Curbing Healthcare Costs is Doctors’ Job
There is a lot of talk about healthcare cost reduction. In recent years, consumers have increasingly been encouraged by employers and insurers to help control rising health care costs by avoiding unnecessary tests, buying generic drugs and reducing visits to the emergency room, among other things. The hope is that a patient better educated and more engaged in health decisions will choose options that will promote better health and decrease costs.
Such “patient engagement” efforts assume that patients welcome the opportunity – or at least are willing – to get more involved in their own care. But as a study… Continue reading
PSA Screening: Weighing Harms And Benefits
Rita Rubin of The Baltimore Sun writes: “For nearly a quarter century, doctors have ordered annual PSA tests for men of a certain age to screen for prostate cancer, despite a lack of evidence that the benefits outweighed the risks – especially when tiny, slow-growing tumors were detected”.
The greatest benefit of PSA appears to be for those 55 to 69 but men in that age group should discuss the pros and cons with their doctor before deciding whether to proceed. For those who opt for screening, waiting at least two years between tests could minimize potential harms – namely false-positives and the detection of slow-growing tumors that wouldn’t have caused any symptoms – while preserving most benefits.
PSA Tests for Men Over 75
Fewer men over age 75 are being routinely screened for cancer with a prostate-specific antigen (PSA) test following a 2008 recommendation against these tests. About 4 in 10 men over 75 get the tests.
Before the recommendation, 47 percent of men over 75 had a PSA test. By 2010, that percentage dropped to 42 percent, according to Medicare data. That occurred without any change in payment policy by Medicare, which continues to cover the PSA tests.
A less-is-more approach may work for older men. In 2007 – before the guidelines – 49.5 percent of men age 65 to 74 had… Continue reading
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