Less is more: The rise of over-treatment in the 21st Century

The country doctor of the early 20th Century had very few tools to address patients’ complaints. Armed with a few simple medications and some basic surgical techniques, they often had to rely on reassurance and bedside manner to ease suffering.

The situation has changed. Backed with an impressive array of medical advances, the tendency is for doctors to treat aggressively. Patients’ expectations have been stoked by glowing media accounts of impressive breakthroughs against an ever-expanding list of maladies. Direct-to-consumer advertising encourages the public to “ask your health professional” about this or that cutting-edge therapy.

Overtreatment has therefore become rife; only in recent years are we coming to re-evaluate highly-touted tests, medications and procedures.

In a recent survey of physicians, “Overtreatment in the U.S.”, doctors admitted that 20.6% of overall medical care was unnecessary, including 22.0% of prescription medications, 24.9% of tests, and 11.1% of procedures. The main reasons cited were fear of malpractice (84.7%); patient request or pressure (59.0%); and difficulty accessing patient records (38.2%) Most of the physicians surveyed (70.8%) believed that doctors are more likely to perform unnecessary procedures when they profit from them.

Another recent study concluded that “5.5% of hospital admissions, 14% of hysterectomies and 10–20% of antibiotics prescribed for upper respiratory tract infections are unnecessary and could be avoided.” (Source)

Lately, there have been some notable instances of overtreatment.

Cancer: Recent papers presented at the American Society of Clinical Oncology (ASCO) showed that aggressive treatment of certain cancers was unwarranted.

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