stethoscope photo

stethoscope photo

SUMMARY: How do doctors decide what to spend money on? How do patients decide? How do insurers decide? It’s a complicated question, and here’s a simple answer: “The McNutt-Hadler Credo for Value-laden Medical Decision Making,” written by two doctors in the form of a blog post at The Health Care Blog. Read on for their advice, or… 



There’s been a lot of conversation lately about rising health-care costs. What are the solutions, though?

These two docs have an idea. We’re giving you a tease of the credo, which was posted by Robert McNutt and Nortin Hadler in response to a previous The HealthCare Blog post about the value of high-tech (and high-dollar) imaging procedures. The entire post is here; the excerpt below does it only partial justice.

“1) Don’t think of money; think of what the money buys. No patient should be offered a pig-in-a-poke.

“2) Don’t think for one moment that medical pricing is rational, let alone market driven. Medical pricing is designed to serve the greed of stakeholders, greed that seems to know no ethical boundaries. Caveat emptor is no match for “common practice” The only way the “consumer” stands a chance is if there are physicians committed to explaining the basis for clinical decisions in an unbiased, transparent, and ethical fashion.

“3) If it doesn’t benefit the patient, we don’t care if they give it away – don’t prescribe or order it. (For example, no stable in-patient should have any of the following tests: amylase or lipase; any test for iron deficiency other than the ferritin; CRP, BNP, MRI after a CT of the head, or any chronic care medicine like a statin, iron tablet, heart healthy diet in a cancer patient, vitamin, a blood pressure medicine that costs more than the cheapest alternative, a non-generic medicine that is available in generic form, enteric coated aspirin, or bone scans in women looking for osteoporosis).”

It goes on like that. It’s strong stuff. The entire post is here.

Jeanne Pinder

Jeanne Pinder  is the founder and CEO of ClearHealthCosts. She worked at The New York Times for almost 25 years as a reporter, editor and human resources executive, then volunteered for a buyout and founded...