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Quizzify's Greatest Hits of Healthcare Waste

Updated: Dec 9, 2020

Lately most of the Quizzify buzz has been about our new engagement guarantee. You can use a free, valid tool to measure our cost-effectiveness in engaging employees. We promise to be twice as engaging, per dollar spent, as your other tools promising the same thing.


But Quizzify is not just an engagement tool. We're also a content tool. We're two tools in one.



And, speaking of content, here are the top ten things our customers' employees learned this year about avoiding the massive amount of waste in the healthcare system. Your employees can learn them next year. To get started, just contact us.


In each case, the title links to a blog post, if you'd like to learn more. And a 3-question quiz accompanies a few of these Greatest Hits.



Until September, it was just us singing the siren song of silver diamine flouride to fix your cavities in lieu of drill-and-fill. No doubt some of you were skeptical. If indeed a cavity be fixed with no pain, no drilling, no side effects, and almost no time or money, your dentist would have mentioned something, right?


You'd have another reason to be skeptical if you had recalled the third answer choice in this first quiz question:

And, yet, dentists really don't want you to know about this "miracle cure." After we publicized it, Kaiser Health News and the Today Show picked it up.

 

As far as surprise bills, cursing the darkness seems to be much more popular than lighting a light. In the last 12 months, we've probably told 500 employers how easy it is for their employees to avoid surprise bills. Maybe 20 of them decided to do something about it. The other 480 seem to prefer to share the cost with employees. (Fortunately, the New York Times chose the former path.)

 

It's Economics 101: the lower the price, the greater the demand. And nowhere is that more apparent than in medical testing. Largely because of employer subsidies, commercially insured Americans get far more tests than they should. Most employees (and employers, and even doctors) are unfamiliar with the arithmetic of false positives. Suffice it to say, a massive number of positives are false.


As a result, here's how Americans stack up against other developed countries, most of which have better health outcomes than we do (this data is old but we like it because it's well-presented...and the tally has increased about 10% since then):

Quizzify teaches employees how to avoid unneeded tests, simply by knowing that "just because it's healthcare doesn't mean it's good for you," and developing a rudimentary knowledge base and some self-confidence in conversations with doctors.

 

Speaking of conversations with doctors, experts recommend that you tell employees to ask doctors the Choosing Wisely questions before agreeing to a test or procedure. And yet have you yourself ever asked those questions?


it becomes much easier if you simply download them into your Apple Wallet. Your employees can too. Just forward them the link.


Being the best vendor carries a lot of responsibility. So in addition to teaching the questions and making them easily accessible, we need to anticipate the third reason employees don't ask them: they are intimidated by the white coats, diplomas, tongue depressors etc. We've thought of that too -- see the PS :)

 

It is an unfortunate coincidence that the symptoms of many tickborne diseases mimic COVID. Especially in the warmer months, if you think you have COVID or the flu but test negative, it may be one of the 15+ tickborne illnesses instead.


 

Not quite a rhyme, but close enough. If you scroll down deep enough in our testimonials ("real quotes from real people with real names"), you'll see someone thanking us for saving her from a battery what would have been a total waste of tests -- with a strong possibility of a wrong result, because Lyme Disease generates proportionately more false positives and false negatives than any other disease.


Saving the tick makes it possible to determine which if any diseases it carries. It's not foolproof, and tick-testing is not covered by some insurance plans, but it beats the alternative, in the second question:

 

As a consultant, I once had to explain an impending capitation reimbursement system to a rather profligate specialist group. One increasingly agitated doctor finally raised his hand, and asked: "Don't you realize that under this system, patients will get only the care they really need?"


Indeed, and tops on the list of things that people should get only if they "really need" them would be spinal fusions. Question #3 on our sample quiz is one of our many questions helping employees to convince themselves to just hold off on surgeries a bit longer...

Some other factoids we cover:

  • Classic mistakes people make leading to back surgery

  • The proportion of back pain that goes away on its own (including mine, after 2 full years of pain and patience)

  • What can be done instead

  • The benefits -- and potential pitfalls -- of seeking a second opinon

  • The #1 diagnosis leading to a spinal fusion (SPOILER ALERT: Failed spinal fusion)

  • The proportion of patients in greater pain five years later.

We offer an entire back surgery quiz, and suggest that employees be encouraged, paid or even required to take the quiz before having surgery. "Self-preauthorization," we call it...and some number likely decide to hold off.

 

This particular urban legend can be traced to a 1929 Pepsodent ad. As with medical checkups, one size does not fit all. Plenty of people can get by just fine with once-a-year visits, while others should get cleanings and checkups 3-4 times a year. "Others" would include, for example, heavy smokers, diabetics, mouth-breathers, and people with a lot of dental work.


The latter are the ones who are most likely to crash on you. Perhaps with an oral health issue, such as an abscess. Some dental problems can morph into serious medical issues.


Yet most dental benefits offer two, but only two, free cleanings/checkups to everyone. Why not, for roughly the same overall outlay, offer one free checkup and then 2-3 more at 80% coverage? Then use Quizzify to teach employees to get the appropriate number, based on their own dental health status.

 

Remember those old Wendy's ads where someone would be asked whether they wanted a fresh and juicy Wendy's hamburger or a dry patty on a stale bun...and they'd always pick the latter?

Well, likewise, the vast majority of employers cover prematurity tests that are 17% accurate instead of educating pregnant employees on why they might prefer a test that's 88% accurate.

 

The only mystery* bigger than why many gastroenterologists now recommend these things starting at Age 45 is why people not at high risk with no symptoms are still getting routine screening colonoscopies at all.


First, this blog post dispels the myth that you need to start them even earlier. Next, it recommends the Fecal Immunochemical Test, or as it is redundantly called, the FIT test. Unlike the colonoscopy, it is completely safe. Further, it requires none of that preparatory liquid. (In the immortal words of the great philosopher Dave Barry: "I don't know what's in this, but it should not be allowed to fall into the hands of America's enemies.")



*Actually, the first "mystery" is easily solved: they get paid.

 

Coming up next month is the complement to this posting: the top ten ways employees misunderstand their health.\



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