Quote:
Originally Posted by MikeWaters
In this case, you are balancing the risk to the patient versus the risk to society (i.e. cost). The question the doctor must answer is "what is best for the patient?" It can't be the doctor that is making societal questions about cost. For example, a psychiatrist may feel a certain medication is the best, but that it is very expensive and might not be covered or affordable. That should not mean that the doctor doesn't present the patient with that option.
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I see what you're saying, but here we're talking about a cost to the patient/society versus a cost to me. Unless you're advocating we just admit every patient to the hospital, in order to never miss a serious event. But even that's not 100%, as you need to then follow up with some sort of stress test--yup, more radiation and possibly more nephrotoxic dye--I don't think that's really beneficial to the patient either. Ideally, yes, we should always come down on the side of the patient, but then ultimately, we'd all be working for free, right (or at least a minimal subsistence to survive on)? The other problem is that those who are trying to "do the right thing" are getting forced out of practice (witness OBs in PA, ER docs in FL, neurosurgeons/orthos refusing to take call for liability reasons, etc.).
I think an expert panel would alleviate a lot of the issues. Europe has it, Canada has it, we don't. Why not?