by Gina Thomas, RN, MBA

Jan 03, 2017

Is Over-diagnosis, Over-treatment, Or Over-prescribing Ailing You?

Healthcare costs are 18% of GDP and according to Berwick and Hackbarth, the estimated annual cost of overtreatment is between $148-226 billion – not including costs of over-diagnosis. Is our society of convenience and demand to ‘fix me now’ causing more ‘harm than health’? We all want to cure what ails us, but most of us are ignorant to the fact that these quick cures may be causing more harm than good. A few years ago there was a fair amount of publicity around over-prescribing especially with the elderly population. It’s common to find an elderly person who takes at least a half dozen drugs without a proven review of the necessity of those drugs. When a person encounters a health issue, many don’t understand WHY they are being treated with a specific treatment or procedure, if there are alternatives, and what the consequences are from both a health and financial perspective. They just trust that the treatment is the best decision for their health.

Are Our Healthcare Treatments Really Determined from an Unbiased Point of View?

Television commercials are filled with a number of medical treatments such as various drugs for chronic illnesses such as depression or Rheumatoid Arthritis. These come with many promises, however, if you pay attention long enough to the commercial it seems that there isn’t enough air space to list all the negative aspects of these drugs. Does the average viewer become numb to that messaging and only hear ‘there’s another pill that will make me feel better’? Additionally, what isn’t displayed in these ads is not explained when they are prescribed are the comparative facts and alternatives. Can anyone be assured that their healthcare treatments are being determined from an unbiased point of view and a significant review of the facts, let alone the financial implications?

In Steven Brill’s ground-breaking TIME Magazine article, The Bitter Pill. He explains, “Unlike those of almost any other area we can think of, the dynamics of the medical marketplace seem to be such that the advance of technology has made medical care more expensive, not less”.

Over-diagnosis, Over-treatment, and Population Health IHI Session

I attended a recent session at the 2016 Annual Institute for Healthcare Improvement (IHI) Conference featuring Dr. James Leo on Overdiagnosis, Overtreatment and Population Health. It was intriguing and frightful as he went into detail on several examples of overdiagnosis and overtreatment. He reviewed how this trend will lead to higher healthcare costs and wastes as well as patient harm.

A couple astonishing notes from Dr. Leo’s presentation that continues to increase my passion about healthcare decision making and the need for greater standards:

“Publication bias-researchers are free to bury negative result… 1/3 of clinical trials are never published in peer-reviewed journal or government registry”.

Having experienced some personal losses due to a lack of comprehensive intelligence, I agree with Dr. Leo that we need to increase physician awareness and set standards for evidence-based medicine to truly have a high standard of care. As consumers, we should understand the benefits and harm by the choices made for our health and quality of life.

Sometimes, like the common cold, it’s better to let nature run its course and avoid a greater detriment to the health of our nation.