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photo: The Guardian
A retired Philadelphia-area pediatrician has done some hard thinking about his life in medicine and concluded that many of America’s health care problems could be solved by doctors’ spending proper time with their patients.
His experience in medicine is that “practicing good medicine can be practicing cost-effective medicine. Time spent asking questions can reap huge savings.”
He cites the example of a friend who continues to limp on a fractured ankle after two months and three office visits. The friend's doctor, rather than reviewing the case and finding out what had happened between visits, ordered an MRI and left for another ‘examination room’.
“These days everyone sends out for an MRI. MRI’s cost $500-$1000 dollars. Canada has as many MRI machines in the whole country as we do in the Philadelphia area, and they seem to get by just fine.”
Concerning the friend’s ankle, he said “I’m just a pediatrician, but I would have asked ‘do you do much walking? Are you improving, even slowly? Maybe you just came out your cast too early.’”
Ted Robinson, 71, of West Chester, graduated from Haverford College in 1959, was educated at Penn medical school, and then did his internship and training in the Army. He worked stateside during the Vietnam conflict, treating the children of soldiers. He retired after 37 years in 2005.
At one point, Robinson’s practice was part of the HMO Philadelphia Health Plan. The success his practice, “Kids First”, was built on the incentives that the HMO system provided for cutting costs.
“We stay open seven days a week so clients did not have to use the emergency room. It can cost a thousand dollars just to be seen in an emergency room,” Robinson said.
He found that he could save even more expense by following up with phone calls to make sure his patients were OK. “Otherwise, I couldn’t sleep at night,” he said.
Comments
Very intruiging Mr. Hartmann. It never ceases to amaze me the amounts of money we are charged for medical procedures! Insurance may not cost so much if hospitals would quit charging $3000 to sit in their waiting rooms!
I only charge 500 dollars (out of pocket discount) for an MRI - which uses state of the art 3T equipment. We charge less for the best technology than anywhere else. In fact Canada only has about 5 3T MRIs in the entire country. Most MRI facilities do not buy the best equipment for their patients. 3T is faster and has twice as much to four times as much detail than 1.5T MRI. Faster, more detailed and more accurate MRI is worth 500 dollars. And as a pediatrician he should be concerned about the 1 in 500 chance of cancer from a CT scan. MRIs should be ordered more - not less.
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