More medicine, more tests and more treatments doesn’t necessarily mean better health.
Some patients might have unrealistic expectations when it comes to the benefits that can come from medical interventions and in turn might overlook some of the potential harms that come with treatment. The results of this not only include potentially disappointing outcomes, but it drives up healthcare costs when people opt in for treatments they might not actually need.
Professor Chris Del Mar and Associate Professor Tammy Hoffmann from Bond University carried out a systematic review of 35 studies analyzing patient expectations of tests and treatments – specifically with interventions such as mammography, prostate specific antigen (PSA) tests, angioplasty, stem cell transplants, statins, kidney transplants, bariatric surgery, inflammatory bowel disease drugs and resuscitation after a cardiac arrest. Their findings were published recently in JAMA Internal Medicine.
With the Rise of AI, What IP Disputes in Healthcare Are Likely to Emerge?
Munck Wilson Mandala Partner Greg Howison shared his perspective on some of the legal ramifications around AI, IP, connected devices and the data they generate, in response to emailed questions.
“We know it’s very difficult for doctors not to do something,” Del Mar says according to ABC Science, which gets even harder when patients insist they want certain tests or treatments.
One thing that might not help, though the intention is good, are the “in-your-face” public awareness campaigns on TV for things like breast cancer testing and the use of relative rather than absolute risk estimates when explaining the number of lives saved by interventions such as screening, Del Mar says. “In fact the odds are you’re not going to die of breast cancer,” he says.
Having longer talks with patients doesn’t necessarily lead to more treatment either, which is a common myth. In fact evidence suggests more talk results in less intervention, according to Del Mar. He gives PSA testing as an example. “If you talk to people first before you do the screening, and explain all the downstream consequences of being screened, a lot of men say they don’t want it,” he says.
While unnecessary or unwanted treatment and tests add to the cost of healthcare, Del Mar says “overtreatment” can also result in physical and emotional harms. This is unfortunate for both the patient and the doctor.
A Personalized Approach to Medication Nonadherence
At the Abarca Forward conference earlier this year, George Van Antwerp, managing director at Deloitte, discussed how social determinants of health and a personalized member experience can improve medication adherence and health outcomes.
With patients sometimes being overly optimistic, it really means that doctors need to go out of their way to explain pros and cons as accurately as they can. Sometimes advising a patient to walk away from a treatment at the time could be what’s best, even if it leaves a patient feeling uncomfortable. There is a satisfaction that comes from being proactive with our health, especially if we are concerned, but sometimes it can do more harm than good.
Ideally patients have a doctor they can really trust and are open to expert advice.
[Photo from Flickr user Alex Proimos]
