Drs. Hartzband and Groopman have a very challenging op-ed in today's NY Times. The title is How Medical Care Is Being Corrupted. They argue that insurance companies have created incentives and disincentives that might cause a physician to override the needs of an individual patient by doing what is best for the general population.
One example they use: "doctors are rewarded for keeping their patients’ cholesterol and blood pressure below certain target levels. For some patients, this is good medicine, but for others the benefits may not outweigh the risks. Treatment with drugs such as statins can cause significant side effects, including muscle pain and increased risk of diabetes. Blood-pressure therapy to meet an imposed target may lead to increased falls and fractures in older patients". If doctor's don't comply, they will receive less compensation and, perhaps, a lower rating on various web sites.
Doctors are also beginning to be told what medicines to prescribe, as more and more insurance companies are offering their recommendations to doctors. Are you aware of many drugs which do not specify side effects or recommend conditions which should not be using the drug?
The companies are assuming that we are at a point in time when we have mastered the ills of man. Merck assumed that Vioxx would take care of many types of pain; at least, they held that assumption until the product was taken off the market.
I think Hatrzband and Groopman make a good case. But, are they just upset that the doctor is no longer in control?
1 comment:
...are they just upset that the doctor is no longer in control?
Shouldn't they be? I'd prefer my doctor in control than some corporate drug manufacturer or insurance company. I think most would agree with me.
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