by Tom aka Rusty Rustbelt
How malpractice drives health care costs.
This is a bullet point narrative, representing a long time line, but illustrates what happens to drive health care costs:
- Emergency physicians use x-rays to diagnose closed-head injuries and miss brain bleeds.
- The hospital and physicians are threatened or sued for malpractice.
- Word circulates about these cases (physicians, administrators, lawyers).
- CT scan technology is improving and is more available.
- In response, ED physicians use more CT scans on closed head injuries.
- Benchmarking studies** indicate CT scans are best practices for closed head injuries.
- ED physicians use CT scans on more closed head injuries. Etc.
- This is how malpractice drives health care costs, even though there are relatively few suits on this specific issue.
** These sorts of studies will be integral to comparative effective programs, added to academic medicine research.
Tom aka Rusty Rustbelt
PS. I am going to be on the road for about ten days next month talking to health care providers about reform, and hope to come home with some insider information (politicians and lawyers and etc. tend to show up at these meetings).
Rdan here: The only item I would add is that the addition of expensive equipment is easier than maintaining patient volume for the equipment (ROI). Such additions were originally seen as revenue enhancers, which turned out to be less than accurate for many practices, or sometimes resulted in efforts to simply push an increase in referrals that insurance paid for, which is seen as safe practice.