Our health care system is broken and patients are footing a larger part of the bill thanks to high deductible plans. This is forcing us to become savvier patients to keep health care costs down. Unfortunately, the medical industrial complex continues to find ways to make money and providing unnecessary care is one way they pull in the dough.
One method to run up medical bills is to order unnecessary x-rays. How does this happen and what can you do to prevent the waste?
When you make an appointment with an orthopedist, the receptionist will ask what is bothering you. For example, if you say it is your left lower leg, when you come into the office, they may order an x-ray of the left lower leg before you are evaluated by the doctor. More offices are doing this in the interest of “saving time” – theirs, not yours. And it costs money! X-rays can easily cost a few hundred dollars and there is no reason to have unnecessary x-ray exposure.
An x-ray is a diagnostic test that should be ordered based on patient history and physical exam. Not every musculoskeletal injury needs x-rays – in fact, we have rules for ankle, knee, and back injuries that were developed specifically to reduce unnecessary x-rays. Also, people visit the orthopedist for muscular issues that may not involve boney structures.
If you are seeing a doctor for a musculoskeletal issue, and you don’t know if an x-ray is warranted, it is important to speak up and question why an x-ray is being done before you are seen by the doctor.
When challenging the issue, always be nice. Simply state, “I’m not sure I need an x-ray and I would like to see the doctor before an x-ray is done.” If there is any pushback, let the tech know you have a high deductible plan, that you don’t think the problem is with the bone, and you want the doctor to examine you to determine if the x-ray is really needed. The tech probably isn’t paid a high salary, so they may have empathy with your situation. Of course, if you think you need an x-ray, by all means, let them do it before the doctor sees you.
I recently had to see an orthopedist for a long-standing problem from a bike injury years ago. The tech called me from the waiting room. I assumed I was being walked to a patient room and lo and behold, she walked me into an x-ray suite. I immediately said, “I don’t know why they are ordering an x-ray. I don’t need to have one as this is an old problem and the doctor has seen me for this before.” She immediately walked me back out to the waiting room and no x-ray was done.
There is one concern with not going along with the “process” of ordering x-rays before being seen – the medical providers may become annoyed with your empowerment. This is their issue, not yours. If they seem to take out their frustration on you, reiterate that you are trying to keep your costs down and that you know x-rays in general should be ordered after the doctor sees the patient. Hopefully they will respect that and give you the care you deserve. If they don’t, post a review of your experience and find a new doctor.
Getting the health care you need and not running up the costs with unnecessary testing and treatment can be tough yet it is important to do. If enough people challenge the system, maybe one day we’ll get the health care we deserve at a cost we can afford.
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