Medication problems. When reviewing a new patient’s medication list, it’s not unusual to run across a duplication, as I did recently when seeing a patient for vertigo who had been prescribed Antivert, a brand-name drug, by her primary-care doctor, and meclizine, the generic equivalent, by her ear, nose, and throat doctor. It’s even more common to find people who are already on multiple medications being prescribed the same drugs again, such as the patients I see after car accidents who are oversedated from multiple prescription muscle relaxants and painkillers. The likelihood of being on too many drugs increases with the number of providers you see. Keeping a list of medications that includes brand and generic names, and making sure all your doctors review them, can help. But there’s no substitute for streamlining the number of physicians you see.
Too many tests. It’s not uncommon for a doctor to reorder a test that another doctor has just had done. Moreover, even minor abnormalities or incidental findings can lead to increasingly invasive testing with a risk of serious complications. In a health survey last year for Consumer Reports, 87 percent of respondents said they completely or somewhat agreed that “it’s better to have a scare that turns out to be nothing than to not get tested at all.” But only 18 percent recognized the risk of having a false alarm.
Waste of time and money. While genuine medical problems should never be ignored, overtreatment takes time away from more pleasurable endeavors. It’s estimated that overtreatment alone was responsible for $158 billion to $226 billion in wasteful spending in 2011, while failure to coordinate care cost $25 billion to $45 billion. Besides the overall implications for health-care spending and the threat to worthy government programs, your own pocketbook is affected. Even with the best insurance plans, copayments for office visits, tests, procedures, and pharmacy bills can add up quickly.
Too much stress. Undergoing frequent tests, waiting for results, and trying to make sense of conflicting opinions can cause undue tension. In the case of my colleague’s father, stress undoubtedly contributed to his headaches. And the multiple painkillers he was taking had contributed to a rebound effect. With reassurance and gradual discontinuation of the drugs, the headaches eventually resolved.