When Patients Are Overtreated

Have you seen patients who are overtreated? If so, you are not alone.

A list of medical care services that are overused was compiled by the National Priorities Partnership, which is convened by the National Quality Forum. Non-palliative services at the end of life is included in the list. In addition, specific tests and surgeries are noted such as x-rays, cardiac CT scans, heart bypass surgery, back surgery, knee and hip replacement, prostatectomy, angioplasty and hysterectomy. To learn more, go to http://www.nationalprioritiespartnership.org/PriorityDetails.aspx?id=598

What exactly is overuse? The Institute of Medicine defines overuse as when the potential for harm of a health care service exceeds the possible benefit.

Palliative care clinicians have been quiet observers of overuse. Dr. David Weissman, professor emeritus at the Medical College of Wisconsin, says, “The continued use of chemotherapy by my peers, as the end-of-life approached, was one of the reasons that drew me to the new field of palliative medicine in the late 1980s.”

Patients are speaking up. This month, Consumer Union’s Safe Patient Project launched a “Share Your Story” survey of patient experience of overtreatment across the lifespan. Go to www.treatmenttrap.org and click on “Share Your Story”. What do you think about patients sharing their stories of overtreatment?

Palliative care enables patients to receive the care they need, no more and no less. That’s why the National Priorities Partnership included palliative care and end-of-life care as one of its six national priorities.

As a health care professional, if you have seen patients overtreated, what do you do? How do you ensure patients receive only the care that will benefit them?

The writer is the author of The Treatment Trap (March 2010) and was chief architect of the Robert Wood Johnson Foundation’s palliative care strategy.

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