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The problem you describe is an economics problem. Doctors and patients are shielded from the costs associated with their health care. Having insurance act as a

The problem you describe is an economics problem. Doctors and patients are shielded from the costs associated with their health care. Having insurance act as a group savings plan is catastrophic for all aspects of healthcare. If, on the other hand, people were paying out of pocket for those tests, who cares? What is the downside of a person being more knowledgable and involved? Unfortunately, the ACA took a step in the wrong direction by hiding more costs from the consumers. If we want a healthy health care system, we need price tags (and insurance for catastrophic events!).

DanBC 12y ago
> What is the downside of a person being more knowledgable and involved? More tests does not mean more knowledgeable. It just means the patient has more noise to either listen to or ignore. That has consequences: stress from some test result; taking action based on a test result when there's nothing wrong; and so on.
- SoftwareMaven 12y ago
  I completely agree with you. I'm pretty picky about what tests I'll take for exactly that reason: stress is dangerous to one's health and many tests have abysmal false-positive rates. My hypothesis is that people, on balance, would be healthier if they took a more active role in their healthcare. I've seen it in a lot of people's lives, but there is a strong confirmation bias there. You don't see the people that tried and wound up worse off. Fortunately, this is easy to study. We could find an answer to whether people are better off, and, more importantly, how to ensure they are better off.
pyre 12y ago
Well, I can think of one downside to just giving the demanding people what they want: over-use of antibiotics creating 'super' strains of bacteria. (I realize that you're specifically talking about tests, but I see tests as just an example of the, "I know better than the doctor," people.)
- SoftwareMaven 12y ago
  I would hope no doctor would prescribe anything without agreeing to the medical benefit of said treatment (I've asked for an off-label prescription before and my doctor pushed back until he understood and agreed it was worthwhile). A patient can't just start taking an antibiotic; the doctor has been given that gatekeeping role, and that is as it should be. Just because patients are involved doesn't mean doctors abdicate their responsibilities as well. (Off-shore pharmacies add a whole new twist to this, and I'm not sure how you address that. I wonder, though, if antibiotic usage in industrial animal husbandry is not a bigger problem than somebody's hypochondriac relative.)

DanBC 12y ago

> What is the downside of a person being more knowledgable and involved? More tests does not mean more knowledgeable. It just means the patient has more noise to either listen to or ignore. That has consequences: stress from some test result; taking action based on a test result when there's nothing wrong; and so on.

SoftwareMaven 12y ago
I completely agree with you. I'm pretty picky about what tests I'll take for exactly that reason: stress is dangerous to one's health and many tests have abysmal false-positive rates. My hypothesis is that people, on balance, would be healthier if they took a more active role in their healthcare. I've seen it in a lot of people's lives, but there is a strong confirmation bias there. You don't see the people that tried and wound up worse off. Fortunately, this is easy to study. We could find an answer to whether people are better off, and, more importantly, how to ensure they are better off.

pyre 12y ago

Well, I can think of one downside to just giving the demanding people what they want: over-use of antibiotics creating 'super' strains of bacteria. (I realize that you're specifically talking about tests, but I see tests as just an example of the, "I know better than the doctor," people.)

SoftwareMaven 12y ago
I would hope no doctor would prescribe anything without agreeing to the medical benefit of said treatment (I've asked for an off-label prescription before and my doctor pushed back until he understood and agreed it was worthwhile). A patient can't just start taking an antibiotic; the doctor has been given that gatekeeping role, and that is as it should be. Just because patients are involved doesn't mean doctors abdicate their responsibilities as well. (Off-shore pharmacies add a whole new twist to this, and I'm not sure how you address that. I wonder, though, if antibiotic usage in industrial animal husbandry is not a bigger problem than somebody's hypochondriac relative.)