http://healthaffairs.org/blog/2009/09/10/bringing-health-care-reform-back-into-a-health-insurance-reform-bill/ The Policy Journal of the Health Sphere Tue, 07 Feb 2012 22:23:43 +0000 hourly 1 http://healthaffairs.org/blog/2009/09/10/bringing-health-care-reform-back-into-a-health-insurance-reform-bill/comment-page-1/#comment-30929 jreichman Mon, 14 Sep 2009 16:09:31 +0000 http://healthaffairs.org/blog/?p=2104#comment-30929 Dr. Luft makes the statment: " This may actually be the cause of defensive medicine—the excessive ordering of tests and imaging to protect oneself in case of an adverse event. Such tests, however, often also add to the physician’s revenue, usually with a much higher profit margin than simply spending more time talking with the patient. " Do you have any data to support this premise? My personal observations (no data) are that excessive testing is at least a two-fold problem: patient expectations and potential threat of litigation for failure to diagnose. Only in very rare instances, is the potential abuse to add to physician revenue germaine. In discussons with practitioners whose specialties have the potential for abuse of excessive testing for finacial gain, the vast majority have strong clinical indicators for the testing. I would agree that "modern medicine" has often substituted testing as a proxy for talking with the patient. Dr. Luft makes the statment: ” This may actually be the cause of defensive medicine—the excessive ordering of tests and imaging to protect oneself in case of an adverse event. Such tests, however, often also add to the physician’s revenue, usually with a much higher profit margin than simply spending more time talking with the patient. ”
Do you have any data to support this premise? My personal observations (no data) are that excessive testing is at least a two-fold problem: patient expectations and potential threat of litigation for failure to diagnose. Only in very rare instances, is the potential abuse to add to physician revenue germaine. In discussons with practitioners whose specialties have the potential for abuse of excessive testing for finacial gain, the vast majority have strong clinical indicators for the testing.
I would agree that “modern medicine” has often substituted testing as a proxy for talking with the patient.

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