Overtreatment in the United States

PLoSOne. 2017; 12(9): e0181970.

Published online September 6, 2017. doi: 10.1371 / journal.pone.0181970

Commentary

In this study, 2,106 physicians from an online community of physicians in the American Medical Association (AMA) Masterfile were asked to participate in a survey.

The survey asked questions about the extent of overuse, causes, solutions, and impact on health care. Outcome measures included the percentage of unnecessary medical care, the most commonly cited reasons for overtreatment, possible solutions, and responses regarding the link between benefits and overtreatment.

The response rate was 70.1%. Physicians reported that a median interpolation of 20.6 percent of total medical care was unnecessary, including 22.0 percent of prescription drugs, 24.9 percent of tests, and 11.1 percent of procedures. The most common reasons cited for overtreatment were fear of malpractice (84.7%), patient pressure/demands (59.0%), and difficulty accessing medical records (38.2%). Potential solutions identified were reported to be adequacy standards (55.2%), easy access to external health records (52.0%), and training of residents on many practice guidelines (51.5%).

Most respondents (70.8%) believed that physicians were more likely to perform unnecessary procedures when they benefited from them.

They also believed that de-emphasizing physician reimbursement through fee-for-service would reduce the use and cost of health care.

The conclusions of this study stated that overtreatment is common from a physician's perspective.