Every age group, from children to seniors, is at risk for being diagnosed with a condition they may not actually have, and being prescribed medications they do not need. In an increasingly litigious environment, where attorneys advertise for clients who may have had a missed diagnosis or experienced a side effect from a prescribed medication, physicians are increasingly caught between their desire to individualize care for their patients and the need to follow published standards of care to protect their licenses.

In other words, the fear of medical malpractice lawsuits is a very real issue faced by many who practice medicine. To avoid public criticism by colleagues or potential rebuke from their professional organization (and sometimes loss of their ability to practice), physicians may feel forced to follow published standards of care. These treatments often include prescribing medications designed to relieve symptoms, but do not usually address the foundational cause of the medical condition.

If you watch any television at all in the U.S., you have seen the advertisements for medications along with a long laundry list of potential side effects from the drugs. Oftentimes these side effects are more dangerous than the original condition being treated.

For instance, Vioxx, an anti-inflammatory medication used to treat musculoskeletal conditions such as arthritis, was eventually pulled from the market after studies demonstrated those taking it experienced a much higher risk of cardiovascular disease, heart attack and death. Unfortunately, by the time Vioxx was withdrawn, an estimated 60,000 Americans had already died from the drug.

This is only one of many instances where a drug has been pulled from the market. Some patients are required to undergo monthly blood tests to monitor organ function in order to stop medication if damage is detected. In some cases, the use of medications is warranted and may help improve your situation, but they must be used cautiously and judiciously. It is far better to address the underlying physical cause of the condition to alleviate the issue than it is to mask the problem by subduing the symptoms.

Most US Physicians Believe Overtreatment Is Harmful, Wasteful and Common

A recent survey of over 2,100 physicians from a variety of specialties across the U.S. asked about their beliefs concerning overtreatment and unnecessary medical care.¹ By their own admission, the participating physicians describe overtreatment of their patients as “common.” The survey found 22 percent of prescription medications, 24 percent of tests and 11 percent of procedures were unnecessarily prescribed, despite years of emphasis from the health care industry to control costs and procedures.

The most common reason physicians cited for prescribing tests, medications and procedures was a fear of malpractice (nearly 85 percent), and pressure exerted from patients (nearly 60 percent).² Senior author, Dr. Martin Makary, professor of surgery at Johns Hopkins, commented on the results of the survey, saying:³

“This study is essentially the voice of physicians about the problem. We’re told that there are too many operations done for narrowed blood vessels in the legs. Spine surgeons say that a quarter of all spine surgery may not be necessary. Half of stents placed may be unnecessary. These are significant opportunities to improve quality and lower costs.”

The study identified some potential solutions, including better training for incoming residents on the appropriate criteria for treatment, easier access to prior health records that may reduce unnecessary testing and more practice guidelines.

Cost of Overtreatment Affects Every Individual

The cost of overtreatment is both physical and financial. As Dr. Ben Goldacre explains in this TEDMED talk, physicians are often misled about the benefits of the medications they prescribe, based on the research published in peer review journals. It’s common practice to publish positive results and withhold studies with negative results from publication.

Naturally, this presents a very lopsided view. Bias also taints the results of many studies. Physicians need to be able to make informed treatment decisions, but publication bias makes this exceedingly difficult.

Overdiagnosis and overtreatment are significant contributors to health care spending that is spiraling out of control. In 2015, the Centers for Disease Control and Prevention (CDC) reported the annual per capita health expenditure was $9,990.⁴ The total national expenditure amounted to over 17 percent of the Gross National Product. Within one year that number jumped to $10,345 per person.⁵ This is a 4.8 percent increase per person in a population of 324 million people in the U.S. at the time of the increase.⁶

Health care expenditure is expected to grow 5.8 percent annually to 2025.⁷ Costs in the U.S. often exceed those for the same products or services in other countries. For instance, one day in the hospital in the U.S. costs an average $5,220 while one day in the hospital in Spain costs $424; bypass surgery in the U.S. is over $78,000, but $24,000 in the U.K.; and Harvoni, the drug used to treat hepatitis C, costs $10,000 more in the U.S. than in any other country.⁸

As Makary pointed out,⁹ “Unnecessary medical care is a leading driver of the higher health insurance premiums affecting every American.” The primary study authors also wrote:¹⁰ “Addressing overtreatment can have a major impact on rising health care costs in the U.S. … Using the IOM’s estimate of excess costs arising from overtreatment, a 50 percent reduction in ‘unnecessary services’ would result in $105 billion in savings each year, or about 4 percent of total national health care spending.”

In an interview with CNBC, Dr. Orly Avitzur, medical director at Consumer Reports, shared some signs you may have been overtreated:¹¹

Leaving the doctor’s office with a list of prescriptions and you don’t know why you’re taking them

Getting a prescription for a symptom instead of your physician sitting with you to discuss what the symptoms may mean

Receiving prescriptions without a conversation of why you’re taking the medication, the side effects and a thorough discussion of what alternatives may be used