In a major report last year, the Institute of Medicine concluded that the number one source of wasteful spending in health care is overtreatment.
Overtreatment is when providers order too many tests, do too many procedures, and choose higher-cost treatments, and it adds up: to the tune of $210 billion a year.
Now, as part of a campaign to reign in this overtreatment and over-testing, the American Board of Internal Medicine has surveyed doctors to find out what they think about this - and to understand exactly why doctors order so many tests.
Here are some highlights from what they found:
Almost 3 out of 4 physicians think the frequency of testing and procedures is a problem.
Question: "Do you think the frequency of unnecessary tests and procedures in the health care system is…" (DK/REF = Don't know / refused to answer)
Patients are part of the problem. More than 7 in 10 doctors say patients ask for unnecessary tests or procedures at least once a month.
Question: "In your own practice, how often do patients ask for a test or procedure that you think is unnecessary?"
For better or worse, doctors usually cave to patients' requests - even when they disagree.
Question: "Let's say a patient came to you convinced he or she needed a specific test. You knew the test was unnecessary, but the patient was quite insistent. Would you:"
Doctors' #1 reason for ordering unnecessary tests: fear of a lawsuit.
Most doctors don't usually discuss the costs of tests and procedures with their patients.
To address all of these problems, the American Board of Internal Medicine Foundation's Choosing Wisely campaign aims to promote care and testing that abides by these four principles:
- Supported by evidence
- Not duplicative of other tests or procedures already received
- Free from harm
- Truly necessary
To that end, they've worked with doctors from a wide range of specialties to identify the top five tests in each specialty that should be more rigorously questioned before they are ordered. If you're wondering how necessary a test is, you can look it up on their site.
"Eliminating needless care is not rationing," concluded the New York Times Editorial Board, in an editorial in support of the effort. "It is sound medicine and sound economics."