Medical Overtreatment: Friend or Foe?

Hadler, Nortin M.

doi:10.1159/000486895

Cited by 2 publications

(3 citation statements)

References 28 publications

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“…The performance of unnecessary procedures on patients is termed overtreatment and is defined as the performance of unnecessary medical or surgical procedures and is a cause of preventable harm and waste in healthcare. (6,7) The performance of unnecessary procedures related to skills acquisition can also be classified as overtreatment. (8,9) Overtreatment is not without consequence and there is a risk that treatment or procedures performed unnecessarily can result in significant harm.…”

Section: Introductionmentioning

confidence: 99%

Potential Overtreatment by Paramedic Students: A Study from Three South African Higher Education Institutions

Makkink

Barnard

2022

Australasian Journal of Paramedicine

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Introduction: Healthcare students are often required to perform predetermined numbers of clinical skills to prove competence. The pressures of meeting predetermined clinical skill numbers may result in students overtreating patients. Overtreatment is not without consequence to the patient. This study aimed to investigate perceptions related to possible overtreatment of patients by emergency medical care students in three South African higher education institutions (HEIs). Methods: This cross-sectional study used a purpose-designed, anonymous online questionnaire to collect data on possible patient overtreatment from emergency medical care student participants at three South African HEIs. Results: Of the participants, 45 self-reported reasonably low incidences of overtreatment of patients. The prescribed skill requirements were deemed appropriate as were practical shift numbers, but there was concern about achieving prescribed skill numbers. Participants generally considered risk versus benefit and clinical mentors generally agreed with student decisions without permitting overtreatment practices. Intravenous (IV) cannulation, oxygen administration and spinal immobilisation were the most common forms of overtreatment with advanced airway management and IV cannulation the most difficult to achieve. Lack of appropriately qualified practitioners and low patient numbers were the most common barriers to achieving required skill numbers. Conclusion: There was concern among participants about not reaching prerequisite skill numbers. Self-reported overtreatment of patients by participants was uncommon. The list of self-reported procedures most often forming part of overtreatment seemed to contradict this. The most common forms of overtreatment were clinical procedures that posed potential risk to the patient. There is a need to further explore overtreatment within healthcare student populations.

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Section: Introductionmentioning

confidence: 99%

Potential Overtreatment by Paramedic Students: A Study from Three South African Higher Education Institutions

Makkink

Barnard

2022

Australasian Journal of Paramedicine

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“…Critics have emphasized focusing on unnecessary services before incurring irreparable costs and losses. These concerns urged Patterson in the early 21st century to dedicate efforts to forming systems that would provide efficient healthcare services (8).…”

Section: Introductionmentioning

confidence: 99%

“…While physicians play a key role in the prevalence of medical service overuse (2,8), few studies have assessed this issue from the perspective of these individuals. According to Lyu et al (2), 21% of the entire medical services in the United States are reported to be unnecessary from the perspective of physicians.…”

Section: Introductionmentioning

confidence: 99%

The Frequency and Causes of Unnecessary Medical Services in Urmia, Iran: Strategies and Control

Dindeh

Karimi

Hosseini

et al. 2021

J Kermanshah Univ Med Sci

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Background: Unnecessary prescription, diagnosis, and medical services are increasing various health problems in the world. According to the World Health Organization (WHO), over-prescription and unnecessary services are the measures that cause significant damages rather than benefits. Objectives: The present study aimed to evaluate the perspective of Urmia medical system members regarding the frequency and causes of unnecessary medical services and their control and prevention strategies in Urmia, Iran. Methods: This descriptive-analytical, cross-sectional research was performed on 102 specialist physicians selected from the Urmia Medical Association, and the selected individuals participated in the survey online. Outcome measures included the percentage of unnecessary medical care and common causes of overtreatment. Data were collected using Johns Hopkins University Unnecessary medical services checklist. Data analysis was performed in SPSS version 22 using descriptive statistics (frequency and mean) and chi-square. Results: In total, 41% of the participants (n = 43) were family physicians, and 59% (n = 59) were specialists of other medical fields. In terms of gender, 53% were male, and the others were female. The main causes of unnecessary medical services at a national level included pressure from patients (66.7%; n = 68), fear of medical malpractice (54.9%; n = 56), pressure from colleagues (23.5%; n = 24), and achieving a high rank in a performance appraisal (40.2%; n = 41). According to the participants, the development of more guidelines and instructions (47.1%; n = 48) and training residents on the appropriate use of diagnostic criteria (50%; n = 51) could be effective approaches to preventing unnecessary medical services. In addition, significant differences were observed between the perspective of the family physicians and the specialists in terms of the fear of malpractice (P = 0.002), lack of medical history (P = 0.17), pressure from patients (P = 0.25), training of residents on the use of diagnostic criteria (P = 0.001), and easier access to medical files (P = 0.001). Conclusions: From the physicians’ perspective, overtreatment is highly common in Iran. In order to solve this problem, efforts should be dedicated to areas such as medical file availability, diminishing the fear of malpractice, and more training of residents. Moreover, it is recommended that patients’ awareness be raised regarding the damages caused by unnecessary prescriptions so that they would not request frequent visits.

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Medical Overtreatment: Friend or Foe?

Cited by 2 publications

References 28 publications

Potential Overtreatment by Paramedic Students: A Study from Three South African Higher Education Institutions

Potential Overtreatment by Paramedic Students: A Study from Three South African Higher Education Institutions

The Frequency and Causes of Unnecessary Medical Services in Urmia, Iran: Strategies and Control

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