Let's talk about medical over treatment

[spinbaby]

There seem to be a couple or more threads in here about people getting inadequate medical treatment. I think an equally pervasive problem is over treatment--more specifically, treating you to the limits of your insurance whether you need it or not.

I happen to work for a company that offers "Cadillac" insurance--in other words, insurance that pays for nearly everything without argument. My pay is less than industry standard, but I stay with the company in large part because they do offer really good insurance. But I have experienced, and I have talked to coworkers who have experienced, pressure to get more treatment than we feel is necessary. For instance, my gynecologist tried to rush me into a hysterectomy, which turned out to be totally unnecessary when I consulted another doctor. Many of us seem to have had a great many MRIs. There is a surprising amount of gastric bypass surgery going on.

My mother lives in a retirement community. 15 years ago, there were a few power scooters, but most residents walked where they were going. Now most residents ride scooters--so many that the place had to add a special room in the main building to park the scooters. Why the proliferation in scooters? Because there are businesses devoted to selling seniors scooters that Medicare pays for.

How often are we not so much patients getting the best treatment, but profit centers to be sold as much treatment as our insurance will pay for?

[napi21]

1. I don't know about over treatment, but I KNOW Dr's tend

to prescribe whatever new drug is being pushed by the drug co's instead of a Generic or old fashioned med that would work just as well.

Our Doc seems to have a habit of having the nurse give you the scripts as you pay the bill and I can never read the damn things anyway. Twice I was prescribed one of those "new" drugs you see advertised on TV. It was done by two diff. docs and over a year apart. The stupid drug was prescribed for back pain in my case and also prescribed for my husband because they thought he had arthritis in his elbow. The drug didn't do a damn thing for either of us, but of course it was $60 for each script!

A friend told me to take the formulary with me the next time I went to a doc so they would know what's in which tier drug.

The other thing that gripes me is when you know the doc is 90% ssure what's wrong with you but insists on an xray or MRI just to be sure. A friend of mine who is a VP at a very large hosp system told me the ins. co's what provide malpractice ins. insist that they do that to cover their own butts!

[Cleita]

2. That happens IMHO because we have an un-level playing field in

medicine so the doctors will treat those who can afford it. They are a business too. When everyone has the same access to the same health care and the doctors are assured of payment, I think you will see them treating the sickest patients not those with the best health plan or cash to pay for it. Years ago hysterectomies, hemorrhoid surgery and tonsillectomies were the surgeries of choice for making money. I remember when I worked at a hospital while in college hearing doctors discussing whether they should suggest a hysterectomy to certain women because they already had several children but for no other reason. There seemed to be a male consensus that this surgery was harmless, along with removing hemorrhoids and children routinely had their tonsils removed just because they might get infected. These were cash cow surgeries. These patients were, of course, mainly middle class with extra money to exploit. I doubt if the poor at the County Hospital were exploited in the same way.

So just because a certain demography gets more medical care than they need doesn't excuse the millions of people who can't get any health care at all unless it's through charity.

[spinbaby]

4. Overtreatment uses resources

The system has some patients getting unneeded treatment at the expense of those who really do need it. In my experience, doctors with a private practice to support are the worst offenders. My husband some years ago had two cysts to be removed. They were next to each other and he quite reasonably wanted them removed at the same time. The doctor made him have each removed separately with the explanation that the insurance wouldn't pay for removing the second one in the same surgery. Total waste of everyone's time just to get more insurance money.

[TreasonousBastard]

3. Here's a New Yorker article that addresses exactly this problem...

http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande?currentPage=all

[Clear Blue Sky]

5. Don't forget the malpractice part of overtreatment.

Every headache in the ER gets a CT scan, even though most don't need it. Ditto for many other procedures.