Little things mean a lot

Abstract

The discussion about healthcare costs in the US — reducing it, controlling it, getting it to the right places — focuses on big ticket items like cardiac catheterisation, end-of-life care, and transplants of all types. Since family doctors don't do transplants or cardiac caths, we avoid the glare of the cost spotlight, mostly. I recently saw a patient with a sore throat. I didn't feel that the patient's symptoms or risks required a strep test. But it was too late, in the new ‘efficient’ system for primary care reengineering, the nurse did it before I got into the room and results were already in the chart. We all understand that antibiotics …