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Always try to avoid getting over-treated

The ordinary patient, with hardly any medical knowledge, may never have come across the phenomenon of over-treatment. Some healthcare providers may also be equally ignorant of the same. Simply put, over-treatment occurs when medical interventions aren’t clearly focused on the specific condition being treated. Clinicians tend to go overboard, with the patient ending up with multitudes of tests and associated treatments that were never required in the first place.

A not too uncommon scenario will do to emphasize the point. A random reader of this column noted an unusual belly ache. She ended up in hospital and was quickly diagnosed with a simple intestinal bug. But she was advised to undergo some blood tests and imaging for good measure. What followed thereafter was catastrophic. The additional tests implied the possibility of a more sinister disease. She ended up with unnecessary surgery, stayed longer in hospital nursing some complications, and her eventual bill was upwards of seven figures. The final analysis showed that all she ever needed was a simple antibiotic. The clinicians had unwarrantedly over-diagnosed and over-treated her.

So why does over-treatment occur? There’s never one single factor to explain the phenomenon. For starters, patients have their own expectations. Some aren’t ever satisfied with what may appear as simplistic diagnostic pathways. There appears to be an insatiable clamor for expanded testing, just in case. This puts doctors at crossroads, and sometimes leads to a pathway that only ends up with more testing and more interventions. At the end point, the patient never really benefits. They end up feeling good that something additional was checked, even when this was completely a waste of time.

Clinicians also play a role in perpetuating over-treatments. It isn’t unusual for some tests to be regarded as routine, meaning they get ordered without second thoughts. The blame here might be the doctor’s training background, or experience. Some doctors feel compelled to act on what is known as incidental findings. That means some unexpected condition becomes apparent whilst in pursuit of unrelated symptoms. Most of such chance findings were never going to cause harm, but some clinicians will divert their attention to such unnecessarily. Then there is the fear of missing something, which takes some doctors on a wild goose chase.

The perils of over-treatment are many. It drives the cost of healthcare upwards. You end up paying for unnecessary care. Patients get real harms with over-treatment, others actually die. It isn’t good for doctors either. It taints their overall professional standing. But can you actually avoid being over-treated? Yes, by being vigilant about your medical encounters. Ask questions. Why too many tests? Why do you need a multiplicity of interventions? Can incidental findings be left alone? Seek alternate opinions, and be restrictive with your medical consents.

Dr Alfred Murage is a Consultant Gynecologist and Fertility Specialist. amurage@mygyno.co.ke

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