The Business of Medicine

In our national debate about the cost of health care, we often forget that medicine is a business and we, the patients, are its customers.  When doctors decide to order a test for us or to do some procedure on us, they are very often doing something which will make them money.  They are selling us something but we really don’t get much opportunity to say we don’t want to buy. 

We have some rules which prohibit doctors from owning labs which will do the tests they order for us but there are lots of opportunities for doctors to make money by ordering tests or treatment.  Five United States Senators have asked the Inspector General of the Department of Health and Human Services to open an investigation into surgeon-owned companies which sell hospitals the hardware the surgeons put in their patients.  These companies operate in at least 20 states. 

Spinal fusion surgery involves the placement of this type of hardware in the spinal column to stabilize it.  The cost of spinal fusion surgery to Medicare increased from $343 million in 1997 to $2.24 billion in 2008.  This increase coincided with the spread of these surgeon-owned companies selling the hardware used in fusions.  The senators want the investigation to determine if ownership of these companies is causing the surgeons to perform spinal fusions which are not really necessary and whether rules are necessary to prohibit physician ownership.

Here is a link to a good article on the subject from the Wall Street Journal.

Most physicians are caring, committed people with the best interests of their patients at heart.  Even so, always remember that we pay doctors for ordering tests and doing procedures.  We don’t pay doctors for keeping you well in the first place.  Don’t be afraid to ask questions and make sure whatever is being ordered for you is really necessary.

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