another medical malpractice/torte reform pet peeve....
One phrase that annoys me is "defensive medical practices", said in a context as if "defensive medical practices are bad because they drive the cost of care....from ucalgary.ca
A number of computer programs are available that can be used to reduce post-surgical infection rates. For example, quality improvement staff at LDS Hospital in Salt Lake City, Utah, used a computer to study the relationship between administration of prophylactic antibiotics and subsequent infections in 3,000 surgeries. The researches discovered that patients who received the antibiotics during the two-hour period before surgery had an infection rate 0.6%, whereas patients who received the medication before or after this time had substantially higher rates of infection. As a result, the hospital encouraged staff to administer antibiotics during this two-hour window period.
A number of computer programs are available that can be used to reduce post-surgical infection rates. For example, quality improvement staff at LDS Hospital in Salt Lake City, Utah, used a computer to study the relationship between administration of prophylactic antibiotics and subsequent infections in 3,000 surgeries. The researches discovered that patients who received the antibiotics during the two-hour period before surgery had an infection rate 0.6%, whereas patients who received the medication before or after this time had substantially higher rates of infection. As a result, the hospital encouraged staff to administer antibiotics during this two-hour window period.
I would call that approach a defensive medical practice. Any one here that would like to suggest that a hospital not give antibiotics post-surgery. It might even be more cost effective to treat the additional infections if you didn't. If you happen to get into surgery sometime, be sure to ask your doctor whether or not he/she will be prescribing a post surgical antibiotic and get back to us, what you told him/her.
Unnecessary tests....that's another one...to the best of my knowledge, a doctor has never given me a clearly unnecessary test. For example, being a guy, I've never been given a pregnancy test. That would clearly be an unnecessary test.
On the other hand, a patient has symptoms and it may well be the case that multiple conditions may be causing such symptoms. Some conditions worse than others, some more probable than others. There are multiple tests to detect the multiple conditions. Are "unnecessary tests" those tests that come up "negative". That's just dandy. If the doctor knew what condition you had for sure, he/she could only test the one that will be "positive".
On the other hand, he/she could test them sequentially, based on highest probability. If the test result was negative, was that an unnecessary test. I don't think so, maybe someone else does.
But, I'm opposed to unnecessary tests...if I only knew what an unnecessary test was, I'd be happy.
jttmab |
