Docs spend $6.8B in unnecessary care

Physicians order at least $6.8 billion worth of unnecessary tests for their patients each year, most of them during patients' annual physical exam. That's the conclusion of a study not from government bean counters, but one led by physicians from the Mount Sinai Medical Center and the Weill Cornell Medical College in New York. Researchers examined the cost of common medical practices that a work group of internists, family physicians, and pediatricians earlier this year identified as being overused.

The new study, published online in the Archives of Internal Medicine in October, used data from federal medical surveys to determine that 12 such overused interventions led to $6.8 billion in unnecessary care in 2009. According to the study, some of the most costly and common sources of misplaced health spending included the following:

• Complete blood cell count ordered at a routine physical exam
• Brand-name statins ordered before trying a generic drug first (accounting for $5.8 billion of the $6.8 billion total)
  
• Blood and diagnostic tests ordered for patients with no related symptoms or risk factors
• Prescriptions for antibiotics for children without strep
• Brain imaging on children who had fallen but displayed no signs of concussion

Minal Kale, an internist at Mount Sinai School of Medicine and lead author of the study, told The Washington Post that the $6.8 billion was a conservative estimate of the cost of the inappropriate care because it didn't account for the financial or emotional cost of following up on false positives.

According to a related article published by NPR, a better alternative to the traditional test-laden annual exam may be described as a regular "check-in" between doctor and patient. At the check-in, the physician and patient could get to know each other better and discuss the patient's health concerns. The physician would then order only tests appropriate for the patient's age and risk profile.

To learn more:
- read the article in the Washington Post
- see the study abstract from the Archives of Internal Medicine
- check out the article from NPR

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