More than half of U.S. adults say they’ve chosen to forgo a treatment recommended by their doctor
“The online poll of 2,286 adults indicates considerable concern among Americans about the frequency with which patients receive too many or overly aggressive treatments from their doctors: 83% feel undertreatment often or sometimes can result in medical problems among patients, while 72% feel overtreatment contributes to problems.

“But these aren’t necessarily mutually exclusive,” says Katherine Binns, senior vice president at Harris Interactive. Both concerns can exist at the same time, she says, especially in light of the large portion of uninsured Americans, who often don’t receive the health care they require.

Thirty-two percent of those polled say in the past they haven’t filled a prescription because they felt it was unnecessary, while 16% didn’t get a diagnostic test and another 10% chose not to undergo a surgical procedure.

Nearly a quarter of respondents say they’ve chosen to get a second opinion because they felt their doctors’ recommendations were too aggressive.

Physicians’ concerns about malpractice (53%), their desire to earn more (45%), and their desire to meet patients’ demands (45%) are seen as the main causes of unnecessary care, according to the poll. Another 30% feel misleading information doctors receive from drug and medical-device companies contributes to overly aggressive treatments.” (via Medrants)

Completely agree – overtesting is a huge problem. How can this change? Well, one can start by reforming some of the drivers for overtesting mentioned above: the fear of malpractice (defensive medicine) and “earning more” (fee for service reimbursement).

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  • KipEsquire

    I went for my biannual physical just yesterday, with a new doctor at the same practice I had been using for several years. I’m 38 and in generally good health.

    He:

    –Wrote a scrip for Lipitor based on my two-year-old bloodwork without waiting for the new results. Previous doctor wanted to hold off.

    –Wants me to see the cardiologist over a “probably nothing” on the cardiogram (no family history of CV disease).

    –Refused to give me my normal Hemoccult test (dad had colon cancer at 65), of course insisting I see the colon guy instead, under the “why not have a colonoscopy?” school of thought.

    –BUT, refused to give me a scrip for Lamisil because, of course, the dermatologist should make that call instead. Make an appointment.

    I only get four weeks vacation every year — when am I supposed to see all these defensive specialists?

    I think he’s my newest ex-doctor.

  • Anonymous

    Ever notice how it’s everyone else’s job to fix healthcare? The lawyers need to change to fix it, or the patients need to change to make it better. Or the drug companies need to quit trying to trick them.

    The doctors never seem to want to take any responsibility. Except for the anesthesiologists.

  • Anonymous

    Why on earth would you have a routine physical with an EKG in the first place ?

  • Rich, MD

    Regarding kipesquire above –

    I agree that lipids should have been repeated before prescribing, and that an ECG probably should not have been done. I might have prescribed lamisil after checking baseline LFTs.

    But I do agree with not doing a hemoccult and doing a colonsocopy. With a family history of Colon CA, screening becomes “case-finding” and I believe a colonoscopy is appropriate in this case. My opinion.

  • Anonymous

    Why the woody over the anesthesiologists while all other doctors suck?

  • Anonymous

    I said “no, thanks” when my doctor wanted to prescribe statins last year for my slightly elevated LDL (a couple of points over ‘prescribe with these risk factors’ guidelines) but normal ratio – after I looked at the studies regarding its efficacy for primary prevention in otherwise healthy women as well as my risk of having a heart attack based on my age; and probability of side effects.

    Guess what – with some modifications in my diet I got both LDL down and HDL up to an excellent ratio this year, as I was sure I would (I would have probably waited with going on drugs for the rest of my life even if I hadn’t).
    No complaints about the doctor, though – I realize he has to prescribe based on guidelines as someone can sue otherwise; but I believe it is ultimately my choice. Especially when it comes to taking a drug for primary prevention. I think in the current malpractice climate patients have to do their own research and decide what is best for them. Especially when it comes to primary prevention.

  • Anonymous

    “I only get four weeks vacation every year — when am I supposed to see all these defensive specialists?”

    If your PCP misses something he’ll be spending one of his 4 weeks vacation in a courtroom having some absolute moron telling him what an absolute moron he is. I’m surprised he didn’t refer you to a urologist for a prostate biopsy; after all, you’re 38, “something” might be brewing down there.

  • cathyf

    In the old days, I used to have an internist who said that if I was miserable for more than a week, it was worth coming in for a strep test. So about once or twice per year, I would go in, he’d do the test, it would come back negative, he would give me sympathy, tell me to have chicken soup and send me home because it was a virus. He always was quick to reassure me that the strep test was the right thing to do even if it kept coming back negative. It was relatively cheap, not invasive, and even if I was 90% sure that I had a virus, it was worth it to be sure. Especially given the possible side effects of untreated strep.

    So about 5-6 years ago I had a wicked sore throat for about 2 weeks. I was pretty sure that I was just run down and so it was a virus that was hitting me hard, but remembering my old doc’s advice about it being worth a swab to make sure, I called the clinic and made myself an appointment. I sat in the exam room, and there was this cute poster (drug company freebee) that said, “Your doctor cares about you too much to prescribe an antibiotic you don’t need.”

    So the doctor comes in, looks at my throat, says, “Ouch!” sympathetically, and does not do a culture. Instead, she sits under the sign and writes out a prescription for amoxycillin! Yeah, of course I threw it in the trash! It really pissed me off, because my kids were both on augmentum that week because they had ear infections that were resistent to the amoxycillin from the week before, and my then-11-month-old daughter had to be held down and forced screaming to take any meds. Seeing the local docs in action breeding antibiotic-resistant bacteria in my community just made me mad!

    cathy :-)

  • Joan

    Cathyf: there are times when a doctor can tell by looking that it’s strep. If you are prone to strep infections you should ask your practitioner to teach you these signs so you can take a look for yourself. It’s not that difficult.

    My daughter went through a phase of catching strep every 2 or 3 months, but they rarely cultured her, because she gets a rash whenever she gets strep. Actually she’s lucky because we can get her on meds right away before she starts to feel too crummy.

    Patients need to remember they are not doctors. Instead of throwing that scrip away, why didn’t you ASK why no culture was taken for a rapid strep test? You made an assumption, but do you have anything other than your own personal experiences to support your decision to pitch that scrip?

  • Dr. Deborah Serani

    Healthcare is so very different and seems to be changing all the time. I think there are many reasons that lend to overtesting. That 50% forgo treatment is a concern whatever way you look at it.

    ~Deborah

  • Jean Marie

    Be careful if you don’t treat strep.
    Doctors are now concerned that such problems as ADHD, tic and tourettes are caused by untreated strep which led to mental illness. Years ago, rabies was caused by an illness and many other problems that led to mind problems. Please test your kids. It takes a very sharp doctor to find this out. My doctor doesn’t, he is quick and my friends son in college was not suffering from mental illness it was strep that was undiagnosed. God help us all!!!

  • mrntsantak

    People are naive the medical practice is a BUSINESS. Doctors do not treat people out of charity. Their business model is as follows:

    1) To diagnose their patients thru exams and test which increases revenue.
    2)Protect their practice from lawsuits

    If they cannot effectively treat you or diagnose you they refer you to another specialist. This protects their practice from lawsuits and removes their legal liability. People need to understand that doctors are trained to be detached from their patients. Basically, you are a customer/specimen that pays their bills.

    Unless you are a celebrity, president of the US you are treated like any other customer.
    The current problem with health care is that their is no competition. Doctors do not compete for patients.

  • Anonymous

    Strep throat always needs to be treated as soon as possible.

    My name is Jerry, I’m 20, and have mild Tourette Syndrome because of untreated strep throat between the ages of 5 and 7.