Reports that American physicians can help prevent the waste of
money on unnecessary medical procedures and excessive hospitalization.
Contribution of dependent patients to a major portion of the national
medical bill; Role of the physician in screening dependent patients;
Clues in screening patients.
By
Christina Ianzito, published on July 01, 1995
Americans waste billions of dollars on unnecessary medical
procedures andexcessive hospitalization. But while lobbyists, insurance
companies, and the government bicker over skyrocketing health costs,
physicians can help plug the money drain them-selves--with a personality
questionnaire and a watchful eye.
According to Gettysburg College psychologist Robert Bornstein,
Ph.D., a major chunk of the national medical bill is due to "dependent
patients"--those who are most compliant and suggestible, and who seek
approval and reassurance from their docs.
In some ways these patients are a doctor's dream. They are more
likely to seek help before a minor medical problem mushrooms into
something larger. And they follow doctor's orders when they are
treated.
But once admitted to the hospital, they're reluctant to leave. They
stay almost twice as long as patients who are more independent
decision-makers. They linger because they're comfortable in roles
acquiescent to, and reliant on, authority figures.
But dependency is more than a personality quirk; it's a serious
accounting issue. Each day a patient loiters in the wards costs a
hospital upwards of $800, not including extra tests the patient may
request. That translates to higher insurance fees and Medicare costs for
the rest of us.
While the trend toward HMOs and other budget-slashing measures will
take a bite out of unnecessary hospitalization--regardless of patients's
personalities--Bornstein argues that there's more to be done. "Physicians
should screen people," he says, "and when someone shows a high level of
dependency, treatment should be structured toward a reasonable release
time."
While a physician can often glean a patient's dependency status
from his initial greeting--a deferential "Hello, sir!" is a good
clue--hospitals seeking a more tangible screening tool can employ one of
several brief personality questionnaires. If a patient agrees with
statements like, "As a child, pleasing my parents was very important to
me," it can foreshadow costly lingering to come.
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