Donald W. Brown. Healthcare Solved—Real Answers, No Politics. J Am Osteopath Assoc 2010;110(11):680–681. doi: 10.7556/jaoa.2010.110.11.680.
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Less than 1% of the population accounts for 30% of the total medical costs, most of which are cancer patients. Another 11% of the population accounts for 43% of the costs, most of these are patients with chronic diseases at advanced or end stages.... The money goes to treating the end results of these chronic diseases that often take decades to develop. That's why it takes so long to reap the benefits of prevention. As a clinician, I believe prevention is necessary, as is adequate continuing medical management. But, it's not the most effective way to impact healthcare expenditures now.
If there is no impact on patient management as a result of the screening tests, there is no point in doing it.... Doctors need to know the costs of the tests they order and understand when the evidence base supports ordering a given test for a given patient. Physicians must understand the power of one test vs. another to get the biggest bang for our healthcare dollars. Otherwise our good intentions will cost the system more money and our patients more worry, both unnecessarily.
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