Q&A: In your opinion, what are the most dangerous healthcare trends?
By far the most dangerous healthcare trends are insurance treatment denials. There seems to be a trend of limiting patient care indicated by the actual treating surgeon by hiring other physicians, often not even specialists in the same field, to deny treatment, tests, and even surgery. These doctors have had no direct contact with the patients, have conducted no examinations, and often do not even have specialty training in the field they were acting as peer review doctors for when they deny care.
The truth is, even if they were the same specialty, there are different approaches to patient care amongst specialists, and one opinion, especially one on the telephone, should never trump another specialist’s recommendations. I feel these peer review doctors should be held accountable for the decisions they make because often the denial of necessary care leads to chronic pain and potentially a chronic injury that has less chance of healing.
The greatest danger is that the guidelines created by insurance companies are more about ensuring the insurance company’s profitability rather than patient outcomes and therefore these guidelines unfairly override the medical judgment of the treating surgeons. That will never lead to better care for the most important person in the equation- the patient.
