How do you know that you unwind on unnecessary spending in private clinics

You prescribe too many tests

If you come to the doctor with the common cold, and left the office with a bundle of directions on costly tests and examinations, it is necessary to guard.

Often enough for the initial survey of full-scale blood analysis.

A research on hormones, the passage of MRI and ultrasound until you do not need.

Ask your doctor what to take one or the other analysis. Make them "just in case" and to pay tens of thousands of rubles, just not worth it. Do not hesitate to ask questions. Clarifies the rationale for a particular purpose. The physician must explain clearly and in detail why it is recommended to do the analysis or to take a certain medication.

If you do not trust your doctor, go to the reception to another specialist with a good reputation and see what tests he will appoint. And only then draw conclusions.

you hurry

"The problem is easily remedied, the operation can be organized tomorrow," "You're lucky, you can now go magical procedure with a decent discount "," If you pass a comprehensive examination, it will be much cheaper "...

As a rule, the purpose of these "great deals" - to make you say "yes". Unless, of course, it's not about a life-threatening condition and emergency hospitalization.

Do not rush to give a positive response. Take a break. If the clinic staff in response to this will frighten the fact that you "missed a good chance," are more likely to have bred on unnecessary spending.

You strongly recommend something

procedure or survey, Which can be taken "exclusively in our clinic," - an occasion to reflect and alert. It's one thing when the facility specializes in the treatment of certain diseases. But the majority of private clinics has a wide profile, and therefore unique, most likely exaggerated.

Before agreeing to treatment, study the market and prices in other clinics. Find out how much it costs a survey by independent laboratories.

Also, do not fall for the offer to purchase on the "super price" supplements, vitamins, and herbal remedies. The main rule - look for alternatives, compare, read reviews.

What should alert

• You are being treated for a long time, but the recovery is going very slowly.
• A doctor at each successive reception finds you new sores and appoint additional examinations.
• The clinic can not clearly explain why you are prescribed a particular examination and procedure.
• Once you give up the "extremely profitable offers" attitude changes dramatically, it becomes colder.

What do doctors say

If the patient is turned into a commercial organization, it will inevitably unleash on the money. He had no chance, he is defenseless. Everything will be reduced solely to the appetites of the clinic, the average check marketers and brand car, which the owner of this private center wants to drive.

Slightly better situation in dentistry, where much of the clinics working in the framework of market mechanisms, and therefore they need to be competitive.

Unfortunately, there is no reliable way to reliably understand that in a medical facility to hold the required amount of research and manipulation based on your medical condition.

But there are some tips to help you avoid a huge check for unnecessary services and get high-quality medical care:

1. Gather information about the clinics. Make a choice in favor of the medical facility, where doctors operate on the principle of evidence-based medicine. This will give a chance to protect yourself from unnecessary costly surveys. Everything will be made solely on the testimony, based on the guideline recommendations of authoritative international medical associations.
2. Prepare for reception. Pre-write a list of questions that you address the attending doctor. From my point of view, the doctor should be clarified any, even insignificant nuances. This will help save money on repeated consultations.
3. At a basic level, try to figure the problem that you go to the doctor. Here the key factor is the choice of sources of information. I strongly advise you to use Google search by keywords. This will only confuse.

As a trusted and authoritative sources for patients, I recommend:

• Section for patients the most authoritative medical directory Uptodate in the world.
• Section for patients Mayo Clinic.
• One of the best Russian medical sites "Evidence-based medicine for all».

In unnecessary examinations are two main reasons: medical error and malice (or not so angry - a conflict of interest).

Somehow I've seen doctors motivation system of one of the nation's largest network of private clinics. They received 10% of the value assigned to colonoscopy or gastroscopy. This does not in any way mean that the doctor will automatically prescribe unnecessary studies.

But the employer seduces him this opportunity. We are all human, the ability to resist temptation at all different.

The real story that happened to my patient in a Moscow clinic business segment. He came to the reception to the gastroenterologist, but the administrator gave him a weighty pack of directions for tests. The patient said he would prefer that the tests prescribed by a doctor.

However, at the reception gastroenterologist immediately he asked: "Where tests?"

- Maybe they will appoint you? - timidly she asked the patient.

- And unless the administrator has not given you directions? - with astonishment and indignation, the doctor said.

- Dala, but ...

- Show... Yes, there is half the necessary tests, no! - summed up the gastroenterologist. However, he did not even know what the patient complains.

Why it happens? There are several doctors motivation systems. The simplest - the physician receives a percentage of all prescriptions. More complex - it receives a salary, but a percentage of the high-sophisticated methods.

In another case, the doctor does not receive a percentage, but earn bonuses for the fulfillment of the standard. The problem is that in this case used samopisnye standards. At best taken as a basis of Ministry of Health standards, which are designed for entirely different purposes. Outcome one: the patient receives three times more appointments necessary.

These systems operate in most health organizations, including the top 20 in terms of revenue. In Moscow, I know only three networks, where such conflicts of interest are not consciously created management.

Universal reliable way to detect that you assign too much, no. But there are some nuances.

Highly qualified and reputable doctor who knows the international standards of treatment and following them back from them with great difficulty and under serious pressure. Work on international protocols - this constitutes evidence-based medicine. This doctor can always argue their destination, referring to the clinical guideline or guideline.

These doctors are usually willing to discuss with the patient the indications for a particular survey, say, how to change the further tactics of treatment depending on the results. If it does not change, it is a sign of unnecessary testing.

Determine doctor evidence-based medicine can be on several grounds:

• He does not make a diagnosis of "vegetative dystonia", "biliary dyskinesia," "chronic pancreatitis with exocrine failure "," dysbiosis "," osteochondrosis "," encephalopathy "," increased intracranial pressure". He definitely will not find you these chronic viral infections: herpes, cytomegalovirus, Epstein - Barr virus, the months of chlamydia.
• He does not appoint rheoencephalography, the study points at Folyu, echoencephalography, any physiotherapy apparatus (electrophoresis, Amplipuls, laser irradiation), plasma exchange (with a few exceptions for very heavy patients in the hospital), or laser irradiation of blood with ultraviolet light, vascular courses and vitamin droppers. It does not prescribe the drug injections, if you have an analogue in the tablets.
• Of medicaments for the physician EBM banned immunostimulants ( "Derinat", "Anaferon"), cardiovascular drugs ( "stugeron" "Cinnarizine," "Vinpocetine" "Cavinton", "Sermion", "Fezam", "Pyracetam", "Nootropil", "Aktovegin", "Cerebrolysin"), antivirals against SARS ( "Kagocel", "Arbidol", "Anaferon", "Amiksin", " Oscillococcinum " "Ingavirin"). Epic manifestation of ignorance - the appointment of systemic enzyme therapy ( "Wobenzym", "Phlogenzym").
• It can not be homeopath, Antiprivivochnikom, HIV dissident deny the role of statins and anticoagulants in prolonging the life of cardiac patients. He can not prescribe drugs or cholesterol-pressure courses "have a drink, and then a break, let the liver will have a rest." It also does not prescribe gepatoprotektory because this group of drugs in developed countries simply do not have.

This way you can distinguish between competent doctor from the illiterate. What is important: it so happened that the doctor usually more competent and honest.