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Friday, March 12, 2010

Medical care WASTE

Eye-opening report in Newsweek about the BILLIONS of dollars wasted on unnecessary medical care. Everyone should read this! Here's an excerpt:

. . . "doctors rip off the system with inappropriate care," says Brody. An estimated one fifth to one third of U.S. health-care costs, at least $500 billion a year, goes toward tests and treatments that do not benefit patients like routine CT scans in the ER . . .

"I hate to say it, but it's true: doctors sometimes do things that do not benefit patients and can even be harmful," says Stephen Smith of Brown University medical school, who is spearheading the effort. Nominations, all from physicians, include antibiotics for upper-respiratory infections (the drugs kill bacteria, not the viruses that cause colds), Pap tests for women under 21 ("solid research shows that they find things that lead to unnecessary interventions but would clear up on their own," says Smith), and me-too drugs that are no more effective than older versions (anything other than diuretics for first-line treatment of high blood pressure).

Smith's group is also considering nixing X-rays and MRIs for lower-back pain: the scans often spot something that is unrelated to the pain. . . Although lower-back pain typically resolves within six weeks, many patients refuse to wait, and surgeons and radiologists have financial incentives to see that they don't. A 2009 study found that Americans spent $85.9 billion for imaging, surgery, drugs, and doctors' visits for lower-back pain—most of it for no benefit. "The use of MRI within six weeks of the start of lower-back pain is not only not useful, but it increases the number of surgeries, treatments, and costs," says anesthesiologist Ray Baker, president of the North American Spine Society, whose members do those very things.

. . . at least 351,000 spinal fusions were performed in 2007, reports the Agency for Healthcare Research and Quality, at a cost of $26.2 billion. Yet except in the tiny fraction of cases in which the pain is caused by fracture or tumor, they're useless—but financially irresistible, points out Shannon Brownlee in her 2007 book Overtreated: Why Too Much Medicine Is Making Us Sicker and Poorer. At $75,000 per spinal-fusion procedure, medical-device makers, hospitals, and surgeons have every reason to keep the gravy train rolling. "We doctors are extremely good at rationalizing," says Brody. "Somehow we manage to figure out how the very best care just happens to be the care that brings us the most money."



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