Despite the constant controversy surrounding high healthcare costs, physcians aren't doing their part to curb such trends, and in many instances, are only concerned about their financial bottom lines. At least that's the opinion expressed by Dr. Howard Brody, a professor of family medicine and director of the Institute for the Medical Humanities at the University of Texas Medical Branch in Galveston, in an editorial published earlier this year in the New England Journal of Medicine.
Howard spoke to the New York Times this week about the editorial, in which he blasts physicians for "regional variations in costs." He points out that if doctors in high-cost regions would only order tests and treatments in similar fashion to their low-cost region colleagues, one-third of healthcare costs could be saved without sacrificing quality patient care.
Instead of "exercising moral leadership" by suggesting ways to cut healthcare costs, even if it means losing money, doctors are "acting like one more special interest group," he says.
To save money, Howard suggests what he calls a "Top Five" solution. The idea entails each specialty society determining its five most commonly performed procedures or tests shown to provide very little meaningful benefit, such as arthroscopic surgery for knee osteoarthritis, and then "issuing guidelines and recommendations" regarding overuse of such procedures.
"When you combine this love affair with high technology with a reimbursement system that pays so much more for technology--and less for thinking and sitting and talking with patients--you end up with an expensive kind of medicine, which, when practiced by doctors, puts more money into their pockets," Howard says. "By taking a public stand and making it harder for individual doctors to say, 'Oh, I know better,' we could build real momentum for cost containment. And we would ultimately all benefit because we don't need all that technology."