Someone gets it: Talking about “activist” medicine and how the US leads the world in it

“I define activist medicine as procedures, treatments, and consultations that have a low probability of affecting the outcome. The procedures and consultations are undertaken to rule out unlikely possibilities, to confirm diagnoses, to improve chances of success, and to reassure patients . . .

. . . I suspect the United States leads the world in the practice of activist medicine. I think that there are several reasons for this, including:

* abundant medical resources, particularly availability of specialists and diagnostic imaging technology

* high expectations on the part of patients

* strong desire on the part of doctors to meet impossibly high expectations

* fear of the consequences of not following activist procedures, in part because of malpractice litigation

* belief that for patients with insurance, no consideration needs to be given to cost”

There is no question that activist, or defensive, medicine is rampant. Can guidelines change this? Unlikely.