The New York Times has an article on misdiagnosis in medicine. Doctors misdiagnosis patient conditions 20% of the time, the article says, because there are no incentives for doctors tied to correct versus incorrect diagnoses. One doctor quoted in the NYT article notes that "doctors don't go down with their planes."
The article points to products like Isabel Healthcare's disease diagnosis software that can help doctors to identify diseases. It is especially useful for conditions that are rarely seen in clinics -- many doctors see the same symptoms and diseases over and over again. The company was started by a businessman whose young daughter was in the hospital for months with Group A Streptococcus that causes symptoms of necrotizing fascitis and toxic shock syndrome. Orginally diagnosed with chicken pox, "only when her organs began shutting down did her doctors realize that she had a potentially fatal flesh-eating infection". (Group A strep is actually a well-recognized secondary infection associated with varicella).
According to the Wall Street Journal only 2% of doctors use software to help them diagnosis illness, sometimes because hospitals won't pay for it, others because medicine is considered "an art". This comment seems more applicable appropriate to a different era. It has become less of an "art" and more of an assembly-line in the U.S., where doctors are forced through insurance incentives (low paying office reimbursements) to see as many patients as possible in a day. Yet if software would benefit patients hospitals also balk at spending $80,000 or so to aquire the licenses.
There aren't tremendous repercussions to this business decision. Malpractice lawsuits tend to occupy the news and high settlements are headlined as though they are common, but it is not malpractice insurance that's driving up the cost of medicine. Regardless, significant action has been taken to limit insurance liability, which provides more (perhaps indirect) incentive for doctors to focus on things other than double checking their work. One trend in care is doctors who treat patients on the condition that they sign away their rights to trial jury. Medical malpractice caps, common in some states, were recently re-introduced in congress to limit "non-economic damages".
The NYT article suggests that doctors are motivated to process patients, order tests and prescribe medicine, and that legislative action is needed to change the priorities in medical care: "For a politician looking to make the often-bloodless debate over health care come alive, this is a huge opportunity.". I'm not sure politicians like Clinton, who have gone that route and been defeated to cries of that "there is 'no healthcare crisis'" would agree. More intuitively, the article asks why patients continue to pay for "wasted procedures and pointless drugs". Because that's business and patients aren't yet poised to protest?
