And in a now-famous study of physicians’ performance, patients received only 55 percent of recommended care for 30 different medical conditions.
At the same time, doctors often prescribe too much of the wrong kind of care.
For example, Canadian researchers audiotaped more than 300 office visits with 39 different primary-care doctors.
Patients were then asked to rate the visit in terms of the relationship with their doctors.
Many insurers focused more on cost at the expense of quality.
They negotiated lower and lower fees for doctors, who slashed the time spent with patients to fit more of them into a day.
“I was a full-time primary-care doctor for more than 30 years. study found that doctors interrupt their patients on average within 23 seconds from the time the patient begins explaining his symptoms.
After months of this, Fred’s wife, Regina, looked up his symptoms on the Web. When the worried couple went back to the doctor, Regina recalls, she walked into the exam room, reading Fred’s chart, and without looking up, asked, “Mr. ” It was a routine question, based on the number of his complaints. Unhappy patients gripe about their doctors’ brusque manner and give them bad marks on surveys and consumer websites like Health Grades and Angie’s List.“There is something in the human body that says we are hardwired to get better when we have a certain relationship,” explains Howard Brody, a primary-care physician and director of the Institute for the Medical Humanities at the University of Texas Medical Branch, in Galveston.The good news is that doctoring may have hit rock bottom—and policymakers and physicians who have begun efforts to rebuild it realize that the only way out is up.Between 20, the number of CT scans performed annually nearly doubled to more than 75 million a year, many of them given, say experts, out of habit or fear of litigation, not because they were likely to help the doctor make a diagnosis.Prescriptions for antidepressants, which are heavily marketed to physicians by drug companies, shot up over the same period, often for patients who did not have a psychiatric disorder.