by Ted Noel, MD
The CDC used to define a “case” as a patient whose characteristic signs, symptoms, and physical examination matched a disease. Labs were only done if clinically needed. Since the “pandemic,” however, the move to boost case numbers is everywhere.
Instantly, a “positive” RT-PCR test in an asymptomatic person after a drive-through tonsillectomy became a “case.” The CARES Act gives thousands extra to hospitals for every “positive,” with a big bonus if the patient’s shadow is seen in an ICU. It’s a classic “one hand washes the other scenario” between outside labs and hospitals. “If you give me more positive results, I get more money, so I’ll send more tests to you.”
My hospital’s Medical Staff President flatly denied any CARES Act benefits at our 2020 Medical Staff Extravaganza, but the incentives can’t be denied. My hospital still sends “coders” out to demand that staff order COVID tests to get more payments. Put bluntly, there’s no way to know what any test means medically if the patient isn’t sick. But “positives” definitely mean money!