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.
Duh, there is no money in actually healing people. Take the profit out of medicine and it will start actually work again.
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?
Stents WORK for heart disease - that’s proven and the story stupidly misleads it for click bait (and slashdot editors happily repeat)
The study in question showed that stents don’t necessarily reduce heart pain in patients with narrowed arteries which is contradictory to the theories about how heart pain/disease work.
Regardless a clogged artery will still kill you and a stent resolves that problem!
More piss poor science “reporting”
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.
This simply isn't the real problem.
Doctors in the US over-treat illnesses, use outdated and ineffective treatments and generally run up the costs of medicine.
The above statement is based on my wife's treatment in the USA and in the UK.
In my own case, I had a problem for which one of the treatments is surgery. I was referred to a hand specialist who only discussed the surgical option with me. When I asked about the alternative treatment that I had discovered using Google, his response was that he didn't do that treatment and I would have to see another doctor. Had I not researched it for my self, I would never have known that there was an alternative. That's on top of the fact that I had to pay for a completely useless consultation with the hand surgeon.
Summary, even if you have good insurance in the USA, you may not be getting the best treatment.
The real "Libtards" are the Libertarians!
Doctors in the US over-treat illnesses, use outdated and ineffective treatments and generally run up the costs of medicine.
Running up the costs is an inherent problem with for-profit medicine.
The last time I went to a doctor, it was for a broken arm. They wanted to do full blood panel and urine tests and follow-up appointments for those. I asked them what for, and they said that they always had to do that if there weren't recent results on file. I asked whether it would change the treatment of the broken arm from a sling to something else, and the doctor said no, but it could discover unrelated issues. Well, I was not there for unrelated issues or to look for could.
I ended up switching doctors, because of the money grab.
Fuck the doctors and their affiliations.
The only way to fix that is to give Doctors the ability to have the case dismissed if they show that they treated the patient according to evidence based practice.
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.
It's approved, but the first doctor I consulted about my hand did not mention it as an option. That's my point: medicine in the USA is frequently bad.
The real "Libtards" are the Libertarians!
Pointless procedures? Infant circumcision comes to mind. Medically worthless, known to reduce man's sexual capacity, occasionally very destructive or even fatal. Without any doubt, it is a heinous violation of one's essential human right to bodily integrity.
Circumcision is child abuse.
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?
Avoiding a cost is just as good as making a profit, if someone else is paying.
politicians are like babies' nappies: they should both be changed regularly and for the same reasons