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Notes -
What drives me insane is how many of these multi-thousand-dollar fuck-ups are the result of someone not on the hook for the bill (sometimes the doctor, sometimes the patient) choosing the vastly more expensive option just because it’s slightly more convenient. This guy gets told to take his infant to the emergency room for a UTI because hey, why not? Insurance will pay for it.
You can see why insurance companies turn into money-grubbing assholes.
Laziness or ineptitude is certainly a cause at times but "I don't want to lose my livelihood" is a potent motivator.
ED pan-scanning is functionally "standard of care" because using your training effectively is going to result in a few miss or near misses at some point and it is much safer to hide behind the donut of truth.
When laziness and safety line up it's really hard to alter behavior.
However there is something to be said for "we are the richest country why can't we have the most expensive care and avoid making certain kinds of mistakes."
I don't think people realize the trade offs we are making and it's certainly worth a discussion but we rarely do that.
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