You Be The Judge

For insight into what’s going through your doctor’s mind when he orders all those “just in case” tests, here’s a must-read by Dr. Happy: Why Does Rule Out Testing Feel So Good? Follow him through the patient exam, consider the symptoms, and then throw common sense out the window because John Edwards (D-Ambulance Chaser) and his comrades may destroy you if you don’t:

Do you send the patient home with a diagnosis of panic attack and follow up with her doctor? Or do you pursue further testing for pulmonary embolism? That is the million dollar question. And let me answer it for you. Our current system is set up to pursue the diagnosis of exclusion without regards to cost. And here’s why. Doctors act out of fear. Patients respond out of the comfort of knowing. And in both situations, neither is personally held responsible for for the cost of their desires. We pay for it through higher premiums. We will pay for it through higher taxes. The patient is immune from the immediate cost of feel good medicine. The doctor is immune from the fear of not knowing. A fear that is driven to spend other peoples money to prevent a bad outcome.

Those of us with high deductible plans, on the other hand, tend to have a discussion with the doctor to weigh the benefits and risks and then decide how best to spend our money. You know, like free, independent, adults. I skipped the doctor’s suggested EKG because it was a “just in case” even though she really thought – and I agreed, after we talked about it – that my chest pains were due to acid reflux. I essentially gave her a CYA – yes, I understand you recommend it, but I’m going to take Prilosec for a few days and see how it goes; if I want to schedule the EKG I’ll call you. So she got to chart the order, and I got to avoid paying for an unnecessary test. Gambling, or a considered decision by an adult who doesn’t expect to have a risk-free life? You be the judge.