Highlights of the important and the interesting from the world of health care:
Too many tests, too much treatment: When it comes to the belief that “more care is better care,” the Associated Press points out that even President Obama (or at least his doctors) may be a victim of that mentality and he’s certainly not alone among Americans. In recent weeks various studies or expert panels have suggested that Americans receive too many angiograms, repeat cesarean deliveries, and PSA tests for prostate cancer. Further, many routine cancer tests, it seems, don’t do much good and can even create problems like false positives that lead to needless and costly procedures. Routine testing is often based on bad science, or on guidelines that quickly become outdated as new science emerges, a Johns Hopkins University expert says.
So why does all this costly and unnecessary care persist? Defensive medicine, the fee-for-service physician-payment system, advertisements that implore patients to get the newest and most expensive procedures, and patient demands on doctors, to name a few. Those are a lot of trends that’ll need to be reversed, but simply educating patients that more care isn’t better care is a good place to start in cutting down on American medicine’s outbreak of too many, too much.
The Hidden Administrative Tasks Draining Small Practices
Small practices play a critical role in healthcare delivery, but they cannot continue to absorb ever-increasing administrative demands without consequences.
The nurses who make more money than doctors: That’d be certified nurse anesthetists, or CRNAs, who were offered an annual base salary of $189,000 last year, compared with $173,000 for family doctors. The numbers come from Merritt Hawkins & Associates, a physician recruiting and consulting firm, and go a long way in explaining the primary care shortage that’s bearing down on the U.S. And it’s nothing new. 2009 marked the fourth consecutive year that CRNAs, advanced practice nurses who administer anesthesia to patients, were paid more than family docs.
Primary care physicians, many of whom are struggling financially as costs rise faster than reimbursements, are beginning to feel like “second-class citizens,” one staffing expert notes. The Happy Hospitalist says the salary disparity is an indictment of the system by which medical providers are paid, which is based on something called relative value units or RVUs. The RVU system rewards procedures over outcomes and that’s a problem, skewing financial incentives and leading to the “more-is-better” mentality when it comes to health care. Until we change how doctors are paid, the primary care shortage is only going to get worse.
Another lackluster biotech IPO: Following in the footsteps of Ironwood and Anthera, Aveo Pharmaceuticals went public last week with less-than-stellar results. The Cambridge, Mass., developer of cancer drugs sold its first public shares at $9, a big drop from the $13 to $15 it had hoped. To add more insult, Aveo, which has no drugs on the market, closed its first day at $8.99. Aveo’s not-so-happy experience just underscores what’s been evident for awhile: Today’s market isn’t going to support the traditional biotech startup that has big dreams but no sales.
Photo from flickr user Muffet