A doctor’s job is exceptionally difficult. They require an immense level of knowledge and skill which does not even guarantee successful outcomes for their patients. There are so many variables in complicated cases that it is often difficult to be certain. However, recent research has found that overtreatment in healthcare is far too common. This is not to say that every doctor overtreats patients or that every patient has been overtreated, but there are significant costs, both financial and otherwise, to this problem. Given the apparent prevalence of overtreatment in healthcare, it is worth understanding just how far-reaching this issue is.
Understanding Overtreatment in Healthcare
A recent study in PLOS One has provided increased insight into the ways that this problem affects the industry. The study shows that overtreatment in healthcare causes both preventable harm and waste. Based on the survey of more than 2000 doctors across the healthcare industry, doctors believe that 20.6 percent of all medical care is unnecessary. Breaking this down further, doctors believe that 22 percent of prescriptions, 24.9 percent of tests, and 11.1 percent of procedures are unnecessary. While this measure is based on the opinions of doctors rather than specific evidence of overtreatment, doctors are the ones most likely to see overtreatment in healthcare. With access to patients prior medical history, a doctor can look back and see examples of patients receiving unnecessary care. For example, one doctor has noted that as many of seven of eight patients he saw in one day had received some kind of treatment or testing that was not needed.
Why is Overtreatment so Common?
Clearly, overtreatment is something that most physicians have seen at some point in their career. This begs the question, why is it so common? Do doctors simply overtreat patients so that they can earn a profit? It may not be this straightforward. While it is true that 70% of physicians admit that doctors are more likely to perform unnecessary procedures if they stand to profit from them, this is surely not the rationale for all overtreatment. In fact, the most common reason for overtreatment may just be the fear of undertreatment. While only 2-3 percent of patients sue their physicians for malpractice, research suggests that 85 percent of doctors justify their overtreatment as the best way to avoid a malpractice suit. Additionally, some doctors fear that by not running potentially unnecessary tests, they may miss something that can help them come to an accurate diagnosis. The same doctor who noted unnecessary care in 7 out of 8 of his patients’ medical history also mentions that he only remembers the times he did not call for a test rather than the times he did. Many doctors likely face the same fears that by not treating a patient, they might miss something important that may negatively affect the patient directly.
What can be done?
Given the complicated and often blurred line between overtreatment and undertreatment, how can physicians help prevent the unnecessary medical costs associated with overtreatment in healthcare? Only 9.2 percent of doctors who responded to the aforementioned survey suggested that their own financial security is something they consider when determining healthcare. This makes it clear that overwhelmingly, most doctors primary concern is securing the care that their patients need. The first step to avoiding overtreatment in healthcare is to accurately diagnose the patient. As Dr. Stephen Martin commented, “if the diagnosis is correct, any treatment that goes along with it is also correct.” By accurately diagnosing the patient, physicians can avoid costly and potentially harmful treatment for their patients. This said, avoiding “scattershot testing” and instead, ordering tests based upon specific evidence, physicians can further reduce overtreatment in healthcare.
Overtreatment in healthcare is a complicated problem with no easy solutions. While many have discussed problems with overtreatment of specific ailments, new evidence suggests that this may be more common than we think. With this in mind, it is always good practice to think twice before suggesting any treatment in order to make sure that it is, in fact, necessary.
