Health-Care Savings Series—Day 8: Avoid unnecessary visits, tests, and treatments

One of the major reasons that medical care is more expensive in the U.S. than anywhere else is overtreatment and overdiagnosis. In our fee-for-service system, doctors and hospitals actually profit by overpromoting and overusing unnecessary, unproven, or potentially harmful tests and treatments. Meanwhile, our system actually discourages simple low-cost counseling and treatments that are proven to save lives and reduce suffering by underpaying those who provide these services.

We investigated such treatment traps in November 2007, and came up with ten overused tests and treatments. Ranging from back surgery to whole-body CT scans, they have in common the fact that they have unproven benefits or are expensive or both.

People with chronic, long-term illnesses or other serious conditions also need to be wary of overtreatment. Studies by researchers at Dartmouth Medical School found that patients living in areas that have the most aggressive, expensive medical care don't enjoy a better quality of life or live any longer than those who are treated in areas that provide more conservative, less costly care. (For more on the Dartmouth findings, see our July report, Too Much Treatment?.) We worked with the Dartmouth researchers to rate hospitals using this data. You can use this tool to find out how your region's hospitals treat people with long-term, life threatening illnesses.

Here are some ways to avoid the treatment traps that our system encourages:

• Designate one doctor, typically your primary care physician, to coordinate all of your medical care, including that provided by specialists. That's especially important if you have a chronic illness that needs to be medically managed for months or years.
• Take lifestyle changes seriously, particularly if you are at risk for conditions such as heart disease, stroke, diabetes or cancer.
• If your doctors recommend a test, ask if the results will affect the treatment going forward. What are the benefits? Will it lead to follow up tests, biopsies or other procedures? Make sure you understand the health benefits and the potential complications and risks.
• When considering a treatment, weigh the benefits against the potential complications. Is the treatment likely to extend your life? How do the side effects and risks of treatment compare with the symptoms of the disease itself?

—Kevin McCarthy, associate editor

Tomorrow: Low-Income Programs and Insurance for the Unemployed