(CNN)When your doctor orders a test for you, is he looking out for your best interests or his own? When looking at 2013 insurance claims from nearly 1.5 million adults with commercial insurance, researchers found that just under 8% of people had received “low-value services,” with the research defined as providing little value to patients, given all the costs and alternatives.
“What, are you supposed to say no?” she asked, noting that “failure to diagnose is one of the most common reasons for filing a lawsuit, so there is a lot of pressure [on doctors] to, if you think of something, to do it.” She also said some patients in high-deductible plans may refuse tests, despite a doctor’s recommendation.
Another important issue: Self-appointed committees that decide which treatments or procedures are low-quality may have conflicts of interest or no direct responsibility for patients, so their guidelines may not always be valid.
More importantly, treatment recommendations and guidelines “can change quite dramatically” over time, explained Orient. As an example, she noted that a radical mastectomy was once considered the only treatment for all breast cancer, yet today, some patients are successfully treated with a lumpectomy.
She does believe all doctors would benefit from learning how to read and interpret scientific studies and the potential risks and rewards for actual patients. As she sees it, medical schools currently do not provide that kind of training.
Not only are doctors inadequately prepared, they may be feeling discontented. In 2013, a report from Deloitte Center for Health Solutions suggested that doctors are increasingly dissatisfied with their jobs. Three-quarters of doctors said they believe the best and brightest may not consider a career in medicine, an increase from 69% in 2011, according to the report. Deloitte also noted that four in every 10 doctors said their take-home pay decreased from 2011 to 2012. Notably, the majority did not blame the Affordable Care Act.
“Doctors don’t get paid for looking at patients and doing the best they can; they get paid for following insurance companies’ recommendations,” said Orient. “It’s terrible.”
Read more: http://www.cnn.com/2016/08/30/health/doctor-money-tests/index.html