Do you think supply/demand test and/or service ordering by physicans is in conflict with the oath that doctors take and is there a reasonable way to determine whether a test is being ordered inappropriately?

Many aspects of health care reform can be tied back to the law of supply and demand. We know that if the price goes up, consumers will demand less. If the price goes up, suppliers will supply more. If we consider physicians as suppliers (of testing or services), then we would expect more of these tests or services to be supplied by the physicians.

Expert Answers

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This question has a fundamental error in that tests are most often performed by other agencies than the physician or medical group, therefore the physician cannot be the supplier of these tests. Similarly, services are also most performed by other agencies for which the physician cannot be considered the supplier. One way this scenario can hold as a generality is if the physician is taking "kickbacks," or pay-backs for sending business to other agencies.

Regardless of the truthful reflection of reality in the question scenario, ordering tests and/or services for patients for the purpose of financial gain and little or no other reason ("just to be sure ...") is a violation of the medical oaths taken by doctors.

Doing significant research on the medical problem or condition being treated may provide a reasonable way to know if tests and/or services are being inappropriately or appropriately ordered.

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