OB/GYN Pushes Doctors To Think About Cost
In case one isn't convinced that a lot of hospital procedures have no logical rationale for a lot of order sets and procedures, some of which may even cause harm, Demosthenes has a few others that persist in her specialty of obstetrics and gynecology.
One is repeat testing in pregnant women for the inherited blood disorder sickle-cell anemia. If a woman tests negative for it one time, she doesn't need to be tested again during subsequent pregnancies. "But we just repeat the test. Why? Because it's too much effort to find the old test."
Pap smears are performed more frequently than the once-every-three year recommended interval as well, she adds. Done too frequently, they may provoke clinically irrelevant findings of things that are unlikely to be cancer, or are so very slow growing as to be meaningless. Yet pap smear tests done too frequently can lead to biopsies, which are uncomfortable, add cost, and "may lead you to have a procedure that could go wrong."
And ultrasounds, which are expensive too, are done too frequently, often in pregnant women who just want another picture, she says.
Demosthenes acknowledges a huge dilemma that doctors like her face every day. They're increasingly being scored, and paid, on the basis of patient experience scores.
- CMS Mulls Income-Adjusting MA Stars
- Providers Prep for New Payment Models as Population Health Grows
- As Retail Clinics Surge, Quality Metrics MIA
- Providers' Push to Consolidate Roils Payers
- 3 Ways to Rev Employee Development Programs
- Former NQF Co-Chair Linked to Conflicts of Interest in Journal Probe
- No Employee Satisfaction, No Patient-Centered Culture
- Transforming Decision Support and Reporting
- Aligning Executive Compensation with Provider Mission
- 6 Not-So-Good Reasons for Avoiding Population Health