"Ultimately, we ought to share decision-making, but the responsibility for cost-containment is in the hands of the doctors,"
Glad they get right to the driving motivating factor.
One day this entire manipulative argument will evolve into a process of directing patients to avoid costly treatment rather than pretending it is about OTOD and potential side effects.
Quoting further: “In the age of cost-containment and concerns about overtreatment, we can’t assume that involving patients more in treatment decision-making will help solve these problems,” Dr. Katz said.
The concept of “cost-effectiveness” is generally applied at the system or patient population level, but patients in the exam room are not focused on cost-effectiveness; individual patients are not interested in the population, but themselves, he maintained.
“Patients are not looking to cut corners and minimize cost, unless they are held accountable. Patients participate in overtreatment. The key issue is that patients are not good arbiters about the cost-effectiveness of their treatment,” he insisted.
Of course I am focused on myself when I seek care. And I hope I never find myself under the care of a physician who is looking to "cut corners" and is focused on "cost-effectiveness" and on "the population" instead of on the individual in front of him (me)!
Jan '13: PSA 1.23, small nodule on DRE (1st screening @ age 40)
Mar '13: Biopsy 2 of 12 cores GS 3+3: rt mid 10% and rt apex 20% w/ PNI+ Stage cT2a (confirmed by Epstein @ Hopkins)
open RRP by Dr. Burnett @ Hopkins. Both nerves spared.
Final Path: GS 3+3, organ confined (tumor extent moderate), SV and 11 nodes all negative (pT2a), clear margins!
PSA: 0.01 @ 6 wks, <0.01 @ 21 wks.