I agree patients need to be brought into the mix. After all, in your proposal what would prevent patients from gaming the system by visiting their clinician early in the month, when the "Rad Dollar" balance has been replenished. Also, pity the poor patient who gets sick on the 31st of the month and every scan ordered is going to cost the doctor some real money. Different standards of care based on the day of the month. Hmmmm........
Thank you for this article. so thought-provoking. agree with comment from George. Let’s bring the patients in to the mix also and they should get a certain amount of lab/rad/diagnostic testing dollars. Insurance companies are already capping PT visits, home healthcare visits, skilled nursing stay days. Let’s take it farther. I love this out of the box thinking. Let’s be open to fixing a system That doesn’t quite work as well as it should.
Sorry, but the only and tiny hope for the healthcare commons lies on the demand side and patients taking informed consent to investigations seriously - despite the massive discouragement from the supply side with its massive material conflicts of interest. The patient is conflicted too, but not usually so materially. (And in a public health service they have a moral obligation to avoid contributing to the tragedy of the commons.) “Before I consent to this test please assure me that there are possible results from it that are likely to change my treatment and outcomes significantly. Please record your yes/no answer and your elaboration on it in my notes.” As I said, tiny,.
For some patient/doctor dyads, the only way the patient can feel certain that their concerns have been heard is if a study is ordered. Another place to reduce costs is by having doctors communicate with their patients. That takes time and the economic incentive is to spend ever less with patients. We are getting what we pay for.
Innovative thinking. Will the radiologist pay patient dollars to Mr Jones when his head CT is done at 3am instead of 3PM. Inconvenience has a price. The ordering doc made their choice, now the resident needs to make theirs.
I agree patients need to be brought into the mix. After all, in your proposal what would prevent patients from gaming the system by visiting their clinician early in the month, when the "Rad Dollar" balance has been replenished. Also, pity the poor patient who gets sick on the 31st of the month and every scan ordered is going to cost the doctor some real money. Different standards of care based on the day of the month. Hmmmm........
Thank you for this article. so thought-provoking. agree with comment from George. Let’s bring the patients in to the mix also and they should get a certain amount of lab/rad/diagnostic testing dollars. Insurance companies are already capping PT visits, home healthcare visits, skilled nursing stay days. Let’s take it farther. I love this out of the box thinking. Let’s be open to fixing a system That doesn’t quite work as well as it should.
I might add “Lab Dollars” and “cardio-bucks” to the mix: and do it early in training years.
Sorry, but the only and tiny hope for the healthcare commons lies on the demand side and patients taking informed consent to investigations seriously - despite the massive discouragement from the supply side with its massive material conflicts of interest. The patient is conflicted too, but not usually so materially. (And in a public health service they have a moral obligation to avoid contributing to the tragedy of the commons.) “Before I consent to this test please assure me that there are possible results from it that are likely to change my treatment and outcomes significantly. Please record your yes/no answer and your elaboration on it in my notes.” As I said, tiny,.
For some patient/doctor dyads, the only way the patient can feel certain that their concerns have been heard is if a study is ordered. Another place to reduce costs is by having doctors communicate with their patients. That takes time and the economic incentive is to spend ever less with patients. We are getting what we pay for.
Sensible Medicine should charge the Belkin Boys for the least helpful article ever submitted to this forum.
Innovative thinking. Will the radiologist pay patient dollars to Mr Jones when his head CT is done at 3am instead of 3PM. Inconvenience has a price. The ordering doc made their choice, now the resident needs to make theirs.