Insurance companies go for profitable tests, but not for more doctor time spent with patients

[eridani]

Cardiologist Speaks From The Heart About America's Medical System

http://www.npr.org/blogs/health/2014/08/19/341632184/cardiologist-speaks-from-the-heart-about-americas-medical-system

As a young doctor working at a teaching hospital, Sandeep Jauhar was having trouble making ends meet. So, like other academic physicians, he took a job moonlighting at a private practice, the offices of a cardiologist. He noticed that the offices were quick to order expensive tests for their patients — even when they seemed unnecessary.It was "made very clear from the beginning" that seeing patients alone was not financially rewarding for the business, he says."Spending 20-30 minutes with a patient might be reimbursed $80, $90, but sending the patient for a nuclear stress test was much more profitable," Jauhar tells Fresh Air's Terry Gross. "A nuclear stress test, at the time when I started working, was reimbursed roughly $800 to $900."

Jauhar was supervising the tests that had been ordered by a physician — and some physician assistants."So even though I wasn't ordering the tests, I was in the office while these tests were being performed — and I felt really dirty about it," Jauhar says.Jauhar's new memoir, Doctored: The Disillusionment of an American Physician, is about how doctors are growing increasingly discontent with their profession. And they're facing more pressures: As the number of patients they're expected to see increases, so does the amount of paperwork. While some doctors who perform a lot of procedures may be paid too much, he writes, many doctors, such as primary care physicians, aren't paid enough.And, he adds, "the growing discontent has serious consequences for patients.

[lunasun]

1. Doctors who perform tests only when justified lose out sometimes even with the patients too

When it is unnecessary in the doctor's opinion sometimes it's the pt whose sister had 10 tests why not them? They have been sold as consumers too on over testing ... Oh yeah each one of those tests comes with a bill!
What is routine as the article shows is debatable

[eridani]

2. This is the first reason why treating health care as a commodity jacks up costs

If you have money, there's strong motivation to sell as much of it as possible, whether needed or not. The second reason is that if you don't have money, little problems grow into big problems before you can get treatment, and that is also very expensive. We lose both ways.