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        "rendered": "Oh, My Aching Wallet: la resonancia magn\u00e9tica en lugar de la fisioterapia para el dolor lumbar lleva a un precio $4,793 m\u00e1s alto"
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        "rendered": "<p><em>El siguiente art\u00edculo fue escrito por\u00a0<a href=\"https:\/\/www.washingtonpost.com\/people\/lenny-bernstein\">Lenny Bernstein<\/a>\u00a0y publicado originalmente en el\u00a0<a href=\"https:\/\/www.washingtonpost.com\/news\/to-your-health\/wp\/2015\/03\/27\/oh-my-aching-wallet-mri-instead-of-physical-therapy-for-low-back-pain-leads-to-4793-higher-price\/?postshare=7791427568835404\">Sitio web del Washington Post<\/a>\u00a0el 27 de marzo de 2015.<\/em><\/p>\n<p>Te duele la espalda (\u00fanete al club) y vas a ver a tu m\u00e9dico de atenci\u00f3n primaria. La mayor\u00eda de las veces, su m\u00e9dico le dir\u00e1 que descanse, tal vez tome un poco de ibuprofeno o hielo en el \u00e1rea afectada.<\/p>\n<p>Pero\u00a0<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/25772625\">cuando los investigadores observaron a 841 personas que necesitaban atenci\u00f3n adicional<\/a>, encontraron que los que fueron enviados primero para resonancias magn\u00e9ticas ten\u00edan m\u00e1s probabilidades de someterse a una cirug\u00eda o inyecciones, ver a un especialista o visitar una sala de emergencias que aquellos que fueron enviados primero a fisioterapeutas. Y ellos (o sus aseguradoras) pagaron una media de $4.793 m\u00e1s.<\/p>\n<p>Las razones, dijo el autor principal del estudio, es m\u00e1s probable que se encuentren en la cabeza de los pacientes y m\u00e9dicos que en la espalda de cualquier persona. Las resonancias magn\u00e9ticas tienden a mostrar todo tipo de cambios benignos en la columna vertebral y la espalda que ocurren a medida que avanzamos en la vida. Pero eso hace que los pacientes busquen soluciones y presionen a los m\u00e9dicos para que los recomienden.<\/p>\n<p>\u201cEl paciente puede sentir y ejercer cierta presi\u00f3n para querer trabajar m\u00e1s\u201d, dijo Julie Fritz, profesora de fisioterapia en la Universidad de Utah. \u201cSimplemente cambia la mentalidad de todos los involucrados. Tiende a acelerar el curso de la intervenci\u00f3n\u201d.<\/p>\n<p>[<a href=\"https:\/\/www.washingtonpost.com\/news\/to-your-health\/wp\/2014\/07\/10\/no-uncle-fred-the-weather-has-nothing-to-do-with-your-back-pain\/\"><em>No, t\u00edo Fred, el clima no tiene nada que ver con tu dolor de espalda.<\/em><\/a>]<\/p>\n<p>Llevar\u00a0<a href=\"https:\/\/www.spine-health.com\/conditions\/degenerative-disc-disease\/what-degenerative-disc-disease\">enfermedad degenerativa del disco,\u00a0<\/a>Por ejemplo. La mayor\u00eda de las personas mayores de 40 o 50 a\u00f1os lo tienen hasta cierto punto, dijo Fritz, pero a menudo no tanto como para causar dolor u otros s\u00edntomas. Pero cuando una resonancia magn\u00e9tica arroja esa noticia que suena siniestra, los pacientes a menudo piden terapia y los m\u00e9dicos de atenci\u00f3n primaria pueden sucumbir, dijo.<\/p>\n<p>\u201cMotiva a los pacientes a querer hacer m\u00e1s para buscar soluciones a ese problema, cuando probablemente deber\u00eda [considerarse] m\u00e1s como arrugas y canas\u201d, dijo.<\/p>\n<p>Otra posibilidad es que algunos m\u00e9dicos tengan intereses financieros en los servicios de im\u00e1genes, se\u00f1ala el estudio.<\/p>\n<p>El dolor lumbar es incre\u00edblemente com\u00fan y debilitante. A<a href=\"https:\/\/www.who.int\/medicines\/areas\/priority_medicines\/BP6_24LBP.pdf\">Seg\u00fan un estudio,<\/a>\u00a0provoca m\u00e1s tiempo de discapacidad en todo el mundo que el VIH, los accidentes de tr\u00e1fico, la tuberculosis, el c\u00e1ncer de pulm\u00f3n, la enfermedad pulmonar obstructiva cr\u00f3nica y las complicaciones del parto prematuro. En Estados Unidos, anot\u00f3 el equipo de Fritz en su art\u00edculo, el costo directo del tratamiento del dolor lumbar fue de $86 mil millones en 2005.<\/p>\n<p>Un examen de resonancia magn\u00e9tica puede costar $1,000 o $1,500 y, aunque muchos est\u00e1n cubiertos por el seguro, los pacientes a menudo tienen que pagar copagos y pagar deducibles. Varios estudios no han mostrado evidencia de beneficios para los pacientes de espalda baja a menos que haya s\u00edntomas espec\u00edficos, seg\u00fan el art\u00edculo de Fritz, que se public\u00f3 el 16 de marzo en la revista Health Services Research. [Fritz es profesora de fisioterapia, pero el art\u00edculo es un estudio revisado por pares, no su opini\u00f3n].<\/p>\n<p>Fritz y sus colegas se propusieron comparar lo que les sucede a los pacientes enviados primero para resonancias magn\u00e9ticas frente a los enviados directamente a los fisioterapeutas. \u201cLos pacientes tienen expectativas de recibir algo percibido como beneficioso\u201d, escribieron. \u201cRomper una expectativa al negar las im\u00e1genes puede ser inaceptable para los pacientes o proveedores. La investigaci\u00f3n del consumidor sugiere que ofrecer una alternativa para reemplazar la expectativa rota es importante para los pacientes\u201d.<\/p>\n<p>Adem\u00e1s de buscar atenci\u00f3n de seguimiento menos invasiva, las personas que fueron directamente a los fisioterapeutas gastaron un promedio de $1,871, mientras que aquellos cuyo primer paso fue una resonancia magn\u00e9tica gastaron un promedio de $6,664 en el a\u00f1o posterior a su queja inicial a sus doctores Con solo unos pocos cientos de personas en cada muestra, reconoci\u00f3 Fritz, la cifra de costos estaba algo sesgada por una peque\u00f1a cantidad de cirug\u00edas muy costosas entre los que primero se sometieron a resonancias magn\u00e9ticas. Pero en general, la diferencia de costos es muy clara.<\/p>\n<p>La fisioterapia se enfoca en educar a los pacientes sobre lo que podr\u00eda estar causando su dolor de espalda, asegur\u00e1ndoles que la mayor\u00eda de los problemas desaparecen con el tiempo e involucrarlos en su terapia, incluso si el terapeuta les brinda ayuda pr\u00e1ctica, dijo Fritz. Tal vez las personas que eligen esa opci\u00f3n est\u00e9n m\u00e1s motivadas para ser parte de la resoluci\u00f3n de su problema, o simplemente se beneficien del enfoque; la investigaci\u00f3n no deja eso claro.<\/p>\n<p>De cualquier manera, \u201ccreemos que esta es un \u00e1rea en la que nuestra profesi\u00f3n tiene algo que ofrecer, especialmente cuando se realiza en el momento adecuado\u201d, dijo Fritz. \u201cHay un lugar para im\u00e1genes avanzadas. Simplemente no es temprano en el curso de la atenci\u00f3n para la mayor\u00eda de los pacientes\u201d.<\/p>",
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        "rendered": "<p>Adem\u00e1s de buscar atenci\u00f3n de seguimiento menos invasiva, las personas que fueron directamente a los fisioterapeutas gastaron un promedio de $1,871, mientras que aquellos cuyo primer paso fue una resonancia magn\u00e9tica gastaron un promedio de $6,664 en el a\u00f1o posterior a su queja inicial a sus doctores Con solo unos pocos cientos de personas en cada muestra, reconoci\u00f3 Fritz, la cifra de costos estaba algo sesgada por una peque\u00f1a cantidad de cirug\u00edas muy costosas entre los que primero se sometieron a resonancias magn\u00e9ticas. Pero en general, la diferencia de costos es muy clara.<\/p>",
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