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What to Know and Do About Medical Overtreatment

By Kyle Marshall | July 17, 2014 | Healthy Lifestyle, Industry Perspectives

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Have you ever wondered if every medical test or procedure is really necessary?

Clearly, some aren’t. The Institute of Medicine says $210 billion is wasted each year on medical overtreatment — tests and procedures that either aren’t necessary or duplicate previous tests.

Overtreatment can even happen when you do something as simple as switching doctors. Your new physician might duplicate blood work or scans that you already had.

Trouble is, it’s hard for patients to evaluate whether a medical service is unnecessary. We all trust our doctors and medical professionals to make that determination. Still, there are some steps you can take.

During a medical visit, ask your doctor about the cost of a test or treatment and what alternatives are available. If you’re unsure of where to start, check out Choosing Wisely, a physician-led health education campaign. Choosing Wisely has a list of evidence-based recommendations to discuss with your doctor to help you choose the most appropriate care for your situation.

It also helps to have a broad understanding of how overtreatment impacts our health care system. Here are four things to consider:

Overtreatment costs a lot. Even within our $2.8 trillion health care system, the $210 billion wasted on overtreatment is a significant amount. We all feel the burden of these extra tests and procedures in our health care costs and in rising health insurance premiums.

Some of this is driven by fee-for-service. Our traditional system pays doctors and hospitals for every service they perform, even when it’s unnecessary or causes a patient harm. This system creates financial incentives to perform extra tests that affect your health care costs.

Overtreatment can harm your health. The costs of overtreatment aren’t just felt in your wallet. They can also have a direct impact on your health. An unnecessary X-ray or CT scan can expose you to excess radiation. An extra test can lead to complications or excessive discomfort that might not have been needed.

Overtreatment happens for a variety of reasons. Much overtreatment takes place because some doctors practice defensive medicine. Doctors may order unnecessary tests because they fear malpractice lawsuits. In one survey by Choosing Wisely, as many as 52 percent of physicians said malpractice concerns were a reason they end up ordering unnecessary procedures.

Some patients contribute to excess medical treatments by demanding tests, treatments and prescriptions from doctors, the survey found. Almost half of physicians say they see patients request unnecessary tests at least once a week. As many as one in 10 physicians say that happens daily.

Overtreatment is getting more attention. Medical professionals and health insurers are looking at ways to address the problem. At BCBSNC, we’re using data to equip consumers with cost-effective treatments in tune with their needs. That way, patients spend money on the best health care for them.

We’re also working with hospitals across North Carolina to create payment systems that offer incentives for quality of care rather than quantity of care. These flat-fee payments offer patients a guaranteed cost for complex procedures like hip and knee replacements for the entire episode of care. This creates financial rewards for hospitals and doctors to avoid duplicating tests and to reduce errors.

Have a story about overtreatment to share? Tell us your experience in the comments below, or post on our Facebook page with the hashtag #LetsTalkCost.