Kate Scannell, MD

By Dr. Kate Scannell, Syndictaed columnist
First Published in Print: 02/17/2013

Hips. We tend not to think much about them -- until they hurt or need replacement -- even as they support our ability to walk, climb stairs, sit and dance.

With the exception of Lucille Clifton's celebratory poem, "Homage to My Hips," poetic works have largely ignored these workhorse joints in favor of hands, backs, necks -- even ankles. Hips rarely qualify as subjects of serious literary concern. In fact, entering "hip" into Amazon's book search window mostly delivers stories about American pop culture, hipsters and bunnies who hip-hop.

All this to explain why it's remarkable that hips have grabbed so many current headlines. Are we finally getting hip to hips, and all that they can teach us?

I certainly hope so.

For example, let's review two such stories which are ... well, joined at the hip, and see what we learn about money, deception, shopping hassles, and, yes -- there's more!

The first story involves an otherwise healthy, uninsured, 62-year-old grandmother seeking hip-replacement surgery for which she must pay out-of-pocket. The cost being of great concern, her dutiful granddaughter calls hospitals throughout the country, in quest of the lowest "complete bundled price" -- that is, cost inclusive of both hospital and physician fees. Read More 

By Dr. Kate Scannell, Syndicated Columnist
First Published in Print: 09/15/2012

Years ago while hurriedly shopping at my local Safeway, I turned my cart into the bread aisle and nearly ran over one of my patients. Relieved that I had not injured him, I immediately pulled back and tried to escape his notice. While I generally enjoyed running into patients (without injurious instruments) in public, I had an appointment to make within the hour and could not afford a lengthy conversation.

Still, I had noticed that my patient held within his hands the same coupon circular I held in mine. Like me, he was selecting food purchases by price and special discount. Weeks earlier, that same man had been in my medical office, strong-arming me for an expensive antibiotic -- all the while I explained that it would provide no benefit for his mild cold. But he had read about the drug in a magazine ad, and, by all accounts, the antibiotic possessed amazing supra-human powers. It was a sniffle-buster, a mucus-vaporizer, a death-avenger; ostensibly, it could bring about world peace and ... well, cure the common cold.

At no point during our office encounter was the subject of cost brought up. My patient's insurance company would pay the bill, so perhaps it did not concern him. To me, it was important to base my refusal to prescribe the drug on "cold" medical facts -- not on a price tag. On clinically sound, scientifically-based reasoning that acknowledged both the uselessness and the potential harms of using bacterial antibiotics for a common cold.

But should I have raised the topic of wasteful spending with my fellow coupon-clipper? Should I have asked him to consider the consequences of resource utilization on a useless treatment that would only profit the drugmaker? That would help abet the escalating costs of health care and insurance premiums?  Read More 

By Dr. Kate Scannell, Syndicated columnist
First Published in Print: 10/01/2011

Vince Lombardi once famously declared that, in football, "The best defense is a good offense."

I thought about the coach's words while reading a new study about doctors ordering unnecessary medical tests and procedures -- whether practicing medicine on the defense or offense. The study was eye-opening in that it surveyed views about unnecessary medical care from the unique perspectives of 627 U.S. physicians on the front-line of medical practice -- internists and family practitioners who often call the plays that determine whether tests or subspecialty referrals are ordered.

In essence, this report in last week's Archives of Internal Medicine reveals that many doctors, by their own admission, believe that too many patients get too much care. And, after analyzing the explanations proposed by the doctors, the authors offer this striking conclusion: "Physicians believe they are paid to do more, and exposed to legal punishment if they do less."  Read More 

By Dr. Kate Scannell, Syndicated columnist
First Published in print: 08/06/2011

THINKING OFTEN about health care, I am increasingly disheartened about the direction it's taking in this country. We seem to be sailing further away from a clear understanding about the goals of medical care, on an expensive junket with politics and commerce commanding the helm.

It feels that we are sinking a little, our ship also bogged down with the weight of the federal deficit and hefty health care costs. We anxiously hang on because it's the only ship in sight, but all of us know there aren't enough lifeboats to go around.

So the last thing our health care system needed was last week's tribal tantrums in Congress rocking the boat for political show. The harrowing rollick not only nauseated most of us passengers -- it also demonstrated that our political officers were inept and unsafe navigators of the financial crisis on which health care drifts.  Read More 

Dr. Kate Scannell, Syndicated Columnist
First Published in Print: 04/30/2011

AS A physician specializing for years in geriatric medicine, I was delighted to learn about Republican Rep. Paul Ryan's plan to dismantle Medicare and replace it with good old-fashioned, coupon-clipping, private-marketplace opportunities for elderly and disabled people seeking health insurance.

It was a brilliant idea. We all know how fun it is to comparison shop for health insurance policies in the first place. But also incorporating the prospect of applying coupons or "vouchers" to insurance purchases -- well, it sounded like a shopper's paradise for the Medicare crowd.

Besides, as a matter of principle, shouldn't the elderly and disabled be freed -- yes, freed! -- from Medicare to pursue opportunities to shop for private insurance, just like more able-bodied, freedom-loving Americans? As a matter of personal liberty, shouldn't they be allowed as many mind-boggling consumer "options" for policies?
Sure, the disabled and elderly may collectively suffer more physical, mental, financial and social limitations in multiple arenas of life -- but the Ryan plan offers them a rare taste of unfettered freedom in the private insurance marketplace.

OK, wait -- I can't satirize the Ryan plan anymore. What it threatens to do to Medicare is entirely too serious and disturbing. Read More