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?
I am in agreement that doctors these days do not take the time to talk to their patients about symptoms and to find out exactly what is bothering the patient before they make a diagnosis which in many instances is wrong and which becomes worse due to the wrong medications being prescribed. Doctors these days are interested in making money and really do not care about the patients, especially if the patients are on Medicare, Medicaid or a low re-imbursing HMO. Some doctors are actually rude to such patients.
Medicaid Mills in poor communities sprout like mushrooms. Many of the doctors operating in such Medicaid Mills prescribe enourmous amounts of wrong medications to patients they see for less than five minutes at a time. As a result, patients become intoxicated with unnecessary medications and costly medicine prescribed for the wrong desease only increase the costs of Medicare, Medicaid, etc.
Many patients are just made increasingly sick by careless, money hungry doctos who see as many as 17 to 20 patients in less than tress hours. I have been a victim of these so I know.
These doctors should be investigated, especially those operating Medicaid Mills or operating out of filthy apartments which pass for medical offices and which the doctors use for two to three hours a day to see loads of patients on Medicare, Medicaid, or low re-imbursing HMOS.