Why is overuse important?
All medicine entails risks that must be balanced with potential benefits to patients. A great deal of uncertainty exists when determining risk vs. benefit that can be difficult for doctors to manage or discuss with patients. We know overuse harms patients in different ways.
Reducing overuse of care will protect patients from the harms, hassles and costs of treatment while maximizing benefits. Groups such as Choosing Wisely and Dartmouth have targeted overuse.
What do we know about overuse?
Despite an abundance of technology in modern medicine, we don’t have strong evidence for most of what we do. Reasons for this are explored by John Ioannidis and Andrew Foy. Overuse is common, estimated to account for up to 30% of medical care and likely impacts most patients according to physicians and administrative data.
Overuse is the result of a proliferation of medical services without a skeptical, practical approach to how to use them on an aging and often chronically ill population. Focusing on overuse is not about rejecting modern medicine, but delivering better care.
Some overuse terms are described in this figure from a Research Agenda we published in BMJ:
How to learn more
Excellent non-technical books discuss medical overuse including Overtreated by Shannon Brownlee, Overdiagnosed by Gil Welch and Hope or Hype by Richard Deyo and Donald Patrick. This short video provides a synopsis for patients.
More technical/medical information can be found in journals JAMA Internal Medicine and the British Medical Journal as well as the Lown Institute or publicly accessible presentations from Preventing Overdiagnosis conference.