The Cost Conundrum
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This recent article in the New Yorker by Atul Gawande speaks to a central issue of the US Healthcare system which is broken at best – the overuse of medicine. And when it comes to your health in this case, more is definitely not better. The states with the most care ranked lowest in quality patient care.
In general surgery the gallbladder is known as the “golden thumb”. A quick, easy surgery that generates massive profits that is usually unneccesary with dietary changes and visceral manipulation to release the tension in the gallbladders compartment.
General surgeons are often asked to see patients with pain from gallstones. If there aren’t any complications—and there usually aren’t—the pain goes away on its own or with pain medication. With instruction on eating a lower-fat diet, most patients experience no further difficulties. But some have recurrent episodes, and need surgery to remove their gallbladder.
Seeing a patient who has had uncomplicated, first-time gallstone pain requires some judgment. A surgeon has to provide reassurance (people are often scared and want to go straight to surgery), some education about gallstone disease and diet, perhaps a prescription for pain; in a few weeks, the surgeon might follow up. But increasingly, I was told, McAllen surgeons simply operate. The patient wasn’t going to moderate her diet, they tell themselves. The pain was just going to come back. And by operating they happen to make an extra seven hundred dollars.
