Attempts to bring down overall medical costs frequently target unnecessary care. But most physicians blame overtreatment on profit motives, fear of malpractice suits and acceding to patient demands, according to a new national study.
Survey findings, published in PLOS ONE, provide physicians’ perspective on an issue that costs the healthcare system upward of $200 billion per year, and where discussion to date has largely been driven by healthcare systems and advocacy groups. Of the 2,327 respondents, nearly 85% cited fear of malpractice suits as a major driver of unnecessary care. The physicians cited requests or pressure from patients to perform unnecessary tests as a driver 59% of the time, and just over 38% mentioned issues with access to prior medical records.
While physicians are generally aware of overtreatment as a cost driver, they tend to have a blind spot when it comes to their own practice, according to Daniel Brotman, M.D., professor of medicine at Johns Hopkins University School of Medicine, and one of the report’s authors. “Interestingly, but not surprisingly, physicians implicated their colleagues (more so than themselves) in providing wasteful care,” he said in an announcement accompanying the report’s release. “This highlights the need to objectively measure and report wasteful practices on a provider or practice level,” he added.
In the course of the survey, researchers also solicited potential solutions to the problem from physicians. The top three responses:
- Improve training for medical residents so that they monitor specific criteria related to the appropriateness of a given procedure, test or prescription.
- Continue to work to improve access to health records so that physicians have the information they need to make fully informed decisions about necessary tests and treatment.
- Improve guidelines for evidence-based care practices, so that doctors and patients can refer to a scientific basis for the best avenue of treatment for a given diagnosis.