Word: mri
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...major problem with American health care today is what policy experts call "perverse incentives." Doctors and hospitals bill insurers for every individual service - every office visit, MRI or hour of operating-room time - a "fee for service" model that drives health-care inflation by rewarding providers who order potentially unnecessary tests, perform potentially unnecessary surgeries and even make mistakes. A hospital readmission caused by avoidable complications just means more billable expenses...
...doctors on salary, insulating them from fee-for-service inducements to overserve; unfortunately, Mayo is hemorrhaging cash on its Medicare patients, because the current system penalizes responsibly conservative care. Doctors don't get paid for thinking about a case or returning a phone call or explaining why an MRI isn't necessary; hospitals don't get paid when their discharged patients don't have to go back to the hospital. Our goal for our health-care system is not more tests or more doctor's visits or longer stays in the hospital - it's better health. But that...
...during a kickboxing class 10 days before. He immediately had a pretty good idea of what had happened, so after limping out of the gym, he called an old friend who is a retired orthopedist. "He said he was pretty sure it was my Achilles, but I wanted an MRI to be sure. He just said 'fine' and gave me the prescription." I spoke with Frank and showed him the powerlessness of his ankle - the squeeze test. I even had him put his finger into the divot in his tendon. I tried to be gentle about bringing...
...which means doing a small operation) or put a cast on with the foot flexed down. The cast treatment isn't as good - it won't restore normal power - but there are none of the risks of surgery (like scarring and infection). So he demanded an MRI, which he got, then called his internist to ask for another specialist. "You're not playing any more basketball, at least not the kind that requires jumping, if you don't have that tendon repaired" is what I told him after taking him out of the cast and examining the ankle...
...going to trust me to operate on you, you're going to have to trust me on this too - you don't need another MRI. You didn't even need the first...