mead cohen berger shevtsova garfinkle michta grygiel blankenhorn
Medical Money Pits
You Don't Need All the Health Care You Get

In many areas of medicine, doctors could reduce the amount of health care they give patients without any adverse effects on the patients’ health. That’s the takeaway from a new campaign led by hospitals and theĀ American Board of Internal Medicine Foundation to get specialists in various medical fields to eliminate wasteful or unnecessary procedures. Via the WSJ, a new study published in the Journal of American Medicine looks at one attempt to reduce cardiac monitoring (telemetry) among patients outside intensive care:

After the changes, the researchers found the hospital group’s mean daily number of non-ICU patients monitored with telemetry fell by 70%, from 357.5 to 109.1, while the mean daily cost for delivering non-ICU telemetry also fell by 70%, from $18,971 to $5,772. The changes had no negative effect on patient care; mortality rates at the hospitals remained stable, as did the number of “code blue” emergency calls to resuscitate patients.

“It is remarkable to achieve such a substantial reduction in the use of this resource without significantly increased adverse outcomes,” Nader Najafi, assistant clinical professor at University of California, San Francisco’s Division of Hospital Medicine, wrote in an editorial accompanying the research publication.

It’s likely that there are pockets of unnecessary care like this all throughout the health system, as doctors themselves have often reported. Some would like to solve this problem by empowering centralized government bureaucracies equipped with standard operating procedures and data charts to impose uniform care throughout the system, but that approach poses as many problems as it purports to solve. Medical bodies like the AMA, however, surely have a role to play, and the key will be getting patients to act, when possible, more like informed consumers, equipped with enough information and incentives to choose doctors committed to providing only the care that is necessary.

Features Icon
show comments
  • lukelea

    My local ER charged Medicare $1200 to prescribe some ear drops for my swimmer’s ear.

    • Andrew Allison

      If it reoccurs, try a 50/50 mix of peroxide and vinegar instead — I’ve used it for years, both prophylactically to get the water out of my narrow canals and in cases when I didn’t and got swimmers ear.

  • seattleoutcast

    Now that I have no health insurance (age 49), I hope there is more of this.

  • Matt_Thullen

    While this is a promising development, remember that this is the U.S. legal system and U.S. culture that we are operating in. GM may be forced into bankruptcy over faulty ignition switches that are responsible for a small percentage of injuries and deaths.,Auto makers have learned very well that when there is a choice between (a) decreasing costs and taking on an associated additional risk of injury or death or (b) increasing costs in order to ensure that even a very remote chance of injury or death occurs, they will take choice (b) every time. The legal system in the U.S. taught them that taking statistically sound risks will be punished severely.

    Unless there is some form of liability reform surrounding medical care, doctors will do exactly what the auto makers have done.

  • Dan

    “while the mean daily cost for delivering non-ICU telemetry also fell by 70%, from $18,971 to $5,772”

    Why does this cost so much in the first place? Isn’t this just the monitor that tracks heartbeat?

  • FriendlyGoat

    Every force in society EXCEPT the patient and the patient’s family should be focused on reducing ineffective care and lowering costs. But when you’re sick or injured, you are SICK or INJURED. No one, not even a staunch conservative or a loopy libertarian, wants to “go value shopping” at that time. This whole notion of talking about forcing sick people to become better consumers is totally nuts.

© The American Interest LLC 2005-2016 About Us Masthead Submissions Advertise Customer Service