HealthLawProf Blog

Editor: Katharine Van Tassel
Concordia University School of Law

Tuesday, June 20, 2006

Probabilities in Health Care

Erza Klein has a great post entitled, "The Problem with Probabilities," discussing the medical dilemma faced by one individual to demonstrate the probabilities issue.  He writes:

"Nice illustration of a constant medical dilemma by Ogged, who happily appears to be stomach-cancer free:

the debate hadn't been between those recommending a gastrectomy and those favoring a follow-up endoscopy, but between those favoring a follow-up endoscopy and those who wanted to send me home and tell me to forget the whole thing. The latter group was convinced that the original finding were just a strange anomaly--not a mistake, exactly, but not worth worrying about. Older, more cautious doctors eventually brought everyone around to the consensus that they couldn't take even the small chance that I do have cancer lightly, so a follow-up is warranted. But even the doctor I talked to "officially" said "we don't expect to find anything."

So much of medicine is probabilistic. If you wanted to really cut costs, you'd take a coldly statistical view of the whole thing, with those who ended up on the wrong side of the numbers regrettable sacrifices. As a society, we're not ready or willing to do that -- and rightly so. But this is the essential conflict: politicians and hospital administrators look at the global budget, while doctors and patients look at the individual's health. The latter militates for constantly seeking the lowest possible error, the former for going with the statistics and saving money where you can.. . . ." [bm]

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