The AMA’s estimates of the time involved in many procedures are exaggerated, sometimes by as much as 100 percent, according to an analysis of doctors’ time, as well as interviews and reviews of medical journals. […]In justifying the value it assigns to a colonoscopy, the AMA estimates that the basic procedure takes 75 minutes of a physician’s time, including work performed before, during and after the scoping.But in reality, the total time the physician spends with each patient is about half the AMA’s estimate—roughly 30 minutes, according to medical journals, interviews and doctors’ records.
The WaPo story does a good job explaining some of the structural features that have lead to these wildly inaccurate time estimates. For example, the AMA uses doctor surveys to figure out how long a procedure takes. The surveys that are sent to the doctors explicitly note that the results will be used to determine pay. It doesn’t take a genius to see that this kind of data collection might, just might, invite abuse. Read the whole thing to get a sense of how deeply flawed the fundamental structural features of our health care system are.This story is just the latest in a long line of recent investigative journalism pieces that have uncovered serious but hidden health care cost-drivers. Together these pieces suggest that changes that diminish the dominant role doctors play are among the most important ways we could start shaving costs off the system in short order. (These would include ideas like giving nurse practitioners more treatment authority and raising the profile of Big Box clinics.)This is where a lot of the real action in health care reform is happening. The debate over Obamacare, sadly, seems largely irrelevant to many of these reforms.[Glove image courtesy of Shutterstock]