Getting to No in health care decision-making

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Thoughtful piece by David Leonhardt of the New York Times, “In Medicine, The Power of No.” Excerpts:

“Can we solve the entire problem of rising health costs by getting rid of needless care? Probably not. But the money involved is not trivial, and it’s the obvious place to start.

Learning to say no more often will be a three-step process, and if the new agencies created by the health act are run well, they can help with all three.

The first is learning more about when treatments work and when they don’t.

The second step — and maybe the most underappreciated one — is to give patients the available facts about treatments. Amazingly, this often does not happen.

The final step is the bluntest. It involves changing the economics of medicine, to reward better care rather than simply more care.”

Disclosure: Dr. Michael Barry, who is quoted in this article, is president of the Foundation for Informed Medical Decision Making, which funds the project.

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Richard Crane

April 12, 2010 at 6:28 pm

What are we old people to do? The Primary Care Physicians are so overbooked and in short supply that when we do get an appt. the session is quick because the Dr. all of a sudden has to enter all his information into a computer that he is not used to using or getting old information out ie; tests and conditions. He listens to my heart, lungs, looks in my throat and reiterates the same thing I have heard him say in prior appts. I know have lost all faith in having and internal medicine doctor look at me. This is a lost art and no young person wants to go into internal medicine but they now are charging more than my cardiologist or other specialist.

Elaine Schattner, M.D.

April 14, 2010 at 7:37 am

Leonardt’s excellent essay adds to the dialogue on how to control health care costs. Of note – the 3 excerpts above are all about learning and more effective (even “blunt,” if you will) communication in medicine.