Doctors More Aware of Unnecessary Medical Treatment Problems, But Few Improvements Seen: Study

Although doctors are usually aware that certain tests and treatments provide little medical benefit, new research suggests that the use of unnecessary medical care continues to increase. 

In a study published in the medical journal JAMA Internal Medicine, researchers indicate that unwarranted procedures and diagnostic testing has risen over the past 10 years, even though most doctors are aware the treatments offer no benefit to the patient.

Researchers reviewed nearly 1,500 studies from January 1, 2015, to December 31, 2015, focusing on medical care overuse. The analysis focused on three categories: overuse of testing, over-treatment and questionable use of services.

Specialty referrals nearly doubled from 2000 to 2010, with referrals for advanced imaging, like CT scans or MRIs, for simple headaches increasing from 6.7% in 2000 to nearly 14% by 2010. This type of medical overuse is not only costly to both the healthcare system and the patient, but unnecessary.

Medical treatment overuse increases like this were seen across the healthcare system for many different types of simple ailments.

Nearly 25% of atrial fibrillation patients with a low risk of thromboembolism received unnecessary anticoagulation treatment, according to the findings. Nearly 34% of patients received unnecessary colonoscopy screenings, against the recommended standard of care.

A study published in January indicated one-third of breast cancer patients receive unnecessary treatments. The study showed many women are told their cancer is worse than it is, causing them to undergo unnecessary chemotherapy and radiation, as well as mastectomies and other surgeries, putting the patients at serious risk of side effects.

The new study also showed 94% of testosterone replacement therapies were given by doctors off guideline recommendations. More than 90% of patients were still offered opioid narcotic painkillers after experiencing an overdose.

Similarly, a study published in March indicated patients who undergo knee replacement surgery are often first inundated with unnecessary treatment often designed to help the patient avoid surgery, including steroid injections, strong narcotic painkiller prescriptions, hyaluronic acid injections, and other treatments that often don’t help and are quite costly.

Among the patients studied in the new research, more than 60% of those with diabetes were treated to “potentially harmfully low” hemoglobin A1C levels.

Study authors indicated unnecessary hospital admissions for low-risk syncope, or fainting, lead to serious side effects, putting patients in danger. Another study published in 2016 indicated patients are often admitted to the ICU unnecessarily, most don’t benefit from the invasive level of care. In fact, more than half of patients in the study could have been cared for in less invasive settings.

The new study also indicated unnecessary admissions for syncope were frequent and current practices for treating Clostridium difficile, low back pain and thyroid nodules should be reevaluated.

The research indicates many doctors are aware these tests and treatments are unnecessary, but continue to use them anyway. The study also indicated doctors were aware of the increase of medical treatment overuse in recent years, yet they still opted for the course treatment.