April 14, 2010 Leave a comment
So, I seemed to hurt my knee pretty bad in January and after thinking it had completely healed, I seem to re-aggravate the injury every few weeks. None of these subsequent injuries had bothered me too badly, so I had not sought ought a doctor. My most recent (and painful) re-aggravation– while coaching U-10 soccer– made me realize this was going to probably keep coming back unless I do something about it. Time to see an orthopedist. Actually, I was already diagnosed with a torn meniscus by two doctors, based solely on the description of my symptoms. The problem is that these doctors are PhD's in Political Science. Turns out, though, they were in all likelihood right.
Anyway, went to the real doctor yesterday (I hate calling PhD's "doctor" except when it makes for a good joke, as above) and, as expected, he said I likely have a meniscus tear. Thing is, this is a soft tissue injury, and based on conversations and research the odds were overwhelming that I would have a soft tissue injury. Why then, did Raleigh Orthopedics fill the need to do 3 X-rays of my knee as soon as I got there (X-rays do not show soft tissue injuries)? The doctor's diagnosis depended entirely upon the clinical examination and my patient history. He literally did not even look at the X-rays until after he gave my my discharge papers– an obvious afterthought. Clearly, an X-ray was not clinically indicated for what I presented with. Yet, Blue Cross/Blue Shield NC will be billed a couple hundred dollars, I'll pay my 20%, and the good people of NC who subsidize my insurance plan all pay higher costs. I don't think the profit motive is the primary reason this happened. Doesn't hurt, though. Mostly, I think the doctors don't want to go to the trouble (not that it is that much in today's modern digital imaging era), of doing an examination, determining if an X-ray is necessary, and than waiting for it. It's just much simpler to have the X-ray there if they need it. There's no downside for them– they get paid for it. If this was an isolated case, no big deal, but there's every reason to believe that there's 10's of thousands of similarly unnecessary medical expenses every single day. That, we've got to get a handle on. Actually, that reminded me of an article about this very problem in the Times from a few weeks ago that I forgot to post. Worth a quick read.