When you’re contemplating surgery, there are two things you’re probably thinking about:
How expensive will it be? And, more importantly, how risky will it be?
A third question should be: Is this surgery even necessary?
The issue of overtreatment, defined by the American Board of Internal Medicine as “care that has a greater potential for harm than benefit,” has become a concern not only for patients but for their physicians.
In a 2017 survey, U.S. doctors said that more than 20 percent of medical care was unnecessary.
As part of the same survey, more than 70 percent of patient respondents said that physicians are more likely to perform unnecessary services when they profit from them.
So, while doctors are taking an honest look at their actions on behalf of patients, many of those patients are still feeling mistrust.
Let’s take a closer look at the issue of overtreatment, and see if we can bring these two sides closer together.
“We can’t just trust our intuition. We need data.”
That’s a quote from Dr. Robert Harrington, a cardiologist and the chair of the department of medicine at Stanford University.
In 2019, Dr. Harrington co-authored a 5000-person trial which, he says, “upended assumptions about cardiac care.”
The trial showed that, for patients with chronic but stable heart disease, lifestyle changes, including dietary changes, and medication were just as effective as more invasive (and more costly) surgical procedures like stenting and bypass.
Even for patients who already had some serious heart damage, surgery did not result in a better outcome than simply taking meds, eating well, exercising and not smoking.
Here are two more examples of this shift in the medical mindset:
- Researchers at Brigham and Women’s Hospital found that, after six months, both physical therapy and surgery brought similar and substantial improvement to patients with a torn meniscus (a common injury to the cartilage that acts as a “shock absorber” between the thighbone and shinbone).
- A 2016 study in the United Kingdom found that men with early-stage prostate cancer were just as likely to survive ten years by actively monitoring their condition and seeking treatment if necessary, as they were from immediate treatment via surgery or radiation.
Help in making wise choices for yourself
As with many important things in life, communication is key when it comes to making thoughtful treatment decisions for yourself and your family. That includes avoiding unnecessary treatments while making sure you get the ones that you do need.
Choosing Wisely is an initiative of the American Board of Internal Medicine that “seeks to advance a national dialogue on avoiding unnecessary medical tests, treatments, and procedures.”
Their stated mission is:
To promote conversations between clinicians and patients by helping patients choose care that is:
- Supported by evidence
- Not duplicative of other tests or procedures already received
- Free from harm
- Truly necessary
If you are looking to make decisions around whether to have a particular treatment, this site is NOT a substitute for talking with your doctor.
Rather, it has a wealth of free materials from a range of national organizations that represent various medical specialties, designed to help you initiate a conversation with your doctor and, hopefully, decide together with them if a particular treatment is right for you.
As an example, here’s an information sheet on treatment options for low-risk prostate cancer. As we mentioned earlier, surgery is not always the best option.
This information sheet outlines the risks and side effects of aggressive treatment, as well as when surgery and/or radiation should be pursued. Watchful waiting, which we’ve reported on, is actually being recommended by even more doctors.
Finally, it urges you to talk with your treatment team before making any decisions.
Editor’s Note: You may have heard the news report recently that popular heart treatments aren’t cutting it. It’s time to discover the truth you won’t find at your doctor’s office! Before you submit to any heart treatment, read this FREE report…
- When It Comes to Some Medical Treatment, Researchers Find Less Is More — Time
- Physical Therapy to Treat Torn Meniscus Comparable to Surgery for Many Patients — National Institute of Arthritis and Musculoskeletal and Skin Diseases
- Study Compares Surgery, Radiation, and Active Monitoring to Treat Prostate Cancer — American Cancer Society
- Talking to the Doctor About Treatment Harms — US News
- Choosing Wisely | Promoting conversations between providers and patients — ChoosingWisely.org