Posts Tagged ‘Duke University’
Here’s a shock – Doctors paid for cardiac tests order more of them
Doctors who earn money for cardiac stress testing are much more likely to prescribe the tests than those who don’t, a new study has found.
Researchers at Duke University studied data on 17,847 patients nationwide who had cardiac bypass surgery or coronary angioplasty, checking to see how often doctors prescribed nuclear stress tests and echocardiograms later than 90 days after discharge…
Among doctors who billed for administering and interpreting a stress test, 12.6 percent prescribed the test, compared with 5 percent of those who were not paid for testing. Results for echocardiograms were similar: 2.8 percent of patients were tested by doctors who billed for both test and interpretation, and 0.4 percent by those who were paid for neither.
After controlling for the patient’s age and disease characteristics, the doctor’s specialty and other factors, researchers found that a patient of a doctor earning money from testing was more than twice as likely to be tested as a patient of a doctor without financial interest in the tests.
“If you’re having symptoms or a change in health status, testing is appropriate,” said Dr. Bimal R. Shah, the lead author of the analysis and a fellow in cardiology at Duke. “But in situations where there aren’t any clinical indications for tests, these reimbursement structures seem to be associated with increased testing use.”
Do you think so? Cripes.
I had one doctor who sent me for a battery of tests at an eye clinic that cost Medicare a bundle – when the headaches I was experiencing actually meant that New Mexico’s hardy and aggressive range of pollen had finally caught up with me and I had developed hayfever.
Yes, I found that he got a spif for the referral – and, no, I never went to him, again.
Tricks and trust that only work for humans and dogs
Brian Hare, assistant professor of evolutionary anthropology at Duke University, holds out a dog biscuit.
“Henry!” he says. Henry is a big black schnauzer-poodle mix–a schnoodle, in the words of his owner, Tracy Kivell, another Duke anthropologist. Kivell holds on to Henry’s collar so that he can only gaze at the biscuit.
“You got it?” Hare asks Henry. Hare then steps back until he’s standing between a pair of inverted plastic cups on the floor. He quickly puts the hand holding the biscuit under one cup, then the other, and holds up both empty hands. Hare could run a very profitable shell game. No one in the room–neither dog nor human–can tell which cup hides the biscuit.
Henry could find the biscuit by sniffing the cups or knocking them over. But Hare does not plan to let him have it so easy. Instead, he simply points at the cup on the right. Henry looks at Hare’s hand and follows the pointed finger. Kivell then releases the leash, and Henry walks over to the cup that Hare is pointing to. Hare lifts it to reveal the biscuit reward.
Henry the schnoodle just did a remarkable thing. Understanding a pointed finger may seem easy, but consider this: while humans and canines can do it naturally, no other known species in the animal kingdom can.
Har! I won’t even suggest the political implications of such a study.
