Slashdot Mirror
America's Doctors Are Performing Expensive Procedures That Don't Work (vox.com)
"The proportion of medical procedures unsupported by evidence may be nearly half," writes a professor of public policy at Brown University. An anonymous reader quotes his article in Vox:
The recent news that stents inserted in patients with heart disease to keep arteries open work no better than a placebo ought to be shocking. Each year, hundreds of thousands of American patients receive stents for the relief of chest pain, and the cost of the procedure ranges from $11,000 to $41,000 in US hospitals. But in fact, American doctors routinely prescribe medical treatments that are not based on sound science.
The stent controversy serves as a reminder that the United States struggles when it comes to winnowing evidence-based treatments from the ineffective chaff. As surgeon and health care researcher Atul Gawande observes, "Millions of people are receiving drugs that aren't helping them, operations that aren't going to make them better, and scans and tests that do nothing beneficial for them, and often cause harm"... Estimates vary about what fraction of the treatments provided to patients is supported by adequate evidence, but some reviews place the figure at under half.
The stent controversy serves as a reminder that the United States struggles when it comes to winnowing evidence-based treatments from the ineffective chaff. As surgeon and health care researcher Atul Gawande observes, "Millions of people are receiving drugs that aren't helping them, operations that aren't going to make them better, and scans and tests that do nothing beneficial for them, and often cause harm"... Estimates vary about what fraction of the treatments provided to patients is supported by adequate evidence, but some reviews place the figure at under half.
Unfortunately, we have an unrestrained free enterprise system for medicine in the US. Doctors have rigged the payment system (CPT codes) so that specialist procedures are reimbursed many times their worth in time and training. The result is that most doctors train to become specialists and focus on doing highly remunerated procedures such as those enumerated in this report. There is no effective regulation of these procedures and so as long as you're not killing a large number of patients, anything goes. It means big bucks for the doctors and hospitals (insurance companies pay but then just tack on their % O&P so they don't really care either).
Of course, people pay more for inflated cost of medical care and insurance and taxes to subsidize the whole system. The result is that we pay about twice per capita what other developed countries pay for health care but end up with poor quality care (lower health indicators than most other developed countries).
Totally corrupt system.
I don't read your sig. Why are you reading mine?
The medical literature clearly indicates that the US is one of the few western countries remaining that routinely extracts nearly all asymptomatic wisdom teeth.
There is no medical reason why this is necessary unless the teeth are severely impacted or arranged in such a way that it is difficult to brush them.
Yet wisdom teeth extraction is a huge multibillion dollar industry for the dentistry practice in the US.
Somebody didn't RTFA! The study was looking specifically at stents used in cases of stable angina that is responsive to medication, and found that the stents were higher risk but provided no benefit over medication in the case of stable angina. The study did not attempt to address the effectiveness of stents in other cases including cases where medication did not control stable angina.
That still represents a lot of excessive costs for no benefit.
This is the original story that should have been linked to. Not that stupid Vox shit.
https://www.propublica.org/article/when-evidence-says-no-but-doctors-say-yes
I don't respond to AC's.
and not much else.
I was hoping for a list of treatments and statistical comparisons of their outcomes.
Best wishes for a peaceful, prosperous 2018,
Doctors perform a LOT of tests and procedures simply as a guard against getting sued. Their malpractice insurance providers insist that the doctors cover their asses.
I know several doctors personally, and one told me that slightly over half his cost of doing business (and medicine IS a business) was malpractice insurance. Next time you walk into a doctor's office, understand that whatever you pay to the doctor goes to rent, salaries, utilities, insurance, supplies, and some $$ to the doctor himself.
It's been suggested many, many times that the solution to the rising cost of healthcare is tort reform or loser pays. Why won't anybody listen?