I don't have a question, just a comment. It seems like one way our country could reduce the cost of health care is to quit sending everyone to a specialist. It seems like everyone is running off to see these highly specialized doctors when their GP could take care of the problem just as well and at a fraction of the cost. That's the way I see it.
According to some health care policy makers, you are on the right track with your thinking. Just using spine problems as an example, we know that the treatment of back and neck (spine) problems accounts for billions (not just millions, but billions) of dollars every year. Low back pain alone accounts for 90 billion dollars in diagnosis and treatment. It is estimated that another 20 billion can be chalked up to lost wages and lost productivity. And those figures don't include similar costs associated with neck pain and problems. Given that up to 80 per cent of all adults will have back pain at least once (and often more than once) in a lifetime, this problem has grabbed the attention of health care policy makers. It's their job it is to hold costs down without compromising care or outcomes (results). When care exceeds recommendations made based on evidence, then health care policy makers get concerned. In a recent report from The Dartmouth Institute for Health Policy and Clinical Practice, it was noted that money spent on spine problems (including both the neck and back) is linked to specialty services that don't necessarily improve results. Expensive MRIs and other imaging tests, referrals to orthopedic surgeons and neurologists, visits to the emergency department, and unnecessary lab testing make up some of the specialty costs that might be considered unnecessary. In addition to expanded diagnostic tests thanks to improved technology, more aggressive marketing of medical supplies has driven some costs up. And the rising costs of care associated with these services don't come with improved results. On the other hand, dollars spent on spine care provided by general practitioners (GPs), chiropractors, and physical therapists have not gone up. This is contrasted with evidence that these services provide improved outcomes. Future research is needed to determine what is the most cost effective treatment (i.e., least cost and most benefits). With the continued rise in health care costs, finding ways to improve results of treatment for spine problems (again, at a lower cost) is important to health care policy makers. It may be necessary to limit patient access to specialty care by restricting (rather than expanding) reimbursement. Policies that encourage better reimbursement can be put in place as more research is done to identify effective spine care.