What Physicians Can Do To Fight The Rising Cost of Healthcare and Support Medical Necessity

Everyone’s trying to tighten their belts lately, and the medical field is no exception. One way to fight the rising cost of healthcare and support medical necessity is with smart diagnoses, fewer unwarranted procedures, and a more open dialogue between doctor and patient. Here are some steps the physician can use to determine if a treatment is medically necessary:

  • Collect a complete medical history. Every medical exam has a portion of medical history Q&A to it, but patients sometimes forget a detail here or there. If you think that a few more facts about their past can change whether a procedure is done or not, then ask. Asking a few more questions to flush out the whole story can rising cost of healthcare and medical necessityenlighten you on what may really be going on.
  • Double check diagnosis. The human body reacts similarly to various problem, so symptoms can be present in a lot of differ diseases. Double checking your diagnosis for similar diseases and matching it up with your patient’s medical history can mean the difference between right diagnosis and misdiagnosis.
  • Ask if the procedures are necessary. Certain procedures are necessary, and others are just a precaution. An article Laurie Tarken released in Fitness Magazine noted in 2009, $325 billion of the nation’s $2.7 trillion annual health care bill went to unnecessary medical procedures. This explains why speciality physicians groups are calling on their members to stop reflexively calling for some 200 tests and procedures to be done. Instead, these physicians are being asked to consider the efficiency of the test, and look for more efficient methods to get a correct diagnosis or treatment.

To be fair, it’s not always possible to avoid asking for tests and procedures to be done, especially in specialities with a risk of high litigation. In that case, it may be possible to simply cut back on preventative measures, such as the annual physical exam to get our health checked out. For some people it may be necessary to get their health checked regularly, while others can go for years between exams without harm.

For example, Laura Esserman, M.D., a professor of surgery and radiology at the University of California, San Francisco and the U.S. Preventative Services Task Force say that you can get a blood test for total cholesterol and HDL every 5 years as long as the findings are normal, but blood pressure testing should be done every other year unless it’s higher than the recommended levels for the patient’s age and fitness level.

Gaining the confidence necessary to diagnosis and call for the correct procedures comes with great training and lots of practice. This could help physicians fight the rising costs of healthcare and medical necessity over time. If you’d like to talk about this, or anything else, please contact us.