Addressing Health Care Overuse and Waste
Health care overuse, waste and unnecessary care continue to be a huge problem in the U.S. In fact, a 2015 Bloomberg News study indicated that out of 55 countries, the U.S. ranks third for health care spending, but 50th for efficiency.
Addressing this overuse and providing responsible stewardship of the resources available to doctors is the mission of Blue Cross Blue Shield of Michigan’s Resource Stewardship Initiative (RSI). This effort is part of the company’s Physician Group Incentive Program, one of many Value Partnerships initiatives.
As a member of RSI’s advisory committee, I feel passionate about improving quality, value and efficiency in the way we deliver health care. There are a limited amount of resources and we have to be judicious in using them.
Everyone in health care has a responsibility to consider the cost of care they provide, but it’s really about providing appropriate and effective care. Here are three examples of the type of inappropriate or unnecessary care that the RSI is targeting:
- A patient with a four-day history of an uncomplicated headache doesn’t need an MRI.
- A patient with a three-day history of uncomplicated back pain doesn’t need back X-rays.
- A patient with symptoms of upper respiratory infection or bronchitis that lasts for a week or less doesn’t need an antibiotic.
Many treatments and tests can actually cause patient harm. Antibiotics, for example, can cause diarrhea, a rash or the elimination of good bacteria in the gut.
Keep in mind that almost every test and treatment has an associated risk. So it’s important for doctors to talk with patients to help them decide which tests should be performed.
In the end, it’s all about doing the right thing for patients and getting them involved in the decision-making process.
By Gregg Stefanek, D.O., a family practitioner at Gratiot Family Practice in Alma.
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