If your doctor got paid extra money for every test performed on a patient, would he or she be more inclined to recommend tests that would otherwise be unnecessary? According to a recent study by researchers at Duke University, doctors are indeed more likely to recommend tests when they earn money from them
– despite the test’s level of necessity, or in some cases, even harm.
For the research, the team from Duke University studied data on 17,847 patients from all across the nation. Each patient underwent either cardiac bypass surgery
or coronary angioplasty, and were all prescribed nuclear stress tests and echocardiograms more than 90 days after they were discharged from the medical facility where they underwent the procedures.
The results, which were recently published in The Journal of American Medical Association
, were quite clear. Evidence was taken from a group of doctors who billed patients for both administering and interpreting a cardiac stress test. Among these doctors, almost 13 percent of the doctors who were paid for tests prescribed more tests, compared to only 5 percent of those who were not paid for testing.
A separate test conducted on the same group of doctors produced similar results; echocardiograms were performed on 2.8 percent of patients by doctors who were paid by the test, and physicians who did not get paid only prescribed echocardiograms a measly .4 percent of the time.
The patients were controlled for various things including age, disease characteristics, and the doctor's medical specialty, among other things. The researchers found out that if a patient has a doctor who earns money from tests, the patient is twice as likely to be tested unnecessarily, compared to a patient whose doctor was not paid based on how many tests he or she prescribed.
Dr. Bimal R. Shah, the lead author of the study and a fellow in cardiology at Duke University, explains that extra testing is only appropriate if you are having symptoms or experience a sudden change in health status. Dr. Shah concludes the study by stating that "in situations where there aren't any clinical indications for tests, these reimbursement structures seem to be associated with increased testing use."
While there are no apparent dangers associated with excessive cardiac stress tests or echocardiograms, the results of this analysis could be proof that not all doctors are entirely patient focused . . . which leads us to question just how safe we are in the hands of our own personal doctors.
Not only that, but what about the tests that do pose a potential danger – such as those involving radiation
(CT scans, x-rays)? If you think you are being unnecessarily tested, don’t hide your concern. It’s your body and therefore your right to get a second opinion.