Drudge Retort: The Other Side of the News
Wednesday, October 11, 2017

A national survey of more than 2,000 doctors across multiple specialties finds that physicians believe overtreatment is common and primarily perpetuated by fear of malpractice, as well as patient demand and some profit motives.

A report on the findings, published today in PLOS ONE, highlights physicians' perspectives on unnecessary health care practices and the potential causes and solutions.

"Unnecessary medical care is a leading driver of the higher health insurance premiums affecting every American," says Martin Makary, professor of surgery and health policy at the Johns Hopkins University School of Medicine and the paper's senior author.

Unnecessary medical services represent the majority of wasted health care resources and costs in the United States, accounting for an estimated $210 billion in excess spending each year, according to the National Academy of Medicine.

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Studies consistently show that overtreatment is also directly associated with preventable patient harm and, on a national scale, the issue represents a significant opportunity to improve patient safety and lower health care costs, Makary notes.

The majority of the physicians who responded to the survey said they believed that at least 15 to 30 percent of medical care is not needed.

Breaking down the types of unnecessary medical care, survey respondents reported that 22 percent of prescription medications, 24.9 percent of medical tests, 11.1 percent of procedures, and 20.6 percent of overall medical care delivered is unnecessary. The median response for physicians who perform unnecessary procedures for profit motive was 16.7 percent.

The top three reasons cited for overuse of resources were fear of malpractice (84.7 percent), patient pressure/request (59 percent), and difficulty accessing prior medical records (38.2 percent).

The top three selected potential solutions for eliminating unnecessary services were training medical residents on appropriateness criteria for care (55.2 percent), easy access to outside health records (52 percent), and more evidence-based practice guidelines (51.5 percent).

"Most doctors do the right thing and always try to," Makary says. "However, today 'too much medical care' has become an endemic problem in some areas of medicine ..."

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This came out last month, and they're referencing statistics -- namely the $210 billion worth of unnecessary care annually that was first available to the public back in 2009 ...

US Healthcare Costs - where the money is going
resources.nationalacademies.org

Taking everything that Dr. Makary is spelling out, and then factoring in the overall aging of the population along with doctors only getting their clinical decisions right 55% of the time ... it's no wonder that healthcare costs are rising above 20% of GNP.

If there is a silver lining to all this, there's still significant savings (hundreds of billions of dollars annually) to be had by improving quality of care in the U.S.

#1 | Posted by PinchALoaf at 2017-10-11 06:43 AM | Reply

This is a problem I've experienced myself.

The Doctors, I think overemphasize the "better safe than sorry" approach which in turn kills the patient on deductibles and out-of-pocket expenses.

#2 | Posted by shane at 2017-10-11 01:25 PM | Reply | Newsworthy 1

A national survey of more than 2,000 doctors across multiple specialties finds that physicians believe overtreatment is common and primarily perpetuated by fear of malpractice

There is a part of the HIGH cost of medical treatment. Get rid of most of the lawyers and the problem goes away.

#3 | Posted by Sniper at 2017-10-11 02:02 PM | Reply | Funny: 1 | Newsworthy 1

"The Doctors, I think overemphasize the "better safe than sorry" approach which in turn kills the patient on deductibles and out-of-pocket expenses." - #2 | Posted by shane at 2017-10-11 01:25 PM

"Are you sure this additional test is worth the expense, doctor?" said no patient ever.

#4 | Posted by Hans at 2017-10-11 02:49 PM | Reply

"Get rid of most of the lawyers and the problem goes away." - #3 | Posted by Sniper at 2017-10-11 02:02 PM

Of course, the problem for the person who is the target of malpractice doesn't go away.

They just have to suffer in silence and poverty.

#5 | Posted by Hans at 2017-10-11 02:51 PM | Reply

This is a problem easily solved by single payer. The government just says "this is the only treatment we'll pay for, these are the only tests we'll pay for, and your condition doesn't qualify for either". No different than any major insurance plan in existence today except that once the government is in charge, there's no recourse for the patient except supplemental insurance (which I'm certain will be EVER so affordable).

#6 | Posted by MUSTANG at 2017-10-11 03:02 PM | Reply | Newsworthy 1

#4 Hans > Not being a doctor, I wouldn't ask that. But, you'd hope doctors would.

#7 | Posted by shane at 2017-10-11 03:04 PM | Reply

This is a problem easily solved by single payer. The government just says "this is the only treatment we'll pay for, these are the only tests we'll pay for, and your condition doesn't qualify for either". No different than any major insurance plan in existence today except that once the government is in charge, there's no recourse for the patient except supplemental insurance (which I'm certain will be EVER so affordable).

Posted by MUSTANG at 2017-10-11 03:02 PM | Reply

You REALLY have no clues do you?? Just talk out of your hiney as per the usual.

#8 | Posted by LauraMohr at 2017-10-11 03:11 PM | Reply

#4

I said it once and the doctor got pissed at me I said fine took the order went home did the research and no it wasn't worth it. Called the doctor the next day and told her I wouldn't be getting that test. She got even madder so I found a new doctor took the results of the first two tests to him told him the third test she wanted that I declined. He informed me that while that test was good to get a baseline it wasn't necessary for diagnostic or treatment purposes.

I did later find out that the test I still to this day have never had is useful for applying for disability and not having a baseline will hurt me if I ever need to apply. Oh well by the time I apply if ever the disability will be so pronounced that I doubt I'll have an issue, I hope at least.

#9 | Posted by TaoWarrior at 2017-10-11 03:23 PM | Reply

Get rid of most of the lawyers and the problem goes away.

Wrong, the negligent doctors would remain. Solution, get rid of negligent doctors and the lawyers will go away.

#10 | Posted by et_al at 2017-10-11 03:37 PM | Reply | Newsworthy 2

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#8 Do you believe that the government will not have a list of covered treatments specific to each condition? Don't be naïve. I'm on the record saying that single payer is the only viable path forward, but buyer beware.

#11 | Posted by MUSTANG at 2017-10-11 03:48 PM | Reply

Studies consistently show that overtreatment is also directly associated with preventable patient harm and, on a national scale, the issue represents a significant opportunity to improve patient safety and lower health care costs

I've been saying these things on this website for YEARS.

#12 | Posted by PinchALoaf at 2017-10-11 06:54 PM | Reply

Ban Big Pharma advertising. People are self-diagnosing and running to their doctors asking for specific pills.

#13 | Posted by SheepleSchism at 2017-10-11 07:12 PM | Reply | Newsworthy 3

Ban Big Pharma advertising. People are self-diagnosing and running to their doctors asking for specific pills.

#13 | POSTED BY SHEEPLESCHISM

In Dr. Kizer's top 10 reasons why health care costs continue to rise he cites direct to consumer marketing as a factor ... you can go to yesterday's Nooner post #1 to the list and the link to the video hear it from the man himself.

#14 | Posted by PinchALoaf at 2017-10-11 07:24 PM | Reply

Wrong, the negligent doctors would remain. Solution, get rid of negligent doctors and the lawyers will go away.

#10 | POSTED BY ET_AL

Wrong

According to healthcare expert Dr. Kizer, a criminal justice approach to rising healthcare costs and waste fundamentally doesn't work due to the highly technical and sensitive nature of healthcare ...

Go to yesterday's Nooner post #1 to see it listed and to hear the man himself explain it.

#15 | Posted by PinchALoaf at 2017-10-11 09:35 PM | Reply

#15

Where did I say criminal justice? Negligence is a technical deficiency, incompetence. Get rid of the technically incompetent and the need for lawyers to find a remedy for that incompetence pretty much goes away.

I'm not gonna watch a 40 minute video hoping to ferret out whatever it is your talking about. I watched the 7 minutes you highlighted and it said nothing of criminal justice.

#16 | Posted by et_al at 2017-10-11 10:06 PM | Reply

I watched the 7 minutes you highlighted and it said nothing of criminal justice.

#16 | POSTED BY ET_AL

It's within that 7 window, at the 20:25 mark ... it's #8 on the list = 'Rising Liability Insurance Costs'.

There's so much variation in healthcare and a lack of accountability, that even egregious situations like a surgeon amputating the wrong limb doesn't change the system for the better ...

Changing the US healthcare system as a whole with "medical tort reform" fundamentally doesnt work.

#17 | Posted by PinchALoaf at 2017-10-11 10:25 PM | Reply

'Rising Liability Insurance Costs'

Again, get rid of incompetent doctors and the cost of insuring that incompetence goes down. So too does the need for medical tort reform. Neither of which is a criminal justice approach.

#18 | Posted by et_al at 2017-10-11 10:33 PM | Reply

#18 | Posted by et_al
Get rid of frivolous law suits.

#19 | Posted by Federalist at 2017-10-11 10:36 PM | Reply

#19

Define frivolous lawsuit.

#20 | Posted by et_al at 2017-10-11 10:39 PM | Reply | Newsworthy 1

Again, get rid of incompetent doctors and the cost of insuring that incompetence goes down. So too does the need for medical tort reform. Neither of which is a criminal justice approach.

#18 | POSTED BY ET_AL

According to Dr. Kizer, it is a criminal justice approach. So there you go ... complain to him.

By the way, here's his bio ...

www.ucdmc.ucdavis.edu

Dr. Kenneth W. Kizer is Director of the Institute for Population Health Improvement, UC Davis Health, and a Distinguished Professor in the UC Davis School of Medicine (Department of Emergency Medicine) and the Betty Irene Moore School of Nursing.

Dr. Kizer's professional experience includes positions in academia and the public and private sectors. His previous positions have included: President, CEO and Chairman of Medsphere Systems Corporation, the nation's leading commercial provider of open source healthcare information technology; founding President and CEO, National Quality Forum, a Washington, DC-based quality improvement and consensus standards setting organization; Under Secretary for Health, U.S. Department of Veterans Affairs and chief executive officer of the nation's largest healthcare system; Director, California Department of Health Services; and Director, Emergency Medical Services Authority, State of California. He has served on the U.S. Preventive Services Task Force and as Chairman of the Board of The California Wellness Foundation, the nation's largest philanthropy devoted to health promotion and disease prevention, as well as on the governing boards of managed care and health IT companies, several foundations and various professional associations and non-profit organizations. He also has worked in various capacities over the years with numerous foreign countries on health-related matters.

Dr. Kizer is an honors graduate of Stanford University and UCLA, and the recipient of two honorary doctorates. He is board certified in six medical specialties and/or subspecialties, and has authored over 400 original articles, book chapters and other reports. He is a fellow or distinguished fellow of 11 professional societies and a member of Alpha Omega Alpha National Honor Medical Society, Delta Omega National Honorary Public Health Society, the Institute of Medicine of the National Academy of Sciences, and the National Academy of Public Administration. He is also a Fellow National of The Explorers Club, a founding member and past president of the international Wilderness Medical Society, a former U.S. Navy diver, and a nationally recognized expert on diving and aquatic sports medicine and the medical aspects of wilderness activities.


See next post for the rest of his amazing bio ...

#21 | Posted by PinchALoaf at 2017-10-12 01:54 AM | Reply

His accomplishments have been recognized with dozens of awards, including the Award of Excellence, American Public Health Association; Distinguished Service Medal, American Legion; Earnest A. Codman Award, The Joint Commission; Gustav O. Lienhard Medal and Award, Institute of Medicine; Justin Ford Kimball Innovator Award, American Hospital Association; Nathan Davis Award for Outstanding Public Service, American Medical Association; John D. Chase Award for Physician Executive Excellence, Association of Military Surgeons of the United States; Exceptional Service Award, U.S. Department of Veterans Affairs; Rodney T. West Literary Achievement Award, American College of Physician Executives; Special Recognition Award, March of Dimes; Rear Admiral William S. Parsens Award for Scientific and Technical Progress, Navy League of the United States; Torch Award, Coalition to Protect All Californians from Tobacco; Founders' Award, American College of Medical Quality; and the Award of Honor, American Society of Health-System Pharmacists.

He has been selected as one of the ‘100 Most Powerful People in Healthcare' by Modern Healthcaremagazine on several occasions, and his work has been featured in Time, BusinessWeek, Fortune, The Wall Street Journal, The New York Times and numerous other magazines, newspapers and national television shows.

#22 | Posted by PinchALoaf at 2017-10-12 01:54 AM | Reply

According to Dr. Kizer, it is a criminal justice approach.

So you say. What does he say on the subject?

... here's his bio ...

Impressive, what does he have to say on the subject?

#23 | Posted by et_al at 2017-10-12 02:03 AM | Reply

Get rid of most of the lawyers and the problem goes away.
Wrong, the negligent doctors would remain. Solution, get rid of negligent doctors and the lawyers will go away.

#10 | POSTED BY ET_AL

Surely you know the answer lies between those two points, right?

#24 | Posted by jpw at 2017-10-12 11:13 AM | Reply

You see this is the beauty of Trumpcare.

If we got rid of the patients the problems would also go away.

#25 | Posted by donnerboy at 2017-10-12 06:45 PM | Reply | Newsworthy 1

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