Review: "People with Minor Injuries are Increasingly Getting CT Scans." - NPR

Nancy Shute published this article for NPR on 1/19/2016

http://www.npr.org/sections/health-shots/2016/01/19/463591099/people-with-minor-injuries-are-increasingly-getting-ct-scans

It's a short article but makes two very important points for why healthcare costs will continue to rise under our current system. They interviewed Dr. Renee Hsia who was senior author on the paper. Dr. Hsia states "patients tend to want to be safe...but sometimes they want more rather than less. It's a very American thing. Also doctors don't want to miss anything."

Bingo times two.

What are typical Americans afraid of? Is it sickness? Death? A combination of both? I'd purport we've done an amazing job of creating an unreasonable expectation of what our lives are "supposed" to be. I don't believe that anyone should suffer but maybe our definition of suffering is culturally different than other places which led Dr. Hsia to mention our "American thing."

What are typical doctors afraid of? Strangely enough, I don't think doctors worry about sickness and death, per se. We can treat sickness and we can comfort in death. No, I think most doctors worry about malpractice. We were taught about lawsuits in the 3rd and 4th years of medical school. Our orientations into residency made it real. Our first day as attendings brought it on home: You are not allowed to make mistakes. Period. Your goal is to guess correctly 100% of the time, or else your ass is grass.

How can we address both the patients' and the providers' unreasonable expectation when it's bleeding the system dry?

Education. From middle school, through high school and college, and into life's work, having access to psychologically minded education helps us build our best lives. When you've accepted yourself fully and are mindful in your actions, suffering is no longer suffering. Yes, this sounds very Buddhist and Eastern medicine, but I have personally found this to be true. Patient mindfulness promotes open discussion of hard topics with their healthcare providers. It leads to a fuller, richer life and death experience.

Provider mindfulness promotes acceptance of our flaws and acknowledgement that our goal is to "save" lives when possible (though ultimately futile). Ideally, we are called to improve the lives of others while they live.

PSYCH removes the burdens of box clicking and RVU generating so that providers have the time to explore the lives of their patients and themselves. PSYCH promotes mental health parity so that patients can wrestle their demons and expectations with a licensed therapist (some of whom may teach in the Eastern tradition.)

Until then, I guess we'll continue to irradiate our bodies in hopes of decreasing our worry. Sounds dangerously counterproductive to me.

#CTscan #mindfulness #PSYCH #education #malpractice

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