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Top 10 Now Top 16 Reasons Doctors Over-Order

Commenters sent in some wonderful additions to our Top 10 Reasons Why Doctors Over-Order:

11: Double-ordering. In the age of collaborative medicine, patients are often transferred from service to service, floor to floor, hospital to hospital. Their records are supposed to follow them… but do not always arrive swiftly, easily, or in a convienent format. Masses of rubber-banded paper; bulky X-ray films; software incompatabilities… the number of ways one doctor's test result can fail to reach the next in the chain is endless. And sometimes, doctors even know that their colleagues have ordered a test…. and re-order it anyway, because it's easier to do the test over than find the result in the mountain of records.

12 and 13: You don't trust the lab results from a different facility and redo it at yours. And it is part of a templated set of orders and it's just ordered along with the rest of the orders.

14. At times physicians order tests for no other reason than to have the information. That is, it won't change the patient's treatment, counseling, or behavior, but is ordered just to "have a better look" or for the sake of having more information to give the patient. It would be prudent to ask,"will it (or might it) change management" before ordering the test.

15. We don't want to accept that our health and lives come with a price tag. Patients whose expensive (often experimental) treatment options are declined by insurance companies understandably ask "How can you put a price on someone's life???" Similarly, they don't want to hear from their doctors that care could possilby be limited by cost.

16. As consumers, we may believe that More, and More Expensive means Better. Just as a shopper may view a deeply discounted item as "cheap", patients may view the least expensive health care facilities as having lower quailty.

This program aired on September 16, 2010. The audio for this program is not available.

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Carey Goldberg Editor, CommonHealth
Carey Goldberg is the editor of WBUR's CommonHealth section.

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