More Bad News about Overtreatment

The bad news about overtreatment seems to get more overwhelming over time.

Shannon Brownlee’s presentation, “Overwhelmed by Overtreatment,” shocked many people at The Alliance Annual Seminar in May 2013. Our guests and members learned that as much as one-third of health care is unnecessary. Too often, this overtreatment harms the people it was intended to help.

Since then, alarming news about overtreatment just seems to keep coming.

• Guidelines for treating back pain typically call for conservative measures such as rest and ice. Instead, doctors too often prescribe “more and more unnecessary tests, narcotics and referrals to surgeries,” according to the Harvard Health Blog, July 21, 2013.
• A panel of experts recently advised the National Cancer Institute to revise its definition of cancer and the terms used for some diagnoses to prevent the unnecessary treatment that can occur when a patient is told that he or she has “cancer,” according to a New York Times article that appeared July 29, 2013.
• Doctors who own a share in radiation centers prescribe radiation for prostate cancer more often, according to an article that appeared Aug. 18, 2013, in the New York Times. When a specific treatment is used at a higher rate for one group than another, it is often an indicator of overtreatment.

Knowing about overtreatment is important, but doing something about it is vital. Brownlee recommends three steps to help doctors and patients counter the trend toward overtreatment:

1. Shared decision-making to help physicians talk with patients so they can visualize the risks and benefits of tests and treatments.
2. Decision aids to help doctors make appropriate decisions about tests and treatments at the time they are ordered.
3. Choosing Wisely, a set of education materials produced by Consumer Reports, to improve the interaction between physicians and patients.

Brownlee doesn’t let patients off the hook for contributing to overtreatment. As Brownlee told the audience at the Annual Seminar,

“To change health care, we the people must rethink what we are getting from health care and what it is we really want.”

That means you and I have to change if we want overtreatment to become less overwhelming. As information about overtreatment continues to hit the headlines, that might be the most important news of all.