Nfld. & Labrador

Wasteful procedures costing N.L. health system millions, doctor says

The lead of a health care advocacy group in Newfoundland and Labrador says inappropriate and unneeded testing and medicine is costing Newfoundland and Labrador millions.

Choosing Wisely campaign looks to improve health care decision-making

Pat Parfrey is a lead on the Choosing Wisely NL project. (CBC)

A full 20 per cent of Newfoundland and Labrador's health care budget is being misused, according to the head of a health care advocacy group.

Unnecessary tests, medications and procedures are gumming up wait lists and costing hundreds of millions of dollars, according to Dr. Pat Parfrey, the project lead for Choosing Wisely NL.

Parfrey is a kidney specialist, and a professor at the Memorial University School of Medicine. He says unnecessary spending is taking a chunk out of the province's $3-billion health care budget — and can even be doing harm to patients.

"There is unnecessary testing in imaging testing, x-rays, in various places. Nearly every place is associated with unnecessary testing," Parfrey told Here and Now's Debbie Cooper in a sit-down interview on Wednesday.

"I think that it just gets worse as medicine gets more complex, and as the type of testing and imaging procedures develop."

He says though patients sometimes go into a doctor's office demanding a test or medication, what they are demanding could cause them harm. 

There's a lot of radiation in some scans, he says. And the proliferation of antibiotic use is leading to antibiotic resistance, which is a problem in the province's hospitals and care homes.

Changing the conversation

Parfrey said the three-month-old initiative, Choosing Wisely NL, is hoping to change the conversation around testing in the province.

It's a collaboration between Memorial University, the medical association, the provincial government and others. 

This idea of how you choose is important- Pat Parfrey

They are hoping to work with patients and doctors, those ultimately responsible for the administration of tests, to cut the amount of unnecessary procedures and medications.

According to Parfrey, it's about administering the right tests, at the right time, to the right patient.

Dr. Patrick Parfrey tells CBC's Here and Now that about 20 per cent of Newfoundland and Labrador's health care budget is misused. 9:48

He said when there's no indication of cancer, nerve damage or infection, for example, "getting low back testing, very quickly, is unnecessary, but getting it done [if the condition persists for] six weeks is necessary."

Not only does the test take time for the patient and doctors, but it also denies a spot to another patient who might truly need it.

"What we would like the system to do [is] get the right test … to the right patient … and get it done quickly, rather than have a huge waiting list."

"Getting this balance between using the [procedure or test] when it's needed, getting the public to understand [when] it's not needed, and for the doctor to be able to resist the demand is a complicated problem." 

Parfrey sees the Choosing Wisely NL project as a long-term endeavour.

With enough exposure and trust from doctors and patients, information from the group might be able to persuade people not to order an unnecessary test.

"This idea of how you choose is important, and we don't, I don't believe, provide enough emphasis on this idea of choosing wisely."

With files from Here and Now, Debbie Cooper

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