OK  Here we go again.

Another article published by a physician who criticizes how physicians practice. 

 Peter B. Bach offers us his opinion  that physicians order tests out of a sense of "knowing best" rather than following medical research.  His words may appeal to a public who doesn't trust the medical profession anyway.  Unfortunately, his argument is flawed. 

When will society come to understand that they can't expect to sue doctors for imperfection and not expect them to order more tests than they would like. In truth,  the odds of finding an abnormality on CT scan, mammography or repeated procedures, although unlikely, do exist.  Failure to diagnosis one case out of a thousand, or two thousand or ten thousand will result in a malpractice claim.  Defending oneself, no matter how often, is an emotional and economic burden that lead to the predominant mode of medical practice–defensive medicine. The American health care system is paying for this, all of us.

 And besides, Bach is just plain wrong when it comes to screening for colon cancer.  Flexible sigmoidoscopy will not diagnose the vast majority of colon polyps and cancers that occur beyond its reach.  And guess what—-gastroenterologists will get sued for missing them.  Just as Obama conveniently decreed that defensive medicine is not responsible for health care expenditures, saying it doesn't make it so.  Until there is comprehensive tort reform, until the trial lawyers stop dictating legislative and judicial policy, there will be no change.  So continue to read articles blaming physicians for the cost of health care.  Just be aware of what factors are at play in the real world.

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