Friday, July 24, 2009

Unnecessary tests for patients

The attitude and training of doctors and expectations of patients( how educated and rich they are) and extent of coverage by HMO/PPO determine which tests are needed or not. In HMO setting ,we are taking about popultaion medicine and the appropriate test is decided by n factor or number needed to treat .It is simple to say that what is good for a popultaion in general is good for you and that is what covered by ins company. On the other hand pts with PPO coverage and high deductable want to pay for tests for which may not be necessary, we just cannot say no because pts expectation is high and is willing to pay. There are several executives panel offered by Labs which can cost 3-4K which included several type of scancer screening, is sometimes ordered for such pts.I have never done that. Severeal time sI have had pts who would bring Carotid US screening test for STROKE???? done outsode for which they paid 100-150 dollars, without even asking their doctors?More evidence based medicine needs to be practiced with focus on strong prevention methods. Good practive of medicine needs to be emphasized.

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