Dr. Weinberger gave a great lecture on cost conscious care; we have $750,000,000 of wasted money, and a big chunk of it is due to unnecessary testing. As residents, we are trained to think twice before ordering tests, but I find that I am getting mixed message. Should I:
- Order a test “preemptively” or be blamed for increased LOS for delayed labs?
- Order a test because a pt. keeps demanding it or risk a low pt. satisfaction score?
- Order a test because the attending wants it or risk a bad eval?
I think we’re all over ordering to “protect our back” and as residents we have more than lawsuits at stake (see above!) – especially with recently published data from Medscape (below) showing that internal medicine is the MOST sued specialty.
How can we get away from these conflicts?
There was a lecture by Dr. Baron of UCSF given in WSU around June 2012 about giving incentives to residents and fellows to reduce cost and improve quality of care and patient safety. Since then he published an article on the Wing of Zock medical blog (linked) It worked in UCSF. Will it work in WSU? Extra cash, anyone?
Here click here for the WSU video.
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