Opinion
Patients and doctors must confront realities that are driving up costs
LETTER — Posted Aug. 10, 2009
To the AMA and all physicians: I have a job for you. If we truly want to have an impact on skyrocketing health care costs, it starts with us. We need the AMA to launch a nationwide campaign targeted at both doctors and patients to address two enormous components of health care expenditures: end-of-life care and the rampant use of unnecessary tests, antibiotics and expensive medications.
In terms of end-of-life care, we need to inject a dose of reality into decision-making. We need to stop the endless cycle of ordering tests and procedures and hospitalizing patients for each new sign and symptom, and address quality of life in a more realistic way. As we all know, most medical expenditures occur at this time, and much of what we do results in suffering instead of comfort.
In terms of the overuse of antibiotics, expensive tests and medications, let's shift our priorities to more efficient care. We don't need to do shotgun expensive workups when we can develop directed approaches. Patients need to be encouraged that the most cost-effective treatments that are tailored to their needs are the best, rather than what they just saw on TV. Doctors need to have the courage to say "no" when patients insist on treatments and tests that are unnecessary. And truly "defensive" medicine can be efficient and well thought out rather than excessive.
Donald S. Levy, MD, St. Louis
Note: This item originally appeared at http://www.ama-assn.org/amednews/2009/08/10/edlt0810.htm.
