Wednesday, July 2, 2008
NYT: CT Angiography May or May Not Be Worth the Cost
Filed under: Business of Medicine
The New York Times has an interesting piece out on the overuse of medical technology. To summarize their five pager: There's not enough data out to suggest that CT Angiography actually reduces costs or improves patient outcomes, but doctors tend to request the tests all the time anyway. They go on to do a so-so job of generalizing the phenomenon...
The problem is not that newer treatments never work. It is that once they become available, they are often used indiscriminately, in the absence of studies to determine which patients they will benefit...Once the F.D.A. approves a test or device, Medicare rarely demands evidence that it benefits patients before agreeing to pay for it. But last year, Medicare officials raised questions about the benefits of CT heart scans and said it would demand more studies before paying for them. But after heavy lobbying by cardiologists, Medicare backed down.
One thing The Times fails to highlight is the factors driving the decision on behalf of the doctors. Not only will they be paid as a result of running the test, they're absolved of potential liability of not running the test. It was our experience in the Ortho world that MRIs and CTs were ordered "just to be safe," lest they be questioned on what could have been found in future malpractice proceedings.
Obviously, medical decisions should be based on statistically sound evidence, but there's a fundamental paradox to gathering sufficient evidence before reimbursement: who pays for all of those scans while the data's collected?
More from the New York Times...
(2)
examples: <b>Bold</b> <i>Italic</i>
