I think we’ve all been in situations where we go to the doctor feeling a little under the weather, and five minutes later leave with an antibiotic prescription—all the while wondering if we really need that medication.

Scenarios like this happen all the time, actually. And it’s just the tip of the iceberg when it comes to unnecessary or inappropriate treatment.

In a recent survey, more than 2,100 US doctors were asked about this sensitive topic. According to their responses, they believe roughly 20 percent of overall medical care is unnecessary, including 22 percent of prescriptions, nearly a quarter of tests, and 11 percent of procedures.

Why all these unneeded tests, medications, and procedures? These docs say that the fear of malpractice lawsuits is the biggest reason, followed by pressure from the patient. A much smaller percentage replied that difficulty accessing patient records made it hard to make better-informed decisions.

None of this is a surprise. An average of 85,000 malpractice suits are filed every year, resulting in hundreds of millions of dollars in payouts. It’s really no wonder that so many doctors over-test, over-treat, and overprescribe to avoid a potential lawsuit. It’s better to be “safe” than sorry, right?

Malpractice reform is a hot topic in Congress too, with several officials calling for sweeping reform that would limit damages awarded and lawyer fees. Until (or even if) that happens, I suspect the trend of needless medical intervention will continue so that doctors can protect themselves.

Patient pressure is another big problem. I know from experience that many patients come in knowing exactly what they want prescribed—be it an antibiotic, pain medication, anxiety meds—even if that drug is completely inappropriate in their case.

It’s times like these that highlight the value of fostering strong, trusted doctor/patient relationships. With every single one of my patients, I strive to build a connection that centers around open communication and research-supported facts. I never want to steer anyone in an unrealistic or, worse, wrong direction.

My goal is that all my patients leave their appointments knowing that I have their best interests at heart—and that sometimes means denying them a medication that I don’t think is needed. Sometimes safer alternatives exist, such as the many natural pain relief alternatives I recommend in place of dangerous opioids and painkillers. Other times, plain old “R ’n R” is all that’s needed to get better—as is almost always the case with viral infections like colds.

How to Avoid Unnecessary Treatments

With all that said, I know many people find themselves in sticky situations with their own doctors, getting unneeded prescriptions or treatment plans.

One of my newest patients came to me after her former doctor gave her an antibiotic prescription just to “shoo” her out of his office within the allotted 5-minute appointment time. He didn’t take her symptoms seriously and claimed it was “probably a sinus infection.” She knew it wasn’t. She didn’t fill the prescription and came to me for a second opinion. And her instincts were correct. She didn’t need that antibiotic at all, but she did get a proper diagnosis and treatment.

Furthermore, the misuse of medications, X-rays, CT scans, and other unnecessary or inappropriate medical care can end up being harmful to your health in the long term, exposing you to radiation and altering your microbiome—leaving you susceptible to other illnesses or conditions. And let’s not forget, all that money you (and your insurance company) spend on tests and drugs you don’t need is akin to flushing hard-earned cash down the toilet.

The best course of action is to educate yourself after you receive a screening recommendation or treatment plan from your doctor.

Now, I know that Google results can often yield confusing, and sometimes downright scary results. But there are some good resources you can directly go to in order to find out what various medical societies recommend in terms of testing and treatment.

“Choosing Wisely” has an important mission:

Choosing Wisely aims 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

Here, several medical societies have come together and created a list of tests and treatments that they say are often overused. Is yours on the list? If so, what do they recommend you do?

Always remember: You are your own best advocate. If you find yourself in a situation where your doctor orders a medication, test, or procedure that you seriously question or doubt you need, do your research and get a second or even third opinion. Being an educated healthcare consumer can save you a lot of time, money, stress, and confusion.

References

• Lyu H, et al. Overtreatment in the United States. PLoS One. 2017 Sep 6;12(9):e0181970.
• Choosing Wisely.

Last Updated: August 16, 2018
Originally Published: November 24, 2017