Sunday, July 25, 2010

Why do Minnesota patients

get more lower back


Great piece on the topic in the Pioneer Press by Christopher Snowbeck. It should be noted that the PP has quite a track record in this area and has had some excellent reporters - Paul Tosto and Jeremy Olson come to mind - in the last few years. Gary Schwitzer, ex U of M J-school prof and health care expert, makes some telling remarks in his outstanding blog HealthNewReview:

The story captured a key question about "what's the right rate of MRIs?" Excerpt:
" (a) spokeswoman for the Minnesota Hospital Association (said) "It is impossible to make judgments from the data ... on whether or not clinicians ordered too many, too few or just the right number of imaging tests."

Bingo. And that's why the data are important whether you live in a high-use or low-use area. As Dartmouth's Jack Wennberg has been saying for decades, we don't know the right rate of utilization of many medical interventions. But the variations across the country show that patients may not be fully informed, may not be told about the tradeoffs of benefits and harms, and may not be provided a truly shared decision-making encounter. Until true reform occurs in these patient-physician encounters, you can forget about getting overuse, overtreatment and health care spending under control.

Snowbeck and the Pioneer Press did a good job of digging and finding an important local story.

And Schwitzer pokes the bigger brother of the Twin Cities newspapers:

And where was the much larger, much better-staffed Star Tribune on this story? The same paper that just stole away Snowbeck's colleague Jeremy Olson who used to cover health care for the Pioneer Press? Deafeningly silent. I had actually written to a key staffer at the Star Tribune recently asking when/if the state's biggest paper was going to mine the data from the new Medicare database to see if there were any important local findings. I got no response. I've not seen a story in the paper on it. And I couldn't find one after I did an online search. Maybe I missed it. But regardless, thank goodness for a little remaining competition between two newspapers in a metropolitan area. And on this one - apparently - the little guy won the day big time.


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