A one-page list of 56 common medical tests and procedures could shake up the way doctors deliver care at Beth Israel Deaconess Medical Center. Why? Because there’s a price next to each item.
Such lists are very unusual. Most doctors have no idea what they are spending when they order care for patients — and finding out is an eye-opening experience.
“I didn’t realize that the prices were as high as they actually were, although I knew that there were some pretty extreme examples,” said David Ives, a primary care doctor and the medical director of Affiliated Physicians Group, the largest group of private doctors that admits patients to Beth Israel.
“One [price] that really pissed me off,” Ives said, “was that when you send someone to an ear, nose and throat [specialist], something like 80 to 90 percent of the time they get a flexible scope of their sinuses.”
Ives says using this flexible cord with chip camera is rarely better than having the doctor look up a patient’s nose or down their throat, but it costs 10 times more than the physical exam.
“It’s just done because the technology is there,” Ives continued, throwing up his hands. “Is there value added for that? And I thought, probably not. And that might someday dissuade me from referring to someone who does a lot of those.”
Ives acknowledges that some ear, nose and throat specialists would disagree and argue that the scope is a valuable test. But raising that disagreement is part of the point of the price list. Phil Triffletti, another primary care doctor at Beth Israel, says that as health care costs continue to rise, physicians need to talk to each other about which tests or procedures are worth the money. Continue reading