HEALTH NOTES

“LABORATORY TESTS CAN BE VERY PROFITABLE”

PART V

I believe that we must all recognize that accurate and appropriate testing is important and crucial for accurate and appropriate diagnosis. However, excessive testing or testing that is inappropriate increases our healthcare costs. I’ll use an example that recently occurred in my office. A patient who had been suffering from lower back, buttocks and leg pain for approximately three weeks and then missed an extended period of work had been treated by her family doctor over the course of her ailment. Her treatment consisted of x-rays, an MRI scan, and multiple medications. The patient was disabled for ten days from work. When the patient hobbled into my office and had to stand to perform paperwork, shifting weight from one leg to the other, this patient had seen little to no improvement, and felt that her condition worsened over the course of her treatment. Upon entering my office, a complete case history and physical examination was performed. I reviewed her MRI scan, which was negative and probably not necessary at that time. A cost savings of about $1000.00. It was apparent, following these procedures, what the condition was that she was suffering from. An accurate diagnosis was concluded and appropriate treatment was initiated. Within one day the patient was significantly improved.

I say this not to tout my practice or diagnostic abilities; however, we all must understand when appropriate testing is necessary. It is also important within the health care arena that we understand when appropriate referrals are necessary. Had this patient been referred to my office initially, when she began experiencing her symptoms, significant health care cost savings would have occurred. I would not have run an MRI scan on the patient, at that time and the multiple medications which I know are expensive could have been avoided. Because this patient has an HMO plan, in which by the way, I do not participate, individual out of pocket expense was low to the patient for these procedures. Only co-payments were necessary to be paid. This is still a significant out of pocket expense for the patient, but the insurance company is the one who had to foot the bill for the MRI scan, and x-rays which is close to the same amount paid for the MRI scan, along with multiple medications. The point I’m trying to make is that just because the patient is not paying the majority of these costs doesn’t mean that health care costs aren’t rising. Next week I will conclude this series of articles with some ideas to guard against this problem occurring with you.