Doctors speak out about unnecessary care as cost put at $800 billion a year

Leading doctors are calling for action to tackle unnecessary care that is estimated to account for up to $800bn in the United States every year.

In a special report for this week's BMJ, journalist Jeanne Lenzer describes how a new movement led by prominent doctors is challenging the basic assumption in US healthcare that more is better.

The report comes as an international conference 'Preventing Overdiagnosis' is announced for September 2013 in the United States, hosted by The Dartmouth Institute for and Clinical Practice, in partnership with the , the leading consumer organisation and Bond University, Australia.

In the US, overly is estimated to cause 30,000 deaths among recipients alone each year, while unnecessary interventions are estimated to account for 10-30% of spending on healthcare, or $250bn-$800bn (£154bn-£490bn) annually.

Examples range from the overuse of and to an of questionable surgery.

Such statistics led a group of prominent doctors from the US, Canada and the UK to come together and discuss how to avoid the harm caused to patients by overtreatment.

Many of them have been warning for decades about the harms of overtreatment, but it is only now, with global financial downturns and growing awareness of the unsustainability of healthcare spending, that the issue is receiving significant attention from the American media and politicians.

They identified several reasons for overtreatment, including malpractice fears, biased research, patient demand, and financial conflicts of guideline writers. Other commonly cited problems included the rapid uptake of unproved technology and the failure to inform patients fully of the potential harms of elective treatments. Several speakers highlighted the way physicians are paid and trained in the US as central factors, and nearly 80% believed that more radical payment reform is necessary to reduce the problem meaningfully.

But as these initiatives begin to move forward, they will face formidable challenges from the healthcare industry and the general public who argue that the overtreatment movement is simply a scheme to ration care, reports Lenzer.

Supporters of reducing overtreatment vigorously oppose this view. "Rationing means that you are limiting necessary care. What we are proposing is limiting unnecessary care – harmful care," argues Dr Diane Meier, Professor of Geriatrics and Internal Medicine at Mount Sinai School of Medicine.

Jerome R Hoffman, Emeritus Professor of Medicine at the University of California, Los Angeles, adds: "There's already lots of rationing in healthcare; wouldn't it be better for us to decide what should be available, based on what's best for our health, rather than having insurance companies decide, based on what's most profitable for them?"

They also point out that resources wasted on unnecessary care can be much better spent treating and preventing genuine illness in those who are underinsured or uninsured.

Ultimately, engaging clinicians at an international level will be key to moving these issues forward. Dr Shannon Brownlee, author of Overtreated: How Too Much Medicine is Making Us Sicker and Poorer says: "The crucial step right now is to get the medical community mobilized around the idea that overtreatment harms patients."

add to favorites email to friend print save as pdf

Related Stories

Overdiagnosis poses significant threat to human health

May 30, 2012

Overdiagnosis poses a significant threat to human health by labeling healthy people as sick and wasting resources on unnecessary care, warns Ray Moynihan, Senior Research Fellow at Bond University in Australia, in a feature ...

Increasing health care value improves health care quality

Sep 24, 2008

Finding better ways to deliver healthcare to patients is key to ensuring that Medicare is able to meet the needs of the nation's baby boomers according to a new paper by Geisinger Health System published in Health Affairs.

Recommended for you

Blending faith and science to combat obesity

59 seconds ago

Science and religion may seem like uneasy partners at times, but when it comes to promoting healthy lifestyles, one UConn Health researcher has shown they can be an effective combination.

Research project puts stroke patients back on their feet

7 minutes ago

Finding the will to exercise routinely can be challenging enough for most people, but a stroke presents even more obstacles. Yet aerobic exercise may be crucial for recovery and reducing the risk of another ...

Air quality and unconventional oil and gas sites

3 hours ago

Research suggesting air pollutants released by unconventional oil and gas production are well over recommended levels in the US is published today in the open access journal Environmental Health. High levels of benzene, hydrog ...

FDA cautions against 'undeclared' food allergens

15 hours ago

(HealthDay)—Some food labels may not reliably list all possible food allergens, according to the U.S. Food and Drug Administration. The agency added that these "undeclared allergens" are the leading cause ...

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.