In the USA, the UK and Australia there is an awareness of a need to wind back the increasing use of excessive medication prescriptions, tests and procedures. There is a call for change — the embracing of uncertainty and a new level of trust and honest communication between doctors and patients, which will result in economic and human benefits.
The increase in unneeded interventions
Ray Moynihan, Senior Research Fellow at Bond University, wrote in The Conversation that it has been estimated “more than US$200 billion a year is squandered on unnecessary tests and treatments”. There is also an increasing trend for healthy people, showing signs of typical ageing, to be diagnosed with “disease” when tests results are compared with standards based on young people. Older people are then provided with procedures and medications which at times have limited or no health benefits. At times the very sick or elderly are given procedures to extend life to the detriment of quality of life.
Profiting on fear and uncertainty
Moynihan feels this excessive testing is linked to doctor’s fear of uncertainty, with more tests ordered to be sure of diagnosis. Research recommending interventions is also often funded by those who will profit from the use of those interventions. Finally, there is the perception that death is a failure of medicine, when medicine can only realistically hope to delay, and not prevent, death.
The call for change
The Choosing Wisely initiative has been launched in Australia to encourage discussion between doctors, clinicians providing testing procedures, and patients, about the needs, costs and benefits of interventions. The medical profession needs doctors who can be leaders of change, considering all stakeholders to make informed, ethical decisions.
Learn the skills to be a leader of change
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