Too Much Medicine Happens Too Often - A columnist at the New York Times asked readers, “Have you experienced too much medicine?” She received more than 1000 responses detailing examples ranging from unnecessary testing and hospitalizations to useless office visits and specialist referrals. Patients are not the only ones worried about too much medicine: 42% of a national sample of primary care physicians believe that patients in their own practice are receiving too much medical care. Too much medicine, or overuse, occurs in at least 3 contexts: when benefits from medical care are negligible, when the potential for harm exceeds the potential benefit, or when a fully informed patient would decide to forego the service. Examples of overuse include overtesting and overtreatment. Spending on overuse is thought to substantially contribute to the unsustainable growth in US health care costs. Wasteful health care is estimated to cost $750 billion annually, limiting equitable access to necessary health care and crowding out spending on other priorities such as public health, education, and valuable social programs. When passed on to our patients, health care costs can be financially catastrophic. The costs of overuse are not measured in dollars alone. Overtesting and overtreatment expose patients to potential harms and downstream complications—and often lead to net harm. Far beyond cost consciousness, the ethical case for avoiding overuse, “first, do no harm,” is a powerful appeal to our professionalism. All thoughtful physicians want to minimize harms from overuse. The challenge is recognizing when an intervention is likely to represent overuse.
Posted on: Wed, 02 Oct 2013 14:06:35 +0000
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