Friday, November 23, 2007

Q: What Scares Doctors? A: Being the Patient -- Printout -- TIME

Q: What Scares Doctors? A: Being the Patient : "Even more insidious is the danger of overtreatment. With well-insured patients inclined toward hypervigilance, doctors afraid of missing something and a reimbursement system that rewards testing over talking, there is embedded in the system a dangerous impulse toward excess. Specialists are typically paid much more to do a procedure than the family doctor who takes the time to talk through the treatment options. A doctor who does a biopsy may be paid as much as $1,600 for 15 minutes' work, notes Dr. Jerome Groopman of Harvard Medical School. 'If you're an internist, you can easily spend an hour with a family where a member has been diagnosed with Alzheimer's or breast cancer, and be paid $100. So there's this disconnect between what's valued and reimbursement.' And yet sometimes, talking is the more important and certainly the safer treatment. Ten more minutes spent taking a family history can reveal clues that prevent a misdiagnosis or an unnecessary test; that childhood injury, that illness during a trip abroad, that family history of excessive bleeding. "

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