It’s Complicated –
August 14, 2020 – The authors of the paper try to suggest causal arrows by putting a lot of statistics in the same place – Oklahoma is some nexus of drug addiction? Why do pill mill doctors move there instead of in places where there is less competition? It doesn’t make a lot of sense – but their conclusion also does not add up.
There are societal factors at work that are not part of a conspiracy, and times when doctors have to succumb to the real world; tests, new examinations, and medicine for a non-specific symptom patients insist they have. Doctors are not casually throwing out prescriptions like candy, nor are they scheduling tests they don’t think people need for profit, but it is true in some cases they more often give patients new tests or are checking off other “precautionary principle” boxes – in order not to be sued.
Malpractice insurance isn’t the biggest non-medical cost in health care, defensive medicine for the inevitable lawsuit is. Including in female health. We live in a free-range tort culture where 74 percent of obstetricians and gynecologists will face malpractice claims by the early age of 45; 78 percent of all malpractice claims find no fault, it was simply lawyers prospecting for easy settlements. In that kind of environment it’s little surprise doctors are told to be conservative and “believe” the patients or to run “it’s not Lupus” tests though they know you don’t have that, and that “chronic” Lyme disease and “GMO allergies” don’t even exist.
