A fee-for-service system could be leading to over diagnosis, this expert feels.
Dr. Sunita Sah has a unique perspective. She practiced medicine for several years in the UK and then moved to the U.S as a general practitioner.
Once in America, according to this account, what she found surprised her. Doctors were recommending patients go through with procedures that wouldn’t have been done routinely, in the UK.
In her opinion, what she witnessed was overdiagnosis.
Was it? A final verdict may depend on your point of view. As an assistant professor at Cornell now, however, Sah feels the treatment guidelines recommended by medical specialist organizations in the United States lead to “spiraling health costs”.
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“Having (a) colonoscopy at the age of 50-that struck me as rather odd when I moved to the U.S., because you don’t really hear about people having colonoscopies as a screening procedure in the U.K.,” she said. “It’s much less invasive to test for blood in the stool. It’s also less costly and doesn’t have the risks of undertaking a colonoscopy.”
Tests for such as mammograms also differ drastically between the UK and the United States.
“The bias is not necessarily malicious or intentional,” Sah said. “In a fee-for-service environment, they (doctors) may be biased to do more rather than less, so it becomes a habit.”
Her recommendation? Ask your doctor questions. Find out which guidelines they’re following and what the advantages and disadvantages are to having certain tests and screenings done. If you’re feeling uncertain, have them explain their thought process.
As a patient, it’s your right to know.
