HOLD ON! Did you see that last charge? Per my friend, the total time spent in the presence of this ER doc was less than 10 minutes. Why so much? The extent of his intervention was to declare this injury non-emergent, refer to another care provider, and order a sling and pain meds. In other words…not much. In another context, why is his bill so much higher than a surgical consult? (Oh by the way, we’re leaving the fact that the ortho tried to talk my friend into an unnecessary procedure.)
Unsustainable economics for everyone.
Everyone except the insurance company and ER doc!
This is interesting: MSNBC did some calculations of the US budget and presented it in terms of a $1000 household budget. Most of your tax dollars go to finance healthcare. Personally disturbing for me, b/c I spent less than $400 on healthcare for myself last year!
For the picture, click here.
I wonder how much we could deduct off that amount if no needless MRI’s were performed. (see previous post)
Using data from a large insurer in California, we identified the self-referral status of providers who billed for advanced imaging in 2004. Nearly 33 percent of providers who submitted bills for magnetic resonance imaging (MRI) scans, 22 percent of those who submitted bills for computed tomography (CT) scans, and 17 percent of those who submitted bills for positron-emission tomography (PET) scans were classified as “self-referral.” Among them, 61 percent of those who billed for MRI and 64 percent of those who billed for CT did not own the imaging equipment. Rather, they were involved in lease or payment-per-scan referral arrangements that might violate federal and state laws. [Health Affairs 26, no. 3 (2007): w415-w424 (published online 17 April 2007; 10.1377/hlthaff.26.3.w415)]
In other words, and put less politely, 60% of doctors were illegally billing for imaging studies. As you know, MRI and CT scans are expensive, often over $1000. The ability of a doctor to be paid for a test like this is just way to fishy for me. I wonder if the patients sent for theses images have the ignorant good fortune to hear, “Good news, your MRI was negative!” more than those patients whose doctors were not getting illegal kickbacks.
The proper use of advanced imaging is to rule in/out a diagnosis. The overuse of these images is rampant, as many people just order the image to “see what’s going on in there” as opposed to performing a thorough and telling clinical exam.
Another excerpt from the article:
What is going to be done about this, because I’m sure there is a lot of needless expense in overuse of advanced imaging?
Why is this referral for profit ban NOT inclusive of Physical Therapy? Why is it ok for a doctor to profit from self-referrals to his PT, but not from an MRI?
I guess this is just another bit of evidence for why we should, as a society, increase our skepticism of the medical profession. They are, after all, human. Check out the WSJ Health Blog on this subject.
Perhaps not directly, but a recent BMJ article says it can help in improving physical function and quality of life measures in patients with early stage breast cancer. Some of the physical measures noted were a 12 minute walk test and a measurement of shoulder mobility. Interesting to note, the physical measures improved right away, but it took some time for the quality of life measures to show an intervention effect.
There have been a series of studies (and this one) recently dealing with the issue. I find the concept refreshing, as it really makes sense to get some supportive literature behind some good integrative care. Perhaps with enough of this type of literature, a woman diagnosed with breast cancer will be able to receive treatment not just for her cancer, but also for her receding quality of life and upper limb function…and have it reimbursed!