Human beings are creatures of habit. Psychology researchclearly demonstrates that people develop automatic responses to specific conditions which become more ingrained with repetition, even if they may not be the best choices.
We often think of doctors as immune to these human imperfections. But research demonstrates that physicians are also creatures of habit when it comes to prescribing medical tests and treatments even when new research has demonstrated that these treatments are not effective.
Each year, medical journals published by the American Medical Association document medical overuse—i.e., when doctors recommend medical interventions that are not helpful. Within the last year, researchers published systematic reviews detailing medical overuse in the JAMA Pediatrics and JAMA Internal Medicine.
The list of medical interventions that are no longer recommended may surprise you:
- Studies demonstrate that commercial rehydration drinks for children, such as Pedialyte, are no better at hydrating sick kids than any other clear fluids, even though these rehydration drinks promise—and cost—more.
- Another example is treatment for early-stage prostate cancer. Research shows that many patients diagnosed with prostate cancer in the early stages have a type of cancer that is not likely to grow or spread. But the treatments for early-stage prostate cancer – radiation therapy or surgery – include serious risks including death, incontinence, and erectile dysfunction.
- Many times, x-rays are unnecessary for ankle injuries and knee surgery is not helpful for torn cartilage.
- Inducing delivery for pregnant women who do not have complications or risk factors is not recommended because it leads to an increased risk for hemorrhage in the mother and increases the likelihood the baby will be delivered by Cesarean section, which carries its own risks. During induced labor, babies experience more stress. And after they are born, they have an increased risk for developmental delays.
The American Board of Internal Medicine created a non-profit organization that is addressing the problem of medical overuse. The Choosing Wiselyinitiative aims to encourage conversations between medical providers and patients about unnecessary tests and treatments.
The initiative includes lists created by national medical specialty societies that provide information about potentially unnecessary tests, procedures and medications and a link to medical literature that supports the recommendation.
Choosing Wisely recommends avoiding screenings for testicular cancer, genital herpes, and all cancer screenings in adults expected to live less than 10 years. They do not recommend removing dental fillings with mercury in them, or prescribing antibiotics for typical ear infections in children, or prescribing any cough or cold medicines to children.
The take-home message: As research findings evolve, it’s natural that unnecessary medical interventions continue to be a part of our health care system. Understanding the evidence surrounding your own health and asking your health care provider clear questions about his or her recommendations can help you avoid medical interventions that you not only don’t need, but could potentially harm you.