Overdiagnosis and overtreatment; how to deal with too much medicine

Gupta, Puneeta; Gupta, Meeta; Koul, Neeraj

doi:10.4103/jfmpc.jfmpc_433_20

Cited by 22 publications

(15 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Such a practice, comprising overdiagnosis and overtreatment, is first and foremost the cause of a large quantity of waste, which has the regrettable implication of in the long run generating a lower quality of healthcare itself due to an ever-increasing reduction in available funds linked to increased public spending [ 30 , 31 ].…”

Section: Discussionmentioning

confidence: 99%

A Fifteen-Year Survey for Orthopedic Malpractice Claims in the Criminal Court of Rome

et al. 2023

View full text Add to dashboard Cite

The number of legal disputes in the field of medical liability has increased exponentially in the last decades. The aim of this study is to investigate the outcomes of criminal cases against healthcare professionals in Italian criminal courts. The hypothesis is that the majority of cases are dismissed and/or most professionals in these cases are acquitted. This retrospective analysis considers criminal proceedings related to medical professional liability registered with the general register of crime reports of the Public Prosecutor’s Office of Rome in the time interval between 1 January 2000 and 31 December 2015. A total of 4793 criminal proceedings were ultimately identified. Proceedings related to the field of orthopedic trauma were then examined and identified. A complete analysis of 132 of the identified files (76.7%) was carried out. The field with the highest risk of disputes was determined to be the field of trauma. The most frequent complaint was found to arise from unsatisfactory surgical outcomes following elective surgery. The most affected anatomical district is the lower limb in both elective and trauma cases, followed by the upper limb in traumatology and spine cases. The surgeon is the most frequently quoted role of the professional involved. The number of physicians actually convicted (3.93%) and for whom liability was thus recognized, i.e., the existence of a causal link between their conduct and the event that took place was established, appears to be extremely small when compared with the far more significant values related to dismissals (53%) and acquittals (14.2%). Adequate legal reform aiming to reduce this disproportion is necessary to ensure physicians experience a more relaxed daily profession and to restore the original connotations of the doctor–patient relationship with the abolition of defensive medicine.

show abstract

Section: Discussionmentioning

confidence: 99%

A Fifteen-Year Survey for Orthopedic Malpractice Claims in the Criminal Court of Rome

et al. 2023

View full text Add to dashboard Cite

show abstract

“…These pose ethical challenges in both human and veterinary medicine, including how to communicate such findings to patients or clients, and whether further diagnostics or treatments should be performed [ 20 , 21 ]. Indeed, “overdiagnosis” is a recognised problem associated with increasingly sensitive diagnostic testing for conditions such as breast cancer in human patients, leading to treatment that does not benefit and may even harm the patient (“overtreatment”) [ 22 ]. It has been also argued that over-reliance on advanced imaging may lead to a reduction in the history taking and physical examination skills of veterinarians, leading to an inflation of veterinary costs [ 19 ].…”

Section: What Constitutes Advanced Veterinary Care?mentioning

confidence: 99%

Ethical Challenges Posed by Advanced Veterinary Care in Companion Animal Veterinary Practice

Quain

Ward

Mullan

2021

Animals

View full text Add to dashboard Cite

Advanced veterinary care (AVC) of companion animals may yield improved clinical outcomes, improved animal welfare, improved satisfaction of veterinary clients, improved satisfaction of veterinary team members, and increased practice profitability. However, it also raises ethical challenges. Yet, what counts as AVC is difficult to pinpoint due to continuing advancements. We discuss some of the challenges in defining advanced veterinary care (AVC), particularly in relation to a standard of care (SOC). We then review key ethical challenges associated with AVC that have been identified in the veterinary ethics literature, including poor quality of life, dysthanasia and caregiver burden, financial cost and accessibility of veterinary care, conflicts of interest, and the absence of ethical review for some patients undergoing AVC. We suggest some strategies to address these concerns, including prospective ethical review utilising ethical frameworks and decision-making tools, the setting of humane end points, the role of regulatory bodies in limiting acceptable procedures, and the normalisation of quality-of-life scoring. We also suggest a role for retrospective ethical review in the form of ethics rounds and clinical auditing. Our discussion reenforces the need for a spectrum of veterinary care for companion animals.

show abstract

“…In spite of this epidemiological situation, data about the distribution of care provision in Switzerland is scarce [47], making it difficult to assess the numbers and specialities of the professionals involved in patient care or their degree of collaboration. However, in light of the increasing financial burden and number of annual medical consultations per capita, we may wonder whether Swiss patients face risks of information loss or discrepancies, potential concomitant over-investigation, over-treatment, complications, emergencies and rehospitalisation, with their concurrent negative effects on patient outcomes and costs [3,[48][49][50].…”

Section: Future Challenges and Opportunitiesmentioning

confidence: 99%