The general public presumably has some idea that the medical profession is regulated. That is about as specific as it gets. We might have some idea about doctor-patient confidentiality and the Hippocratic Oath. That’s about it. Really fancy folks have heard of HIPAA. I assume the average person also thinks that there are too few regulations, that doctors are robbing people blind, and that there oughta be a law against those waiting room times, although I have no polling data on that so [citation needed].

I work with traffic records. Off the top of your head, can you think of any regulations dealing with those? Who can access them, whether companies can buy them for mailing lists, what your insurers can get, what an officer can see if you are stopped…? p>0.95 that you have been or will be in a crash. But the regulations are not that important to you unless something goes catastrophically wrong.

I’m amazed that the general public has no knowledge of the laws involving medical regulation. Did you think we were free to do whatever, like in a democracy?

No one else here is interested in where this is situated on an overall heirarchy of correctible economic waste due to bias?

really? How often are these laws violated? enforced? It’s hard for me to reconcile that claim with the signs in the elevators asking doctors not to talk, but I would like to know rates.

Perhaps you recall the famous Business Week cover story in 2006, “Medical Guesswork?”

“The problem is that we don’t know what we are doing,” [Dr. David Eddy] says. Even today, with a high-tech health-care system that costs the nation $2 trillion a year, there is little or no evidence that many widely used treatments and procedures actually work better than various cheaper alternatives.

This judgment pertains to a shocking number of conditions or diseases, from cardiovascular woes to back pain to prostate cancer. During his long and controversial career proving that the practice of medicine is more guesswork than science, Eddy has repeatedly punctured cherished physician myths. He showed, for instance, that the annual chest X-ray was worthless, over the objections of doctors who made money off the regular visit.

He proved that doctors had little clue about the success rate of procedures such as surgery for enlarged prostates. He traced one common practice — preventing women from giving birth vaginally if they had previously had a cesarean — to the recommendation of one lone doctor. Indeed, when he began taking on medicine’s sacred cows, Eddy liked to cite a figure that only 15% of what doctors did was backed by hard evidence.”

http://www.businessweek.com/magazine/content/06_22/b3986001.htm

Let me see if I understand the logistics of your story. You were in some position in an orthopedic surgeon’s office such that you could hear conversations in three different locations, that being two different examination rooms, and at least a commons room where the doctors speak to one another. If you were a patient, that would involve you being in a third exam room; if not, you were a non-doctor, non-patient allowed access to medically-privileged conversations. Picture the doors, insulation, physical distances, etc. I will assign a probability <0.1 that your story is true. If I’m wrong, then that doctor has a lot more to be concerned about than performing unnecessary surgery: he has violated a number of federal laws, the minimum fine for each patient being $10,000. He has also violated a number of ethical laws for which he could lose his state medical license. If he’s the typical orthopedic surgeon, $5000 would not in any way influence whether he could take a trip. You, on the other hand, if you’re lying, have only been exposed on a blog post.

So, I’ve got to decide which to believe: a person who hasn’t got a clue what a week-long trout fishing or whitewater trip in Montana costs, or the imaginary doctor in the story. I’ll go with the doctor.

The patient left, and the doctor immediately walked into another room, and told another doctor, “I’ve decided to take that vacation in Montana.”

The other doctor asked him, “How much will that cost?

”

And he answered, “About $5,000.”

(Which caused me to wonder not only about the morality of the doctor, but also how one could spend $5,000 in Montana in one week.)

That aside:

Curt – Your point would be a good one, but is it true? I don’t think insurance generally covers procedures that haven’t been supported by clinical studies. But I’m not sure.