One In Five Million
You have to wonder if Mikey would ever happen to mention, when he talks about the cost of medicine, something about this:
I was appalled to learn of a colleague’s fate at the hands of a Mahoning County (Ohio) jury in a recent malpractice case. The patient presented with what any prudent physician would deem to be muscular back pain and went on to die of an aortic dissection. Given the patient’s age and sex, the likelihood of such an occurrence would be about two in 10 million.
The likelihood in the presence of back pain would be higher, but given the particulars of the case would still be vanishingly small. Making the diagnosis in a case like this would require a policy of obtaining a CT scan on virtually every case of back pain.
Why not obtain a CT scan on every patient with back pain or, for that matter, perform every test known to medical science on every patient who is ill? After all, peoples’ lives are at stake.
There are two reasons. First, nearly every test in medicine is inaccurate. A test that is positive often leads to further testing which, if the test result is in error, is unnecessary. Such testing is sometimes invasive and therefore potentially dangerous, and if the patient is hospitalized unnecessarily there is the additional risk of life-threatening infection. Because of this, the search for extremely unlikely diagnoses would kill more patients than would missing those diagnoses. Researchers at Dartmouth University have shown that more care is often worse care.
The second reason is cost. Embracing this policy would necessitate closing the Pentagon and abandoning public education. As it is, some of my younger colleagues, paralyzed by the fear of being sued, regularly spend $2,000 to diagnose a cold.
Malpractice is defined as a bad outcome resulting from negligence; negligence is defined as other than what a prudent physician would do in similar circumstances. That my colleague acted prudently is beyond dispute. The patient was a victim of fate, not negligence. My colleague was a victim of a process wherein a class of professionals with the morals of a drug dealer hires medical prostitutes to mislead juries in order to win the malpractice lottery. Nationwide, the money being diverted from patient care to service this process is $192 billion per year, approximately 10 percent of the entire cost of health care, enough to pay for all the costs incurred by America’s uninsured more than twice over, and far more than the annual cost of the wars in Iraq and Afghanistan.
I’ve probably said this before, but there is a perception in America that doctors note symptoms, look them up in a great big book and come out with a perfect diagnosis. It ain’t so. Medicine is as much art as science, as much instinct as knowledge. Our bodies are not very good at indicating what’s wrong with them and most physicians have to to act on incomplete knowledge. When they guess wrong—even when the right guess was a two in ten million shot—they get sued. And we all pay. Not only with malpractice premiums but with the cost of unnecessary tests.
But forgot that. Our expensive healthcare system is entirely the result of evil insurance companies, evil drug companies and evil providers. Don’t think. Just feel. That’s it. $8 for adults. $4 for children. Be sure to buy the DVD.
Comments
To make matters worse, not only do people expect doctors to be infallible and practically god-like (and unfortunately some start to believe it themselves) far too many people also don’t give all the information asked of them. Sometimes they’re embarrassed, sometimes they’re hiding something, sometimes they just don’t know or remember. But often there’s lacking info.
While the show does often show them coming up with the solution in the nick of time.. a show like House does, I think.. try to really show people this. Unfortunately I don’t think most people see that aspect much, if at all.
With the lottery (as put in the article) masquerading as a legal system in this matter, even having left out important information that can make the difference won’t necessarily mean much to a jury that tends to be swayed more by presentation and appeal to their personalities then by cold hard facts. It amazes me how many people’s reactions to a sad, but nonetheless accidental death of someone is not something to live through and move on, but is something that can be exploited into a nice fat check.
They call it Practicing Medicine for a reason. It is always practice! I try not to trust completely in doctors. I was having back pain a couple of years ago and my doctor took and x-ray. She then said it was just because I was over weight. I lost weight and my back was still in pain. I demanded an MRI and after much hesitation and protest she got me in for one. The reports came back and low and behold I have three degenerating disc, and two herniated discs. It stems from an injury I recieved in the army, but still as I have learned Doctors don’t know everything. Medicine is changing every day. If Mr. Moore is trying to state that Doctors should be able to heal everything and know everything he is an imbecile!
If Mr. Moore is trying to state that Doctors should be able to heal everything and know everything he is an imbecile!
We already know he’s an imbecile. I don’t think for one second he expects doctors to be able to fix everything. He does, however, expect the Government to fix everything. And that’s the whole problem.
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Great. My wfe called medics Sunday morning after I’d bitten the heck out of my tongue in my sleep during what appears to have been a grand mal seizure - the first I’ve ever had, to my knowledge.
Numerous expensive tests later its been concluded that I have an old, large, benign tumor living in the right side of my brain behind my temple, and that it needs to come out on Friday.
I’ve been doped up and feel just fine overall, but I guess the prognosis is grim, according to Mikey. I expect to be a vegetable within a week so if I don’t post anymore you know why. You’re either rich or dead in this country, therefore my prognosis is rather grim (even tho my surgeon looks a bit like Kevin Spacey, and he’s always good).
Good thing I learned sign language and Morse code when I was still healthy; I can hopefully still communicate with my lawyers if they don’t suck that part of my memory out by mistake. I don’t much look forward to living under a bush. 8 years under any Bush is deadly.