On Tuesday, Hall of Fame former Green Bay Packer quarterback Bart Starr was giving a speech in Madison Wisc. when he collapsed. He is 78 years old and left the venue on his own volition, speaking coherently and headed, the Milwaukee Journal Sentinel Online said, straight to the Dane County Regional Airport.
I hope so. I hope he didn't turn around and drive to the nearest emergency room where he would be subjected to a battery of medical tests -- none of them cheap, all of them time-consuming and half of them likely unnecessary, I mean "just precautionary."
Sometimes, our bodies react to exhaustion, or skipping breakfast, or getting dehydrated in the heat. Sometimes we feel light-headed, or it hurts, or causes us to feel unwell. It isn't always something big, dreadful and a cause for alarm. It isn't always necessary to rush to the doctor. And yet, we respond to whatever ails us as a worst-case scenario.
It's an attitude I blame on the medical community, who without preying on our fears, would be out of jobs.
I know a breast cancer survivor who says that she no longer can just have a headache; when her head hurts from staring 12 hours at her computer screen, her doctors want to run tests to rule out a brain tumor. When that persistent pain in her leg flares up after she runs too far, it can't just be a tired muscle; her doctors want her to come in so they can rule out bone cancer.
My husband, who had open heart surgery in 2006, recently stumbled on uneven pavement while he was texting me (read: not watching where he was going). His fall led to X-rays, blood work an EKG and countless other tests with the recommendation that he then head over to the ER for a CAT Scan "just to be sure." Just to be sure of what?
He exited Urgent Care with a Band-Aid on his nose, and we went over to watch our daughter's soccer game. On a follow up visit with another doctor, we learned he had indeed suffered a barely visible hairline fracture of his nose -- surgery optional, but with the recommendation that we have his oxygen levels checked and breathing monitored "just to be sure." We changed Band-Aids and went home.
About three weeks later, he woke up light-headed and vomiting. Since our primary care doctor is nearly impossible to get in to see, we went back to the Urgent Care -- and this time, after more X-rays, blood work, an EKG and other tests, he was sent to the hospital ER in an ambulance. Ten hours and countless tests later, he was discharged with the diagnosis of "uncertain," and advised to see both his cardiologist and his gastroenterologist. Dutifully, he did. Final upshot: Lay off the brussel sprouts; they cause gas and indigestion.
The bills from the fall and the brussel sprouts are thousands of dollars thus far, and are still coming in. Yes, we have insurance and yes, those bills will be negotiated. Our portion will be several hundreds of dollars, for which I am both grateful that they aren't more and annoyed that they are at all.
How much of what my husband was subjected to was unnecessary? Historically, doctors have had a medical malpractice insurance policy looking over their shoulder and advising them to leave no stone unturned. Better to be safe than sorry; as a doctor, you don't want to be accused of missing something. And let's not ignore that from a business perspective, as long as the patient has insurance or Medicare and you are going to get paid for it, well, why not be as cautious as you can be?
Here's why: Because it's unnecessary. Because it contributes to the spiraling out-of-control medical costs that threaten to ruin the lives of the uninsured and diminish the quality of the health care we all get.
Just because a test is available doesn't mean it needs to be administered. "60 Minutes" recently did one of its exposes -- you know, the kind where the company CEO starts stammering uncomfortably -- about hospitals run by Health Management Associates setting quotas for their ER doctors to admit more patients, especially those over 65. Why the magic age number? Medicare-covered, of course. Do the math: An empty hospital bed equals no money; an occupied bed paid for by the government is certain revenue.
HMA insisted that its doctors make the best medical decisions based on the needs of their patients, not its business bottom line. I don't need to play "who do you believe?" with them. I'm just still hoping Bart Starr went straight home, put his feet up and relaxed by watching a game.