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There is a refreshing new trend in the health industry: An acknowledgement that more medical care is not always good for our health. We’ve heard this story before from suspiciously profitable HMOs. This time, it’s coming from physicians themselves.
Physician News reported nine physician associations’ list of 45 overused common tests and treatments. The list — which includes things like electrocardiograms for people who have low risk for heart disease, X-rays for uncomplicated headaches and chemotherapy for patients with advanced cancers — gives association members guidance about selecting these items for patients.
Changing the professional attitude toward low-value services will mean counteracting a powerful force — the profit motive. Physicians, like most economically rational people, generally tend to recommend tests and treatments that reward physicians financially. This was noted in a recent Journal of American Medical Association article written by a group of behavioral economists, “Incentives in health: different prescriptions for physicians and patients.” For example, the article cited oncologists who are paid based upon the chemotherapy drugs they administer; these oncologists not only tend to use more of these drugs, they also tend to use more expensive drugs.
The economists call for an entirely different incentive scheme for physicians. Until then, we can at least begin moving toward more effective use of medical services. Many physicians may already know that certain services are overused or have limited value. Making the service list public will have two effects: one will be to put forward a new professional standard. The desire to conform to professional values is an intangible, but an important force in changing behavior.
The second effect will be that consumers will now be in on the scoop. Consumer Reports will be publishing the results, in partnership with the American Board of Internal Medicine. When the knowledge becomes widespread that you don’t need an MRI for your back pain, it’s likely that fewer scans will be done.
This is all good news for future health and for medical costs. Over time, we will avoid the less valuable and hone in on the more valuable services.
Guest blogger Linda K. Riddell is a principal at Health Economy, LLC, where she works with clients on gaining practical tools to comply with health care reform, and to maximize the new opportunities that health reform offers. She can be contacted at LRiddell@HealthEconomy.net
There is a refreshing new trend in the health industry: An acknowledgement that more medical care is not always good for our health. We’ve heard this story before from suspiciously profitable HMOs. This time, it’s coming from physicians themselves.
Physician News reported nine physician associations’ list of 45 overused common tests and treatments. The list — which includes things like electrocardiograms for people who have low risk for heart disease, X-rays for uncomplicated headaches and chemotherapy for patients with advanced cancers — gives association members guidance about selecting these items for patients.
Changing the professional attitude toward low-value services will mean counteracting a powerful force — the profit motive. Physicians, like most economically rational people, generally tend to recommend tests and treatments that reward physicians financially. This was noted in a recent Journal of American Medical Association article written by a group of behavioral economists, “Incentives in health: different prescriptions for physicians and patients.” For example, the article cited oncologists who are paid based upon the chemotherapy drugs they administer; these oncologists not only tend to use more of these drugs, they also tend to use more expensive drugs.
The economists call for an entirely different incentive scheme for physicians. Until then, we can at least begin moving toward more effective use of medical services. Many physicians may already know that certain services are overused or have limited value. Making the service list public will have two effects: one will be to put forward a new professional standard. The desire to conform to professional values is an intangible, but an important force in changing behavior.
The second effect will be that consumers will now be in on the scoop. Consumer Reports will be publishing the results, in partnership with the American Board of Internal Medicine. When the knowledge becomes widespread that you don’t need an MRI for your back pain, it’s likely that fewer scans will be done.
This is all good news for future health and for medical costs. Over time, we will avoid the less valuable and hone in on the more valuable services.
Guest blogger Linda K. Riddell is a principal at Health Economy, LLC, where she works with clients on gaining practical tools to comply with health care reform, and to maximize the new opportunities that health reform offers. She can be contacted at LRiddell@HealthEconomy.net.
