Obtuse Ordering

medical testsAfter examining the amount of physician-related spending on various tests, scans, x-rays and examinations ordered by almost 22,000 general internists and hospitalists – doctors that work exclusively in a hospital, but do no invasive procedures – over almost 500,000 distinct Medicare hospital visits over the four years ending 12/31/14, and after controlling for the health of patient, it turns out that higher physician spending is not associated with better patient outcomes.

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  1. Marc Brinitzer says:

    By design or not, your post suggests that hospital tests, scans, etc. are wasteful and that doctors are cavalier about spending. While this may be true some of the time, a lack of correlation between physician-spending and better patient outcomes could have causes other than the implied inefficiency. For example, hospitals treat emergency, trauma, and acute care needs where a variety of tests are often needed to quickly determine cause and extent of injury or illness, and where unfortunately many patients die anyway. It should also be noted that Medicare patients by definition are in the most medically expensive phase of life where many have chronic illnesses and secondary complications that can be more difficult to diagnose and treat. Finally, the threat of litigation demands of hospitals and doctors a risk management strategy that minimizes misdiagnosis and exposure to law suits.

    I appreciate and enjoy your excellent presentations and funny posts, however in this case I think you could be more cautious about supporting the simplistic and reductive thinking of those who see efficiency in health care only in economic terms. It would also be helpful to those interested in this issue to cite the source.

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