Media Drives up Costs of Healthcare

Heard a clip on NPR today about antibiotic overuse for acne.  Now normally, I would think that a segment about antibiotic overuse is a good thing.  But as I listened I realized that there were several problems. 

The first, minor, problem is that the dermatologist and patient she interviewed were mother and daughter!  Now, family treatment is one of those things in medicine that we really would be better off not doing, but certainly is not something to be advertised to a national audience and therefore passed of as routine practice. 

The second problem is more insidious…the reporter only discusses dermatologists as the physicians who treat acne, and makes statements that suggest that dermatologists are the usual and customary place to go for acne.  So, what happens when the NPR-listening segment of my practice has a teenager with acne?…they call up and ask for a referral to a dermatologist – not out of lack of respect for my skills, but because they’re now enculturated to ask for a dermatologist for an acne problem.  I think ALL primary care physicians should be angrier about this, but the truth is we’re so angry at everything else, we have to pace ourselves.

The Graham Center published a study showing how many places would become medically underserved if family physicians were to suddenly disappear.  When we actively or incidentally tout direct access to specialty care, we weaken the primary care base, drive up costs unnecessarily (with the mistaken impression that "specialist=better") (even if you’re consulting your cardiologist for an anxiety attack…), and, I believe, will eventualy cause our patients more dissatisfaction.  Trouble is, before we get to the point of patient dissatisfaction, patients will have to experience the "that’s not my specialty" statement more frequently…

I get a headache when I worry about this.  I guess I should call a neurologist…