There are many forces driving utilization in health care. Patients come to doctors for explanations and relief. They relate symptoms that will likely lead to diagnostic testing. For example, if you tell your physician that you have a burning sensation when you urinate, it is likely that you will be asked to surrender an aliquot of your urine for analysis. If you enter your doctor’s office with some difficulty breathing, fever and a cough, I’ll wager that there’s a chest x-ray just around the corner. These diagnostic tests are appropriate. When does utilization morph into overutilization? I don’t know where the threshold between them lies. Moreover, doctors disagree amongst ourselves on what constitutes an unnecessary medical test. Doctors agree that there is too much testing and prescribing going on, but they tend to point their fingers toward their colleagues rather than toward themselves. Think of politicians here. It’s common for a congressman to criticize another cong
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