Our healthcare costs not producing results? My take on this matter

The money we spend on healthcare in this country does not all go towards improving mortality or disease outcomes statistics. As a practicing physician, I can tell you that we spend more healthcare dollars trying to meet our patient's expectations and in practicing defensive medicine than in actually improving outcomes.

Example: Patients who present with low back many times have the expectation that they will need an MRI. Even if I'm able to convince them that an MRI is not justified in the acute stages of low back pain, if they are not better in the next few weeks, they will demand an MRI. In many cases, the doctor will go ahead and order the MRI at that point. In this low back pain case, the cost of healthcare goes up steeply after the MRI is ordered. Now will there be any improvement in any outcome measures of back pain as a result? Most likely no. Studies have repeatedly shown this to be the case. In fact, for most back pain cases, patients get better with simple, low cost conservative treatment such as back rest.

A similar case of low back pain treated in a third word country would likely have a similar outcome as in this country- the patient gets better after a few months of conservative treatment. In this country however, we will have spent money on countless office visits, MRIs, physical therapy etc, while in a third world country, the only cost would have been a single office visit. So does this mean that our healthcare system has inferior outcomes? No, its just that our healthcare users have a different set of expectations from their healthcare system than in other countries.

As far as "defensive medicine" and costs, when there's an unfortunate healthcare outcome for example, in this country it's automatically assumed in many cases that it's the fault of the healthcare provider. Remember the recent ex-Patriot coach, Charlie Weis's lawsuit? Situations like this natuarally effect the practice of medicine by our healthcare providers.

For better or worse, our healthcare dollars do not all go towards improving outcome statistics. The cost of healthcare, as well as happiness in general, is just higher in this country.