When we think about medical errors, we tend to think about treatment that went wrong -- a patient who was injured or died during surgery, a test result that was misinterpreted, or a medication mix-up. In the past few years, we've started learning about another kind of error -- overtreatment. Too much is not always a good thing -- which goes against a lot of our cultural grains about "more is better" in health care.
Rosemary Gibson, author of The Treatment Trap, a book that looks at this issue, teamed up with the Consumers Union's Safe Patient Project, to start gathering stories of overtreatment from patients -- and doctors and nurses -- nationwide. (Get to the survey via her website or via the CU safe patient page here.) It's obviously not a scientific survey, but the story bank can shed light on what patients experience, and inform health care leaders and policy makers.
The survey asks two questions: "Have you had medical care you thought was unnecessary?" and "Have you declined medical care you thought was unnecessary and obtained a medically appropriate alternative?" The focus is on types of overuse identified by the National Quality Forum's National Priorities Partnership, which include spine surgery, heart bypass surgery, hysterectomy and prostatectomy. (See this National Priorities report, particularly page 14). Overtreatment can be damaging in and of itself -- and it can expose people to all sorts of other risks and errors and infections and complications.
As stories come in, Gibson told us, she and her colleagues will "look for overall patterns, and at some point will share the aggregate information with progressive leaders in medicine and health care."
"It's very hard for the health care industry to tackle this," she said."Financial interests are so entrenched that it creates a wall of silence. Nobody wants to talk about overtreatment except the people who are affected by it."
(For more about overtreatment, see both Gibson's book and blog and our New America Foundation colleague Shannon Brownlee's book, Overtreated. We've read both of them.)
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