Across the medical field, doctors are reconsidering the status quo
. Many surgeries are medically necessary and even lifesaving–but increasingly, evidence suggests invasive care shouldn’t always be a physician’s knee-jerk reaction.
A 2016 paper found that men who actively monitored their early-stage prostate cancer were no more likely to die over the next decade than those who opted for surgery or radiation. Research has shown that physical therapy can be just as restorative as surgery for a torn meniscus. Studies have found that C-sections are not only unnecessary for many deliveries but also potentially risky. Numerous minimally invasive alternatives to open surgery have been shown to be safer and equally effective.
That shift stands not only to improve patient outcomes; it could also chip away at care costs. A 2010 Institute of Medicine report estimated that overtreatment costs the U.S. medical system $210 billion per year. In a 2017 survey, U.S. doctors said more than 20% of medical care was unnecessary–even as access to care is lacking for many.
Overtreatment also often begets overtreatment. In a fall 2019 survey of about 400 internists, 94% said they had observed an unnecessary “cascade of care”–an ultimately frivolous chain of interventions often triggered by a fluke test or screening. Co-author Dr. Ishani Ganguli, an assistant professor of medicine at Harvard Medical School, says these cascades waste patients’ time and money and lead to unnecessary pain and stress. She and other doctors are bringing awareness to these consequences through research and resources like ChoosingWisely.org, a website that aims to spark conversation between doctors and patients about which tests and procedures are actually worth it. “Things are changing, but slowly,” Ganguli says.
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