Sunday June 18, 2017

Why overtreatment and overdiagnosis can be bad for your health

When it comes to medical care, there is a growing mountain of evidence that doing more is not always better. In fact, it may make matters worse.

According to a recent study, doctors order more than a million medical tests and treatments every year that are not only unnecessary, but are potentially harmful.

Sometimes doctors order a blood test, x-ray or MRI to err on the side of caution. Some medical tests or procedures are conducted in hospitals simply because that is the way it has always been done. Sometimes, patients demand a prescription that may not be appropriate and the doctor relents. 

This August in Quebec City, the Quebec Medical Association will host an international conference dedicated to preventing over-diagnosis, part of an ongoing campaign to raise awareness of the problem.

Dr. Guylène Thériault is on the board of the QMA and a member of the planning committee for that gathering. She is also a family physician and the medical officer of public health for the Outaouis region, in Gatineau, Quebec. In addition, Dr. Thériault is assistant dean in the faculty of medicine at McGill University. 

Dr. Lisa Hicks studies ways of preventing harm to patients from cancer treatments. She is a malignant haematologist at St. Michael's Hospital in Toronto and an associate professor of medicine at the University of Toronto.

Dr. Wendy Levinson is a professor of medicine at the University of Toronto and chair of Choosing Wisely Canada, an organization that raises awareness of unnecessary tests, treatments and procedures. 

They spoke with Michael about which diagnostic tests and treatments are necessary, which are not, and why it's important to understand the difference.

Click 'listen' above to hear the panel. You can download a copy of Dr. Levinson's four suggested questions at this link

During that conversation, Dr. Levinson referred to an article about over-diagnosis and over-treatment in the Journal of the American Medical Association, co-written by renowned American physician Dr. Ezekiel Emanuel. It's called The Perfect Storm of Overutilization.

Michael spoke with Dr. Emanuel in December, 2014 about his controversial essay in The Atlantic magazine, "Why I hope to die at 75."  You can hear that conversation, here.