As summer students working with Choosing Wisely Canada, we were part of a national, physician-led campaign to reduce unnecessary tests, treatments and procedures. The campaign has developed recommendations regarding commonly used tests, treatments or procedures that are not supported by evidence, and/or could expose patients to unnecessary harm. We feel strongly about the importance of …
Last week, the Ontario Medical Association and the Ontario government announced they had reached a tentative agreement that they hope will end their current dispute. The tentative agreement, which will run until March of 2014, will affect doctors in a number of ways and also has implications for the wider health care system. In this article, …
The number of diagnostic imaging tests performed on Canadian patients has been increasing rapidly in recent years. Although the cost of each test is small, the aggregate costs add up quickly. The costs have become sufficiently large that both doctors and the government have raised questions about whether all the tests that are being performed …
How can the idea of early detection and screening for cancers even be a debate? What could possibly be the downside of catching cancers early, and treating them before they cause great harm, even death? Logic says if you can’t prevent a cancer in the first place, then diagnose it as early as you can, …
For our health care system to remain sustainable, scarce resources must be managed effectively both at the system level and on the front lines. In health care, decisions by doctors have a major impact on resource management in front-line care. But our health care system does not provide doctors with all of the information they …
Here’s a startling but true story. In 2008, the Ontario Ministry of Health and Long-Term Care paid about 10 million dollars for 13 million blood sugar test strips. They were used by 49,000 Ontarians aged 65 or older who had diabetes. What’s so startling about that? The people who used the strips were not receiving …
The thought of the annual Pap smear causes me as much discomfort as it does any young woman. When I read the new guidelines for cervical cancer screening in Ontario, reported in last month’s issue of Journal of Obstetrics and Gynaecology of Canada, I was slightly relieved at the recommendations being put forth. Rather than …
I applaud Helen Walsh for her recent post about walking away from yet more invasive testing. Her post made me reflect on recent cases of medical expense from my own practice. Patient details have been altered to protect their identities. One patient has an annoying condition that gives him pain with some activities, related to …
As a rural family doctor I have to factor in travel costs when referring my patients for specialized services. Costs of travel include not only transportation expenses but time from work and home. Increasingly patients are being forced to travel again and again after having tests. A good example is breast screening which causes many …
Blood glucose test strips are the third most expensive cost for the Ontario Public Drug Program. A study released in 2009 suggests that the Ontario government is unnecessarily spending between $19 and $42 million per year on glucose test strips. However, no changes have yet been made to reduce the use of blood glucose test …