Unnecessary Medical Procedures Along With Medical Nnegligence
Helping Patients and Doctors Choose WiselyFor the past two years, the American Board of Internal Medicine
Foundation, one of the largest physician organizations in the US, has
released reports on the most overused tests and treatments that provide
limited or no benefit to the patient, or worse, causes more harm than good.
Last year’s report warned doctors against using 45 tests, procedures and
treatments. This year, another 90 tests and treatments were added to the
list. To learn more, I encourage you to browse through the Choosing Wisely
web site,4 as they provide informative reports on a wide variety of medical
specialties, tests, and procedures that may not be in your best interest. As
reported by NPR:5
“The idea is to curb unnecessary, wasteful and often harmful care,
its sponsors say — not to ration care. As one foundation official pointed out
last year, rationing is denial of care that patients need, while the Choosing
Wisely campaign aims to reduce care that has no value.”
Unfortunately, it seems matters will only get worse with the passage of
the Affordable Care Act because it’s just a continuation of the same broken
process. I agree that people should be covered under health insurance, but
they should be covered with appropriate care; not care that perpetuates the
same problems addressed in Dr. Makary’s book.
“What we’ve got to do is educate the everyday patient to empower
themselves, to understand what they’re having done, and to learn to ask the
right questions,” he says. “We’ve put together a list of sort of important
questions a patient should ask, and we’ve put it on the book website,
Your Solution For Disease FREE Health.
Things like: 'Do I really need to have this done? What if I don’t
take this medication? And then, whatever that consequence could be, what are
the odds that that could happen? And if it does happen, can we treat it once
I remember consenting people for surgery as a resident. I was way
over my head. They would ask me, 'What happens if I don’t have an operation
or take a medicine?' And I just give them a standard answer sometimes. 'You
could die. Something could go wrong.' And yet, I was rushing. You’re working
sometimes for 40 straight hours; you’re working 120 hours a week. As a
resident, you’ve got a mission. You get certain things done to get through
this little list of things you need to do during the day... Research now
shows that most patients are under-informed about the risks of medical tests,
procedures and medications, and the benefits are overstated.”
On Referrals, and...
According to Dr. Makary, under-referral is another major issue that leads
to improper medical treatment. Some doctors will simply declare that “nothing
can be done,” without realizing a specialist may have an entirely different
set of tools at their disposal. There are even “micro-specialists” out there
specializing in a tiny area within a particular field of medicine. The trick
is to find them.
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“There are probably not enough referrals to specialists as there
should be. I think sometimes you need to take things in your own hand and
just ask for one. Or say, you know, 'Would it help if I spoke with someone
who specializes in this?' Or go to their websites and find the experts. There
are some very good websites out there now for patients, [like]
ConsumerReportHealth.org. Medicare is now putting a lot of hospital
performance up on the web in their website Hospital Compare. It’s
HospitalCompare.hhs.gov. So, there are some good resources out there now.”
Dr. Makary suggests asking an emergency room nurse for their
recommendations for specialists and doctors well-versed in a particular
ailment. Another helpful strategy can be to ask around for alternative
practitioners or treatment options. Your local health food store can be a
good place to start.
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