Newspaper article

U.S. Physicians Say Up to 30 Percent of Medical Services Are Unnecessary

Newspaper article

U.S. Physicians Say Up to 30 Percent of Medical Services Are Unnecessary

Article excerpt

Most physicians believe that a significant portion of the medical care dispensed in the United States is unnecessary, according to a recent study published in the journal PLOS One.

They also believe that medical overtreatment causes patients preventable harm and wastes health care resources, the study found.

Such beliefs are not new, even in the medical community. In 2012, for example, the Institute of Medicine (now the National Academy of Medicine) reported that of the $750 billion wasted each year by the U.S. health care system, $210 billion was squandered on unnecessary services.

But the current study is apparently the first one to ask a large, nationwide group of physicians from a range of specialties their thoughts about overtreatment.

"Most doctors do the right thing and always try to; however, today 'too much medical care' has become an endemic problem in some areas of medicine," said Dr. Martin Makary, the study's senior author and a professor of surgery and health policy at Johns Hopkins University, in a released statement.

A detailed survey

For the study, Makary and his colleagues conducted an online survey in 2014 of 2,106 physician-members of the American Medical Association. The respondents included primary care physicians (internal medicine practitioners, family medicine practitioners and pediatricians), as well as those from a variety of specialties, such as cardiology, endocrinology, geriatrics, oncology, rheumatology and sleep medicine. Most of the respondents worked in urban settings (67 percent), for academic institutions (66 percent) and received a salary (64 percent) rather than fee-for-service payments. Almost half of the respondents had at least 10 years of medical experience post-residency.

The survey asked the physicians a series of specific questions about overtreatment, its causes and its solutions. An analysis of their answers revealed that a majority of them -- 64.7 percent -- believe that at least 15 percent to 30 percent of medical care is not needed. On average, the response from physicians was that 20.6 percent of overall medical care is unnecessary, including 24.9 percent of tests, 22 percent of prescription medications and 11.1 percent of procedures.

Even more troubling was the finding that 71 percent of the respondents said physicians are more likely to perform unnecessary procedures when they personally profit from them. That particular belief was strongest among specialists and physicians with at least 10 years of post-residency experience.

A fear of malpractice suits

The top three reasons the physicians cited for overtreatment was fear of malpractice (84.7 percent), pressure from patients (59 percent) and difficulty accessing the prior medical records of patients (38.2 percent). Other reasons cited included inadequate time spent with patients, pressure from colleagues and medical institutions or management, as well as concerns about "looking good" in performance evaluations. …

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