NCPA Study: More Patients Exerting Control over Health Care Delivery

Patients are increasingly by-passing doctors and managing their own health care, according to a study released today by the National Center for Policy Analysis (NCPA). They are ordering their own tests, going on the Internet to get second opinions and researching their own conditions.

“Patients are less trusting of doctors, insurance companies and employers,” said NCPA Senior Fellow Devon Herrick, the author of the study. “Increasingly, they want to become personally involved in managing their own care.”

The study maintains that one catalyst for change is the tendency for employers to shift more health care costs to employees. In some cases, employers are setting up Health Savings Accounts (HSAs) so that employees have direct control over their own health care funds.

As patients control more of their own health care dollars, they are obtaining results as good or better than standard physician care, Herrick maintained. Among the options cited in the report:

• Parents can order simple-to-use home testing devices to determine whether an earache is caused by an infection or whether a child’s sore throat is a strep infection. Ear infections are the number-one reason children see a doctor.

• America’s more than 16 million diabetics can purchase about 20 different monitors to test blood glucose at a cost of less than $70 for 100 test strips.

• The more than 20 million asthma sufferers, including 2.5 million school-age children, can develop a self-management plan with their physician using a software package at a savings of nearly 30 percent.

• Patients can order a battery of more than 50 individual blood tests online that provides a thorough biochemical assessment of blood count, thyroid, lipids, and liver and kidney diseases, among others, at a cost of only $89.

• Patients also can order “virtual exams” and genetic tests to detect cancer, heart disease and other conditions.

In addition, the total cost of unnecessary visits to doctors’ offices and emergency rooms is about $31 billion annually, according to the study, which also claims that up to one-quarter of physician visits are for conditions patients could have treated themselves and 55 percent of the 103 million hospital emergency room visits each year are judged to be unnecessary.

Legal and regulatory barriers to patient self-management remain. Many state medical boards consider the practice of cyber-medicine to be unethical, and consulting a physician online is often difficult – if not illegal, the study notes.

“Patient self-management is the latest trend in health care,” Dr. Herrick added. “Technology makes it possible and patients demand it.”

To view the study online, see http://www.ncpa.org/pub/st/st276/.