Overutilization Of Healthcare

A friend of mine recently had a baby.  He’s perfectly healthy and hanging out at home with his mom and dad, getting used to being out here in the world.  But two months before he was born, my friend’s doctor got concerned that the baby wasn’t growing well, so she ordered an ultrasound.  The scan showed that the baby was growing just fine (indeed, he was nearly nine pounds at birth) but also indicated a problem in his intestines.  My friend was told that her baby probably had a blockage in his intestine, and would likely need surgery as soon as he was born.  She questioned the doctor at length about this, and was told that there was definitely something wrong, but that they wouldn’t know the severity of it until after the birth.

For the last two months of her pregnancy, my friend had weekly ultrasounds, and did more than her fair share of worrying.  When the baby was born, he was immediately taken from his parents and transferred to the NICU, where he was subjected to a range of tests.  He was not allowed to nurse for the first 24 hours after he was born.

Turns out that he’s perfectly healthy.  There are no issues with his intestines, and he was discharged from the hospital without surgery or the two week NICU stay that my friend had been expecting.

I was reminded of my friend’s story when I read this article by Marya at Healthcare etc.  Was my friend’s doctor practicing defensive medicine?  Probably.  Was she just trained to see problems, and thus spotted one that turned out to be nothing?  Whatever happened, it absolutely had an impact on the healthcare costs associated with my friend’s pregnancy and birth.  Eight extra ultrasounds and 24 hours of testing and monitoring in the NICU are not cheap.  She hasn’t seen the EOBs from her health insurance company yet, but I’m sure that the cost ended up being significantly more than it would be been without the looming fear of problems that hung over the last two months of the pregnancy. Luckily my friend has health insurance, so she won’t end up paying directly for the extra care.  But all of us pay for stuff like this in the form of higher premiums.

I found Marya’s article in last week’s technology-themed Grand Rounds, hosted at Medicine and Technology.

About Louise Norris

Louise Norris has been writing about health insurance and healthcare reform since 2006. In addition to the Colorado Health Insurance Insider, she also writes for healthinsurance.org, medicareresources.org, Verywell, Spark by ADP, and Boost by ADP, and Gusto. Follow on twitter and facebook.

Comments

  1. You make some good points about overutilization. But let’s look at things from the other side of the story. Suppose for a second that there had been something wrong with your friends baby and the doctor had missed it? Whose fault would that have been? Would you be here arguing the opposite? That the doctor could have simply ordered some extra ultrasounds and monitored the baby in the NICU for a day and found the problem and then everything would be OK. Would you be advocating that your friend sue the doctor for malpractice because he/she wasn’t thorough enough? If I’m a doctor and my livelyhood and reputation is on the line and I can protect myself by ordering a few more test, do you blame me? And then, the insurance company who tries to stop this overutilization is demonized for denying treatment to a patient. It’s a real catch 22. But I’m quite sure the government can fix it???

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