Comments on: Wait, What?

By: Will Large Employers Dump Healthcare Coverage? - Better Health

Will Large Employers Dump Healthcare Coverage? - Better Health — Mon, 24 May 2010 12:59:39 +0000

[...] Fortune magazine reporting on this so breathlessly? I think they — like so many others who have written or talked about healthcare reform — don’t seem to know all that much about their subject [...]

[WORDPRESS HASHCASH] The comment’s actual post text did not contain your blog url (http://www.seefirstblog.com/2010/01/11/wait-what) and so is spam.

By: EJ

EJ — Sat, 23 Jan 2010 16:31:29 +0000

An ounce of prevention is owrth a pound of cure.

Enough said

By: Aurora

Aurora — Thu, 21 Jan 2010 02:29:33 +0000

This is a great post. I've been learning more about end-of-life care here in Oregon, which has been a hot topic for a long time. The state has now instituted a computerized program for end-of-life care directives, which in theory will make them available to doctors when Your Time Comes, and tell them what you would prefer to have happen to you. I think that this sort of system is a step in the right direction, and a way to save money> For instance, if someone did not want certain end-of-life treatments, they could opt out and that information would be easily accessible to not only their doctor, but also perhaps emergency services and other health care workers they run into. http://bit.ly/4vHIpM

By: MKirschMD

MKirschMD — Wed, 13 Jan 2010 00:01:21 +0000

Evan, time is only one factor that promotes more testing. Defensive medicine is another one. In addition, as I alluded to at the end my comment above, patients often expect and demand more care. They (along with many physicians) are infatuated with technology. I've rarely met a patient who resisted having a CAT scan done. Finally, we are now in a medical culture of excess when we do more simply because this is the way medicine is practiced today. Because there are many factors at play, it will be difficult to reverse the trend of excess. The medical profession and the public will have to learn together that less medicine means more healing.

By: Evan Falchuk

Evan Falchuk — Tue, 12 Jan 2010 20:13:03 +0000

There's something interesting I have seen in lesser developed countries. Because doctors spend much more time with each patient, listening to them, doing a thorough physical exam, they rely much less on diagnostic testing. This is true even though in many cases the same level of technology is available as in the US.

It's almost as if many US doctors end up ordering diagnostic tests because they need to use them as a short-cut given the limited amount of time they have with each patient. It seems to me the problem with this isn't that it's wasteful (it is) but that it robs the patient of the judgment of their doctor.

By: MKirschMD

MKirschMD — Tue, 12 Jan 2010 06:32:22 +0000

Evan, nice post. While the variations in end of life care suggest that there is excessive medical care being practiced then, I believe we need a wide angle lens here . I think that excessive care is being practiced at all phases of life. Indeed, I suspect there is much more money being expended on excessive care in midlife, than there is at the end of life. My suspicion is that if physicians could practice more strictly according to medical evidence, then we would have enough money to cover the uninsured, with several tens of billions of dollars to spare. How do we do this? I have no idea. Physicians, including me, pursue more treatment and testing than is necessary for many reasons. Getting us to practice differently will require a new system with different incentives and compensation formulas. And, patients will have be be satisfied that less is more. www.MDWhistleblower.blogspot.com