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.

Comments

No Money

[Anonymous Coward]

Duh, there is no money in actually healing people. Take the profit out of medicine and it will start actually work again.

Re:No Money

[VeryFluffyBunny]

In the UK, where the NHS is the only real game in town and health insurance is a national govt. system, doctors are allocated budgets for the numbers of patients that they have enrolled on their books. It's in their interests to spend as little as possible on keeping their patients as healthy as possible in order to conserve their budgets. The NHS is one of the best health services in the world in terms of outcomes for per capita spending. Well, that's the last time I heard. The current UK right-wing* administration are doing their best to wreck it.

*right-wing in the UK is still thankfully far left of the Democrats in the USA.

Follow the money

[mspohr]

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.

Damn stupid story

[Anonymous Coward]

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”

Re:Damn stupid story

[sjames]

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.

Same thing happens in dentistry

[ravenspear]

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.

Re:better than getting sued

[arth1]

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.

Double negative

[petes_PoV]

The point of those operations was not to heal people. It was to avoid a lawsuit. It is much better for a hospital or a doctor to put a patient forward for some treatment than to do nothing. That leaves them open to malpractice or negligence claims. And since they aren't the people paying, it makes no difference to them if the procedure works or does nothing.

Avoiding a cost is just as good as making a profit, if someone else is paying.