February 11, 2009 4:00 PM
- Text
Defensive Medicine: Cautious Or Costly?
(CBS)
It started as a simple stomach ache, but Alexandra Varipapa, a sophomore at the University of Richmond, decided to go to the emergency room.
There, doctors ordered a full CT scan, a radiation imaging test, which found a harmless ovarian cyst. She never questioned the CT scan, CBS News correspondent Wyatt Andrews reports.
But her father did - when he got the $8,500 bill, $6,500 of which was that CT scan.
"I was pretty flabbergasted," said Robert Varipapa, himself a physician.
Varipapa says his daughter's pain could have been diagnosed far more easily and cheaply with a $1,400 ultrasound.
"A history, a pelvic examination and probably an ultrasound," he said. And he would have started with the ultrasound.
But the hospital defends the CT scan, saying an ultrasound might have missed something more serious.
"It would not have ruled out appendicitis obviously, it would not have ruled, necessarily, out a kidney stone," said Dr. Bob Powell, ER medical director of Bon Secours St. Mary's Hospital.
Varipapa agrees, but asks why not start simple - and do the CT scan only if necessary?
"Well it's my opinion this is defensive medicine," Varipapa said.
Defensive medicine is what happens when doctors order too many tests because they are afraid of missing a diagnosis and later losing a multi-million dollar lawsuit for malpractice. Defensive medicine these days is so pervasive, some estimate its yearly cost at more than $100 billion.
Dr. Kevin Pho runs the popular medical blog, Kevin M.D., where doctors routinely confess exactly how they run up costs by practicing defensive medicine.
"Defensive medicine is bad medicine," Pho said.
In a post, one ER doctor says he's just admitted two patients to the hospital - when he was sure "neither was having cardiac (problems), but what am I to do?"
Another admits that in his practice, "every patient with a headache gets a (CT) scan."
"It's much easier to defend the fact that you ordered a test than it is to not order the test at all," Pho said.
And the costs of defensive medicine today are increasingly paid by patients, even those with insurance - because of rising deductibles and co-payments.
"There's no doubt in my mind this is a significant driver in health care costs today," Pho said.
Experts tell CBS News you should ask basic questions.
First: Why is this test needed? Ask about the cost and if there's a less expensive, alternate test. Ask if the test results might change your diagnosis - or treatment. And, "what is the risk if I don't have the test?"
"They didn't really talk to me about doing anything else," Alexandra Varipapa said.
In Varipapa's case, the hospital insists her CT scan was medically required, given her symptoms.
But in the end, the hospital did present an $8,500 dollar bill - for a condition that went away on its own.
There, doctors ordered a full CT scan, a radiation imaging test, which found a harmless ovarian cyst. She never questioned the CT scan, CBS News correspondent Wyatt Andrews reports.
But her father did - when he got the $8,500 bill, $6,500 of which was that CT scan.
"I was pretty flabbergasted," said Robert Varipapa, himself a physician.
Varipapa says his daughter's pain could have been diagnosed far more easily and cheaply with a $1,400 ultrasound.
"A history, a pelvic examination and probably an ultrasound," he said. And he would have started with the ultrasound.
But the hospital defends the CT scan, saying an ultrasound might have missed something more serious.
"It would not have ruled out appendicitis obviously, it would not have ruled, necessarily, out a kidney stone," said Dr. Bob Powell, ER medical director of Bon Secours St. Mary's Hospital.
Varipapa agrees, but asks why not start simple - and do the CT scan only if necessary?
"Well it's my opinion this is defensive medicine," Varipapa said.
Defensive medicine is what happens when doctors order too many tests because they are afraid of missing a diagnosis and later losing a multi-million dollar lawsuit for malpractice. Defensive medicine these days is so pervasive, some estimate its yearly cost at more than $100 billion.
Dr. Kevin Pho runs the popular medical blog, Kevin M.D., where doctors routinely confess exactly how they run up costs by practicing defensive medicine.
"Defensive medicine is bad medicine," Pho said.
In a post, one ER doctor says he's just admitted two patients to the hospital - when he was sure "neither was having cardiac (problems), but what am I to do?"
Another admits that in his practice, "every patient with a headache gets a (CT) scan."
"It's much easier to defend the fact that you ordered a test than it is to not order the test at all," Pho said.
And the costs of defensive medicine today are increasingly paid by patients, even those with insurance - because of rising deductibles and co-payments.
"There's no doubt in my mind this is a significant driver in health care costs today," Pho said.
But there are ways the patient can sort out the necessary from the unnecessary tests.
Couric & Co. Blog: Do I Need This Test?
Experts tell CBS News you should ask basic questions.
First: Why is this test needed? Ask about the cost and if there's a less expensive, alternate test. Ask if the test results might change your diagnosis - or treatment. And, "what is the risk if I don't have the test?"
"They didn't really talk to me about doing anything else," Alexandra Varipapa said.
In Varipapa's case, the hospital insists her CT scan was medically required, given her symptoms.
But in the end, the hospital did present an $8,500 dollar bill - for a condition that went away on its own.
Latest Now in CBS Evening News
- Life on the streets of Syria
- In Japan, screaming "I love you" for Valentine's
- Syria's rebels "disillusioned" with America
- Evening News Online, 02.12.12
- Japan's men overcome shyness of sharing love
- Squatters cite old law to claim homes
- Death toll rises as extreme cold sweeps Europe
- Syria protesters grow frustrated with UN
- Unpopular austerity package ignites Greece protests
- Whitney Houston always remembered in her hometown
- Whitney Houston cause of death under investigation
- Whitney Houston never forgot New Jersey roots
- Former Pa. DEP chief on contaminated water from gas drilling
- Evening News Online, 02.11.12
- Catholic votes and the Obama contraceptive quarrel
- Making the 1st ever US women's Olympic boxing team
- Ohio unemployment hits 3-year-low
Latest CBS News Headlines
on Facebook Most Discussed Stories
on CBS News
- Triumph, tragedy dominate Grammy Awards
- GE to hire 5,000 veterans over next 5 years
- Private equity firm to buy SeraCare for about $78M
- Gwen Stefani runway show inspired by '60s rock
on Facebook Most Discussed Stories
on CBS News
