Friday, April 24, 2009

My doctor is a genius; yours sucks

Thanks to the WSJ Health Blog, a pointer to a survey showing how Americans feel about their physicians. Turns out it's pretty similar to how they feel about Congress -- they hate the aggregate, like their individual representative.

The Journal boils the findings down this way:

Asked whether it was a “major problem,” “minor problem” or “not a problem” with the U.S. health-care system that too many patients were getting tests and treatments they don’t really need, 49% of respondents chose “major problem” and another 39% called it a “minor problem.”

At the same time, 82% of respondents said that they hadn’t received an unnecessary medical test or treatment over the past two years. And 87% said their doctor during that time hadn’t recommended an expensive test or treatment when a cheaper alternative would work just as well.

I'll come out and say it. I've had unnecessary tests: lots of them. Some soreness around the ankles and a few minutes in bed led to an ultrasound. Layers upon layers of CTs and MRIs. Exotic blood tests and more. Don't get me wrong -- I don't feel like my doctors have been profligate. Dr. S is actually pretty conservative, rejecting the hastily proposed idea of a brain scan, for example, when long-acting morphine starting giving me headaches and making me throw up.

Interestingly, the biggest tester of all my doctors, a glorious radiation oncologist who will still, two years after treatment, seek us out in the halls of the hospital and call as at home to ask if we need any help, is probably the physician that I love and admire the most. It's not because of the tests, but perhaps the aspects of a doctor's temperament that make him or her more likely to be more aggressive about testing are related to the parts of a physician's personality that are good at making a patient feel well-looked-after and cared for. Which is what we all want, really.


The WSJ blog post has a lot of added information and context that I didn't bring in here, so it's worth reading if this topic interests you.

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