Prevent unnecessary medical care — by asking your doctor these 4 questions first Jul 22, 2019 / Daryl Chen Justin Tran By raising questions and taking on a more active role in decision making, patients can do their part to avoid needless medications, tests, treatments or procedures, says neurosurgeon Christer Mjåset.
Full Answer
How can you prevent unnecessary care?
To prevent unnecessary care, Martin recommends patients start by asking about the reason for any recommended tests, including those ordered in multiples. "If a patient were to hear something to the effect of 'let's get some lab tests,' I would ask the clinician: How many and why?" he says.
Why do doctors perform unnecessary procedures?
The top three cited reasons for overtreatment were “fear of malpractice” (84.7%), “patient pressure/request” (59.0%), and “difficulty accessing prior medical records” (38.2%) (Table 2). Seventy-one percent of respondents believed that physicians are more likely to perform unnecessary procedures when they profit from them.
How much medical care is unnecessary?
Twenty-seven percent of respondents believed that at least 30–45% of overall medical care is unnecessary; 4.6% of respondents believed that none of the medical care delivered is unnecessary.
What is the National Health Bill for unnecessary care?
Based on various estimates, the national health bill for unnecessary care – or medical waste – is between nearly $500 billion and almost $1 trillion. According to the Dartmouth Institute for Health Policy and Clinical Practice, 30 percent of Medicare spending goes to care that is unnecessary or harmful.
For what reasons might a provider not want to accept a patient?
The most common reason for refusing to accept a patient is the patient's potential inability to pay for the necessary medical services.
Can a doctor refuse to continue treatment?
As a rule of thumb, if unnecessary delays in care may cause irreparable harm, physicians can face legal liability for their refusal to treat. If you need urgent medical attention, and a doctor refuses to treat you, you can pursue a medical malpractice suit against the physician and/or the establishment they work for.
Do doctors perform unnecessary procedures?
Doctors continue to provide unnecessary tests and procedures, study finds. Doctors and patients need to engage in shared decision-making to reduce unnecessary tests and procedures. A review of a year's worth of medical research found plenty of examples of doctors ordering unnecessary tests and procedures.
What are some reasons a physician may wish to terminate a medical contract of care for a patient?
Guidelines. The reasons physicians give for wanting to dismiss patients include patient noncompliance, failure to keep appointments, or rude behavior.
Can a doctor refuse to prescribe medication?
When, Why, and What are my Options? Yes, a doctor can deny you medical treatment. Private doctors have some more leeway to deny treatment to patients than those in Medicare-compliant hospitals, but there are circumstances under which even doctors serving Medicare patients may choose not to serve a patient.
Can a doctor refuse a patient?
Physicians are generally not obligated to treat any individual seeking non-urgent or non-emergent care. That said, physicians who receive a request to accept a new patient should consider whether the individual requires emergency care.
Why do doctors do unnecessary surgeries?
Why Are So Many Unnecessary Surgeries Occurring? While some doctors believe their patients need surgery due to their lack of competence, training, and experience, there are other surgeons who intentionally recommend unnecessary surgeries to patients in order to make more money.
What is considered unnecessary surgery?
When is Surgery Unnecessary? Unnecessary surgery has been defined as "any surgical intervention that is either not needed, not indicated, or not in the patient's best interest when weighed against other available options, including conservative measures."
Why do doctors order unnecessary tests?
The top two reasons the doctors ordered these tests were fear of missing something that would help them diagnose their patients, and protection against malpractice. “The over-testing is not due to lack of knowledge on the physicians' part or poor medical judgment.
Under what circumstances and how might a healthcare provider terminate a contract between the provider and a patient?
In general, the physician-patient relationship can be terminated in two ways without creating liability for abandonment: 1) the physician ends the relationship after giving the patient notice, a reasonable opportunity to find substitute care and the information necessary to obtain the patient's medical records, or 2) ...
Is it ethical for a physician to terminate patient care?
Terminating the Patient-Physician Relationship. The patient-physician relationship is wholly voluntary in nature and therefore may be terminated by either party. However, physicians have an ethical obligation to support continuity of care for their patients.
Can a doctor get rid of you?
Removing a patient from your practice: A physician's legal and ethical responsibilities. While a doctor may discharge a patient for any nondiscriminatory reason, termination is not without pitfalls. Physicians should follow a careful process so as to avoid claims of patient abandonment.
How much of Medicare goes to unnecessary care?
According to the Dartmouth Institute for Health Policy and Clinical Practice, 30 percent of Medicare spending goes to care that is unnecessary or harmful.
What does it mean to avoid overdiagnosis?
Avoiding overdiagnosis and overtreatment also means letting go of some longstanding notions, such as the doctor always knows best; more treatment is better; and that improved technology and early screening will definitely lead to better outcomes, Hoffman says.
How much is the national health bill for unnecessary care?
Based on various estimates, the national health bill for unnecessary care – or medical waste – is between nearly $500 billion and almost $1 trillion.
Can a doctor address a patient's health concerns?
In general, patients should expect that their doctor can address most of their health concerns, except where specialists are needed to treat specific issues like chronic conditions or in more complex medical cases.
Why do physicians provide unnecessary care?
Many primary care physicians in the United States reported providing unnecessary medical care in response to patient requests; several factors predicted this behavior.
How does consumer-directed competition affect health care?
Consumer-directed competition can increase price sensitivity, create a system of value-seeking patients, and contain rising unnecessary spending.
What is the role of ACOs in healthcare?
Existing healthcare policies, such as encouraging the formation of ACOs under the Affordable Care Act (ACA), may help in providing well-coordinated, high-value, patient-centered primary care, but the tension between patient satisfaction and cost-saving incentives may make the impact on unnecessary care uncertain.
Do PCPs acquiesce to patient requests for unnecessary referrals to specialists?
Overall, we found that PCPs commonly acquiesce to patient requests for unnecessary referrals to specialists and for brand-name drug prescriptions, and several physician characteristics predicted this behavior. Ideally, the enormous natural experiment underway in the United States involving combinations of physician- and patient-level incentives will illuminate the solutions to the unnecessary medical practices our study reveals. Future studies should examine how differences in patient-physician relationships (eg, paternal vs autonomous, longitudinal, or acute), supply sensitivity (eg, availability of specialists), consumer incentives, and the new care models (eg, ACOs via ACA and other shared-decision models) impact these behaviors.
Is Area-Level Medicare spending associated with unnecessary practices?
Area-level Medicare spending was not associated with the 2 unnecessary practices. Conclusions: Many PCPs reported acquiescing to patient requests for unnecessary care. Provider and organizational factors predicted this behavior. Policies aimed at reducing such practice could improve care quality and lower cost.
Do pediatricians prescribe brand names?
Compared with internal and family medicine physicians, pediatricians were less likely to prescribe brand-name drugs upon patient request— an outcome potentially attributable to the patient populations cared for by these specialties and/or to the relatively standardized drugs/regimen used in pediatrics.
Do PCPs provide specialty referrals?
In this national survey, we found that PCPs reported commonly acquiescing to patient requests for unnecessary medical services. Over half of PCPs sometimes/often provided specialty referrals due to patient requests and more than one-third reported prescribing brand-name drugs in response to patient requests. These frequencies likely underestimate the actual frequency of such practices due to social desirability bias. Nonetheless, ours is one of the first studies to provide estimates of the prevalence of service provision in response to patient requests for care that has been deemed unnecessary.
What are the problems caused by unnecessary medical treatment?
In addition to bloating the medical economy, unnecessary medical treatment can cause a wide variety of problems for the patient: anxiety, pain, longer recovery times , the need for more treatment, incapacitation, even death. In case after real-life case, The Treatment Trap reveals in frightening detail how this can happen to unsuspecting patients — ...
Why do doctors want to cover all bases?
They want to cover all their bases because patients' lives are in their hands. Fear of missing a diagnosis drives overuse. Patients are afraid, too. Many will want everything done.
What percentage of people who have heart bypass surgery do not need it?
A. A study by the Harvard School of Public Health and the Rand Corporation concluded that one-third of people who were told they needed heart bypass surgery did not need it. In addition, 17 percent of patients who had the surgery did not have severe enough heart disease to warrant surgery. The problem was that the angiograms were read incorrectly. If the 17 percent figure were applied to the number of bypass surgeries performed annually in the U.S., 42,500 surgeries may be unnecessary.
What percentage of respondents are very or moderately concerned about their physician colleagues overtreating patients to boost their income?
A survey by the American College of Physician Executives of their members found that 80 percent of respondents were very or moderately concerned about their physician colleagues overtreating patients to boost their income. When the bottom line supersedes the patient's interest, that is a profound violation of trust.
How long before surgery should you ask for informed consent?
Finally, if you are considering surgery or a procedure and the decision does not have to be made right away, ask for the informed consent form a week or more before the procedure.
How to combat fear during illness?
A. One way to combat fear during an illness is to know that you are not alone. Reputable online communities, like the Association of Cancer Online Resources, offer a place where people in similar situations can learn from others about their experience of illness and how they manage it.
How many people do not need heart bypass surgery?
A study by the Harvard School of Public Health and the Rand Corporation concluded that one-third of people who were told they needed heart bypass surgery did not need it. In addition, 17 percent of patients who had the surgery did not have severe enough heart disease to warrant surgery.
What is unnecessary care?
Unnecessary care is the general overuse of health care resources including receiving excessive testing, medication, procedures or treatments. Some examples include: getting multiple x-rays, MRIs, CTs for the same complaint or hospitalization for conditions that can be treated as outpatient.
How to avoid unnecessary care and cost?
The best way to avoid unnecessary care and cost is to be actively engaged in your health care and practice open communication with your doctor. By asking questions about specific procedures and treatments, you can make informed health care decisions based on data and evidence. Ask these questions:
Why do people ask for further testing?
Sometimes patients request or insist upon further testing because of anxiety or self-diagnosis.
When you're sick, do you deserve the best treatment?
When you’re sick, you deserve the best treatment options to help you feel better. There’s no question about that. Since your health is important to you, taking extreme measures to combat illness or injury may seem like the best option. Be cautious though – when it comes to health care, more doesn’t always mean better.
Should I do procedures to live a longer life?
The answer should be clear and direct. Work with your doctor to decide the best treatment for your specific medical condition. Procedures should help you live a longer, healthier life, but should not be excessive or unnecessary.
Should doctors walk patients through all the options?
But those options may cause more harm than taking a more cautious approach to testing or treatment. Doctors should be the ones to walk their patients and their families through all the options, including potential risks, to ensure they receive the right care, and the right amount of care.
Can excessive testing cause radiation?
Cost is not the only issue; excessive testing can also expose you to radiation and invasive procedures with side effects that may cause more harm than good when compared to simpler, and often more effective, treatment plans.
Severity
Many people aren’t sure what warrants a therapy session. But in reality most people wait until their symptoms are unbearable, Massey-Hastings said. For instance, many couples don’t see a therapist until their issues are deeply entrenched, she said. (Specifically, that’s usually when partners attack each other or withdraw from the relationship.)
Getting Started
Again, many are unsure how or where to start. As Howes said, “Therapy may seem like a strange, foreign land to someone who’s never been.”
Time & Energy
The last thing you probably want to do after leaving work is rehash your problems. “Many of us are so tired from working hard and dealing with emotional stressors, there’s no energy left to talk through problems,” Howes said.
Money
Therapy can be costly. But you can find affordable treatment. For instance, many therapists offer services based on a sliding scale. Community mental health centers offer therapy at little or no cost, Howes said.
Loved Ones
Well-meaning loved ones are another deterrent. “People suffering with symptoms may be told by well-meaning friends and family that they will get through it, that it’s just a phase, or they may provide well-meaning but deficient solutions,” according to Massey-Hastings. For instance, if you’re depressed, they might suggest exercising more, she said.