Saturday, November 18, 2017

OVERTREATMENT - Who's guilty/? Who suffers?


Rich Duzak, MD on TW referred to this article/study:

https://mobile.nytimes.com/2017/09/06/well/live/health-care-overtreatment-doctor-survey.html?utm_content=buffer0dd92&utm_medium=social&utm_source=twitter.com&utm_campaign=buffer;

Overtreatment is Common, Doctors Say, which referred me to;

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0181970 Findings were that "over 20% of all medical care" was unnecessary"

Their numbers were specific enough to make me examine some of my past care memories:

"22.0% of prescription medications",  
Yes, I did leave a doctor due to too many RXs for pain killers, and no RX for physical therapy.  Have you ever left a doctor for prescription reasons?


"24.9% of tests"
Cancer has come into my life more than once, but I'm inclined to believe the endless biopsies I've received were probably all necessary, and so was a slight surgery performed during one biosy.

One of my current MDs agrees with my negative opinion of a certain test I took, and agreed with me Rabout another that I don't want.  Recently my primary MD gave me a chest Xray because my allergy cough was so bad I couldn't drive.

Have you ever left a doctor because you felt you were getting too many tests?

And here's no surprise:  The doctors responding to the study were not the first to blame part of the #s of tests on pt demand.
Have you ever "forced" your doctor into a test he didn't think was needed except to let you win or calm you down?

 "and 11.1% of procedures."  
This one made me a little queasy:  More than a little.  Most procedures are just plain NOT reversible. More scary, they can leave us in worse shape than before, or (face it) dead.

Then the AHA! moment:  "More than 70 percent of doctors conceded that physicians are more likely to perform unnecessary procedures when they profit from them,"

And they give specifics, like unnecessary spine surgery (I think mine was probably necessary, but I've read often of others that were not and are not necessary.)

The study senior author, Dr. Martin A. Makary, a professor of surgery at Johns Hopkins., mentioned a couple other typical surgeries that may often be unnecessary. 
In all my reading, better training is all I remember ever seeing suggested to lower these figures.

In a strange town, or after an accident, we may need more safe choices.  
Has your doctor ever mentioned this overtreatment problem?  Has he ever told you that a surgery you suggested (or insisted on) for yourself was unnecessary?

But surrounded by familiar faces, how do we know what's necessary?   Oh...

The Second Opinion?