doctors overtreating patients

Doctors admit to giving too much medical care to their patients.

Nearly half of doctors believe their patients are getting too much medical attention, but they’d love to compare notes with other physicians, according to a survey published on Monday.

 

Just over half say they are giving their patients the right amount of care, but the doctors also believe the U.S. health system is set up to encourage overtreatment and over-testing, a team writes in the Archives of Internal Medicine.

Dr. Brenda Sirovich from the Outcomes Group at the VA Medical Center in White River Junction, Vt., and the Dartmouth Institute for Health Policy and Clinical Practice and colleagues surveyed 627 doctors from an American Medical Association database by mail. More than 40 percent of the respondents said patients in their own practice received too much medical care, while only 6 percent said their patients got too little care. About 52 percent said they provided just the right amount of care.

“Physicians seem to see that there are excesses of the medical care system,” Sirovich said in a telephone interview. “Almost half saw it in their own practices – their own patients are getting what they describe as too much medical care.”

No surprises on the culprits, as seen by the doctors – the fee-for-service system, which pays a doctor for procedures and tests, and the fear of lawsuits. “Doctors perceive that it is very easy to be sued for not doing something,” Sirovich said. Just 21 percent feared that they might be sued for ordering an unnecessary test.

Of course, most doctors believed that they, personally, did not succumb to over-treating patients because of fee-for-service incentives but that their colleagues did.

“They say if they had more time with patients, they would probably do less stuff,” Sirovich said.

The Obama administration has tried to tackle the issue of fee-for-service incentives. Last month, the Centers for Medicare and Medicaid Services said it would start offering so-called bundled payments, in which a medical practice is paid for a course of treatment as opposed to piecemeal tests, visits and procedures.

But the doctors felt they would benefit from being able to see what their colleagues were up to. “Most of the doctors wanted to know where they stood,” Sirovich said. “We thought that was sort of promising, that they were curious about their fingerprint. And that suggests they are perhaps open to reflection and feedback and change.”

Dr. Calvin Chou of the University of California (San Francisco) and San Francisco Veterans Affairs Medical Center said better communication might help. “Implicit in these findings is a kind of trained helplessness – it seems that physicians know they are practicing aggressively but feel they have no recourse,” he wrote in a commentary in the same journal.

Photo credit: Komo News

Via National Journal

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