[joshgel]

I'm a doctor. I'm pretty sure I know what those things mean. But ya, wouldn't expect you to.

Ultimately that's irrelevant, because you don't choose the services you get in a hospital, "I" do. If I come in and recommend this or that test, are you going to check the price? Of course not, because the issue is only partially hidden prices. Its also knowledge asymmetry and fear. I think most doctors only recommend tests they feel will be helpful and in my current position I have absolutely no incentive to order extra or unnecessary testing, so I try not to.

I suspect (but I guess it hasn't been proven) that moving away from fee-for-service towards Medical Home type payments will resolve a lot of this as long as quality measures are carefully monitored and decreases in quality are appropriately sanctioned.

[beatgammit]

I thought doctors had to be a but conservative due to lawsuit concerns and insurance requirements. I hear about concern over doctors misdiagnosing, so I'm guessing that doctors order more tests than strictly necessary to cover themselves.

[DanBC]

> I think most doctors only recommend tests they feel will be helpful

Why are the rates of over-testing and over-diagnosis so high?

[jrowley]

> Why are the rates of over-testing and over-diagnosis so high?

It is something health systems are aware of and working on, but if you go to the doctor with lower back pain and they say, get a better pair of shoes, take epsom salt baths, and deal with it, you might get frustrated. It doesn't cost the physician anything to order an MRI, but that procedure alone can costs $10k to your insurance, and may very well not reveal anything novel from the physical. But both the patient and physician feel more confident and there is no incentive against the physician for ordering the test. This particular example is such an issue, that a national quality measurement standards org has a measure dedicated to it:

https://www.ncqa.org/hedis/measures/use-of-imaging-studies-f...

And now that we are monitoring it (at some cases, down to the physician level), we can see awareness grow and individual physicians are changing their ordering habits. Very cool.

[Peradine]

"helpful" may be defined as helpful in preventing the doctor from being sued