One driver of runaway health care spending is over-treatment, a problem widely acknowledged by medical professionals. So why hasn’t anything been done to counteract the trend? Perhaps it’s easier to diagnose in others than oneself. A new poll of doctors found that 3 out of 4 MDs believe their colleagues order unnecessary tests or perform unnecessary treatment. Kaiser Health News breaks down the numbers:
In the survey, 47 percent of doctors said one patient a week requests something unnecessary. While most doctors believe they are most responsible for interceding, 48 percent said that when facing an insistent patient, they advise against it but still order the test. Another 5 percent said they just order the test […]Not surprisingly, few of the doctors agree with health policy analysts who believe that the financial rewards that come from extra procedures are a major reason why they are ordered. Only 5 percent of physicians said they are influenced by the presence of new technology in their offices. Just 5 percent believe the fee-for-service-system of payment, where physicians are paid for each thing they do rather than a lump sum for keeping a patient healthy, plays a role.
It’s unsurprising that doctors would claim that concern for patients trumps financial benefit. But both patients and doctors are working within a system with perverse incentives. Patients with comprehensive insurance can’t easily discern the real costs of their treatments. Doctors are encouraged to over-treat because they earn a fee for each discrete service, and have to make expensive new technologies profitable.Demanding patients, who are often insensitive to costs, interacting with trigger-happy doctors, makes for a fiscal disaster that none of the parties are fully responsible for. Changing the structure from the roots is crucial to making any significant progress to an affordable system.