Overtreatment Could Be Costing You a Fortune

When your doctor tells you that you need a test, medication, or procedure, most people don’t question it. But 1 in 4 medical tests are unnecessary — as are 1 in 10 surgeries, according to a survey of more than 1,500 physicians, published in the medical journal PLOS One, reporting that doctors regularly overprescribe medical care.

“While there’s both overtreatment and undertreatment in our health care system, the bigger problem is overtreatment,” says Michael Hochman, M.D. He’s a Los Angeles internist and host of the Healthy Skeptic, MD podcast. “A lot of people don’t realize that getting too much care may harm you due to side effects from medications or unnecessary complications from medical procedures.”

It’s also expensive: People in the top 10% of out-of-pocket spending on medical services paid an average of $5,390 per year.

Why does overtreatment happen?

There are 3 common reasons for overtreatment:

Fear of malpractice

Almost 85% of physicians surveyed in the PLOS One study voiced this as a major concern. “There’s this belief among many doctors that more is simply better,” says Dr. Hochman. “There’s a worry that if they leave out anything, they’ll get sued.”

Pressure from patients

About one-third of adults and half of kids with upper respiratory infections are prescribed antibiotics even though they’re mostly unnecessary, according to a 2021 report published in Pediatric Drugs. The main reason doctors give? Patient pressure, even if it’s subtle (for example, patients describing sore throat pain as being as sharp as a knife or coughing so hard that they threw up). Yet research shows that antibiotics don’t work to treat viral infections, and they can even raise the risk of harm by promoting antibiotic resistance.

Difficulty accessing prior medical records

This is especially true if your care is being managed by a team of doctors. More than 30% of all seniors see at least five different specialists a year, up from just 17.5% in 2000, according to a 2021 study published in the Annals of Internal Medicine. But managing all this information can be confusing, which is why many doctors end up repeating tests or running unnecessary ones, says Dr. Hochman.

Ways to avoid overtreatment

There are some steps you can take to avoid overtreatment in your own health care.

Ask your doctor about watchful waiting

Whether it’s persistent lower back pain or a nagging sinus infection, there are some situations in which you don’t have to rush into treatment. More than 20% of Medicare patients presenting with lower back pain undergo imaging tests, for example, although the condition usually resolves on its own.

“It’s really important that patients engage in shared decision-making with their doctors, which means you work together to select the best tests, treatments, and care plans that work for you,” explains Dr. Hochman. “Much of the time, waiting a few days or weeks, or even months, won’t affect the overall outcome, and sometimes conditions can resolve on their own.”

Get a second opinion

“It’s a good idea to get a fresh pair of eyes on the situation, as another doctor may see it from a different angle,” explains Dr. Hochman.

A 2021 study published in Mayo Clinic Proceedings found that getting a second opinion cuts the chance of misdiagnosis in half. A third opinion drove it down even further, to 16%. Dr. Hochman recommends that you meet with someone who is at a different hospital or medical center, as they are more likely to approach your condition with a different perspective.

Do medication reviews

About 45% of Americans take least one medication, according to the Centers for Disease Control and Prevention. But it may not always be necessary. More drugs aren’t just more expensive — they carry a higher risk of negative effects, says Dr. Hochman.

That’s why he recommends that patients do a yearly medication review to check whether they really need all the medications they’re on. This review can be done either with the primary care provider or the pharmacist. It can also help with drug costs too, as you may be able to switch to a cheaper medication. (Want to spend less on prescription medication? Here’s how.)

Come prepped to appointments

It’s a good idea to bring a list of medications and supplements you are taking — and the names of the providers who prescribed them — to each visit with your primary care provider, as well as the names of any other specialists you’re seeing, says Dr. Hochman.

Another tip: Go over your electronic health history with your primary care provider to clean up your medical records. “This way, all your doctors know exactly what tests have been done, and what medications have been given, so nothing is repeated,” he explains.

If you have access to your patient portal, you can also print out both the notes and the after-visit summary of recent specialist visits, Dr. Hochman adds. You can give these to your provider when you see them and go through the notes together to make sure nothing is being duplicated — and that there are no gaps in your care.

Additional sources
Physician survey of overprescribing medical care: PLOS One
Prescribing unnecessary antibiotics: Paediatric Drugs
Seniors visiting specialists: Annals of Internal Medicine
Second opinion cuts chances of misdiagnosis: Mayo Clinic Proceedings
Percentage of Americans taking medication: Centers for Disease Control and Prevention