When Medical Informatics Clashes With Medical Culture – Informationweek

Notes how the lack of information on costs hampers more informed choices by doctors and patients. A number of articles have talked about the particularly opaque nature of costing and billing in the US (although I expect that the HMOs have fairly good data and reimbursement schedules), as do the more public universal systems in other countries. Quote:

Many physicians would argue that ignoring these more remote diagnoses means putting costs ahead of patients’ welfare, and that’s simply unethical. But Rosenbaum and Lamas point out in their recent NEJM editorial, Cents and Sensitivity–Teaching Physicians to Think about Costs, “Considering cost serves not only the equitable distribution of finite services but also the real interests of individual patients. Medical bills, after all, are among the leading causes of personal bankruptcy.”

Those bills would be significantly lower if physicians stopped ordering unnecessary procedures. And there’s now solid evidence to show that some routine diagnostic and screening tests really are a waste of money.

Among the worst offenders: screening EKGs, chest X-rays before outpatient surgery, and CT scans or MRIs after a patient faints. Unnecessary tests have become so prevalent that nine major medical organizations have launched “Choosing Wisely” campaigns to educate clinicians and the public about wasteful testing.

When Medical Informatics Clashes With Medical Culture – Healthcare – Electronic Medical Records – Informationweek.

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