June 14, 2009

doctors and the cost of health care

a nytimes editorial on the contribution of over testing and over treatment to the high costs of health care, similar to recent atul gawande's essay in the newyorker, which has become an unofficial ethnography on the subject, even referenced by obama.

what's omitted is that while costs scale with the number of tests and treatments performed without affecting outcomes on average, for some patients, the extra care translates into substantial benefits.

these patients comprise a small fraction of the overall population, but the benefits they reap should not be understated. likewise, in some cases, the extra tests and treatments are essential, playing important diagnostic and learning roles, particularly in academic medical centers, where patients may be referred to receive specialized care, and doctors are working in training.

one hopes that remedying the high costs associated with superfluous tests and treatments, doctors will remain free to make decisions in the best interests of individual patients, and not aggregate statistics.

No comments: