"So rather than talk to a patient about why they don't need a test, and not having them get one and risk having them be dissatisfied," a doctor feels pressure to allow it. "You don't want to make the patient angry." Reducing costs and unnecessarily harmful utilization, she says, "are incentives that are not consistent with each other."
A few increasingly vocal doctors are crying out across the country to get their peers to pay attention to even these silly little things. At this rate, I'll have another few examples from other specialties in my e-mail in the next few days.
Demosthenes isn't talking about cutting a billion dollars from her hospital's costs. But as she says, these early efforts are "low hanging fruit." And having a baby is one of the biggest, if not the biggest, reason for hospital admission.
A few swipes at the cost curve here, and a few swipes there. We might just start talking about real money.