, he said.

While many patients also demand routine tests, they're often bolstered by advertisements, medical information online — and by doctors, too, Welch said.

"To some extent we've taught them to demand these things," he said. "We've systematically exaggerated the benefits of early diagnosis," which doesn't always improve survival. "We don't always tell people there might actually be downsides" to testing.

Posted by Orrin Judd at March 12, 2010 5:42 PM
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