This post focuses on the debate’s central myth.
Myth IV–Doctors Order Unnecessary Tests in Fear of Being Sued
The argument goes that doctors order unnecessary tests out of fear of being sued for medical malpractice. The thinking is that doctors order every test possible so that treatment will not be second guessed. In the event that the doctor is sued, the jury will say that the doctor did nothing negligent and did everything possible. Therefore, the cost of healthcare and insurance rises to pay for all of these unnecessary tests.
I have one answer to this claim: poppycock!
There is one simple reason why doctors order tests: it is good medicine. No doctor will admit to doing unnecessary testing. No patient going under the knife will say that his pre-surgical tests were wasteful.
Doctors have an arsenal of tests, such as the MRI, which prior generations did not have. When there is a suspicion of a problem, it is good medicine to do further examination and testing so as to “rule out” the condition. The availability of tests are but one of doctors’ tools.
In the “good old days” doctors were able to diagnose a lumbar herniated disc without the MRI and EMG. Indeed, back surgery was done without those tests. However, today no spinal surgeon would give-up the MRI and EMG. If you were to ask a spinal surgeon why he does the pre-surgical tests, his response is that it is good and careful medicine.
This claim is also ridiculous because health insurance will not pay for unnecessary testing. Indeed, often the insurance company will require a letter of “medical necessity” from the treating doctor before it approves an expensive test. For example, the treating doctor has to show need for an MRI so that not only will his bill be paid, but the insurance company will pre-approve the test.
However, if a national health plan does pass, it is very possible that the opposite will occur. There will be much less testing since care will be rationed. As we have heard from Britain and Canada, there are long waits for MRI’s on so-called elective surgeries, such as spinal surgeries and knee and hip surgeries.
Mark E. Seitelman, 9/11/09, www.seitelman.com.