Overtreatment in the United States.

Area of Science:

• Health Services Research
• Medical Economics
• Clinical Practice Improvement

Background:

• Overtreatment in healthcare leads to preventable harm and significant waste.
• Clinician perspectives on overtreatment are not well understood.
• Physician insights are crucial for addressing healthcare inefficiencies.

Purpose of the Study:

• To survey physicians on the prevalence of overtreatment.
• To identify the primary causes and implications of overtreatment from a physician's viewpoint.
• To gather physician-proposed solutions for reducing unnecessary medical care.

Main Methods:

• A survey was distributed to 2,106 physicians from the American Medical Association (AMA) masterfile.
• Physicians reported the extent of overutilization across medications, tests, and procedures.
• Key outcome measures included reasons for overtreatment, proposed solutions, and the perceived link between profit and overtreatment.

Main Results:

• Physicians estimated 20.6% of medical care is unnecessary, with higher rates for prescription medications (22.0%) and tests (24.9%).
• Top reasons cited for overtreatment were fear of malpractice (84.7%), patient pressure (59.0%), and poor access to medical records (38.2%).
• Suggested solutions included resident training on appropriateness criteria (55.2%), improved access to health records (52.0%), and more practice guidelines (51.5%).

Conclusions:

• Overtreatment is a prevalent issue from the physician's perspective.
• Addressing overtreatment necessitates incorporating physician-identified causes and solutions.
• Reducing fee-for-service compensation is seen as a potential strategy to decrease healthcare utilization and costs.