Healthcare in America - a Tale of Feast or Famine

We're all familiar with the accounts of America's healthcare "have nots," the tens of millions who get by with no health insurance and the hundreds of millions who are vulnerable to partial health insurance or capricious insurance companies.   But what about the "haves," the lucky people with the gold-plated health insurance coverage?   A study of primary care physicians finds the "haves" are undermining American healthcare.   They're simply getting too much healthcare for their own or anyone else's good.

In a new poll of primary care physicians, nearly half of them said their patients received too much medical care and more than a quarter said they were practicing more aggressively than they'd like to.

That could mean ordering more tests, prescribing more drugs or diagnosing people with diseases, although they would never have experienced any symptoms.

"Physicians at the frontline of medical care are telling us that their patients are getting too much care," said Dr. Brenda Sirovich of the VA Medical Center in White River Junction, Vermont, who worked on the survey. "And we don't think we are just talking about the 627 physicians that we surveyed."

"We spend a lot on healthcare in this country, more than anywhere else," Sirovich, also at the Dartmouth Medical School, told Reuters Health. "We realize that this is unsustainable."

...So why would doctors order tests that they themselves believe are excessive?

Three reasons stood out in the survey, which is based on a random sample of U.S. doctors: fear of malpractice lawsuits, performance measures and too little time to just listen to patients.

Four in 10 also believed that other primary care physicians would order fewer tests if those tests didn't provide extra income. (Of course, just three percent thought that financial considerations influenced their own practice style.)

"I'm not saying that physicians do tests in order to make money -- there is a potential to be a real cynic here -- but I think that the reimbursement model for most healthcare encourages utilization in a variety of ways," Sirovich said.