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Stop being Over Treated!

Writing in the British Medical Journal, they suggest some patients are given pills or have tests they do not need by doctors who feel under pressure to act.

They argue patients should feel able to discuss whether there are simpler, safer options that are right for them. But experts warn they must not change treatment without medical advice.

The Academy of Medical Royal Colleges (AoMRC) says a culture of “more is better,” where the onus is on doctors to “do something” at each consultation has bred unbalanced decision making and over-diagnosis -labelling patients with conditions that may in the end do them harm. Overtreatment can place patients at high risk of adverse events. Shared decision making can help to reduce this overtreatment and may be particularly beneficial to groups and significantly improving health outcomes

Launching the Choosing Wisely campaign, experts are calling on medical organisations to identify five procedures each that should not be offered routinely or in some cases not at all.

These might include:

  • Pills for mild depression
  • Too many routine and unnecessary blood tests
  • Medicines for mildly raised blood pressure

Prof Dame Sue Bailey, a leading psychiatrist and chair of the AoMRC, argues many patients with mild depression could instead be offered group exercise classes or talking therapies first.

And she says frequent blood tests can be particularly distressing for elderly people with frail skin. She also argues that for some patients with mildly elevated blood pressure, changing their lifestyle might be the most appropriate initial option.

But other experts defend the use of these pills in mild, moderate and severe cases and the charity Blood Pressure UK warns patients to consult their doctors before changing their medicine.

Changing evidence

Nevertheless, as science advances and the evidence shifts, experts say individuals should be encouraged to check whether procedures are definitely right for them.

For example, patients are advised to ask:

  • Do I really need this test or procedure?
  • Are there simpler options?
  • What happens if I do nothing?

The campaign is already under way in Canada and the United States. And while experts acknowledge that asking doctors to change familiar practices could be controversial, they say it is worthwhile if it leads to better care.

Dr Aseem Malhotra, heart specialist and author of the report, said: "Over-diagnosis and over-treatment are the products of a broken system. For the sake of our patients there needs to be a radical overhaul in culture so we can provide the best quality care."

Prof Bailey added: "It is not and will never be about refusing treatment or in any way jeopardising safety. It is just about taking a grown-up approach to healthcare and being good stewards of the resources we have."

And Jeremy Taylor, of the patient charity, National Voices, welcomed the initiative. He said: "The evidence shows where patients are involved in the decision, people will often choose less intervention. They do not ask for endless new treatments, but make appropriate - and often less costly - choices."

Healthcare RM fully endorse this potential culture shift, we've been encouraging our clients to take personal ownership and take preventative treatment to reduce lifestyle risk factors before they get ill or injured.

At Healthcare RM we assess the individual by fully evaluating their causative and contributory risk factors and behaviours to prevent future occurrences of both physical and psychological ill health conditions.

The Health and Wellbeing team within Healthcare RM use this approach within all corporate programmes to proactively manage potential risks to sickness absence.

If you want to find out more or invite our team into your workplace to prevent the need of treatment (or even over-treatment!), don't wait, just get in contact with us.

 

Article with thanks to the BBC (article) and the BMJ (article).

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