Using data and anecdotes, as he does so well, Gawande argues that pointless medical care is widespread in the United States. We are over-tested and over-treated. Countless CT scans, MRIs, and EEGs, among other tests — not to mention arthroscopic surgeries, thyroidectomies, and spinal fusings — are done inappropriately and unnecessarily, he maintains.
Gawande worries that high cost, high profit testing and procedures tend to drive out necessary and often less-expensive forms of care, The solution, in his view, is to strengthen the primary care system, so that dedicated primary care physicians will have the time and the resources to deal with the real needs of their patients. He feels that progress is being made along these lines under the Affordable Care Act, but worries that the gains could be undone.
One take-way for seniors is that we need to try to find primary care physicians who are willing to work with us in devising realistic, common sense approaches to our ailments.