Robert Pearl, MD, Warns of Overtreatment in Health Care

One of the biggest myths about staying healthy is that more care is better care, Robert Pearl, MD, writes in an April 24 post on the University of Southern California Annenberg Center for Health Journalism website. Dr. Pearl, CEO of The Permanente Medical Group and Mid-Atlantic Permanente Medical Group, adds that commonly held belief is not only false but quite dangerous.

“Overtreatment can be harmful to patients,” he says, “with the complications at times worse than the original problem.”

The article cites four reasons for the state of overtreatment in health care, which include:

• A culture that values intervention over prevention
• A fee-for-service reimbursement system that rewards volume over value
• Direct-to-consumer advertising that encourages the latest, most expensive drugs and invasive procedures
• Physicians’ lack of time and incentives to explain why a procedure or drug can make a difference

Offering hope for knowledge and empowerment, Dr. Pearl highlights four ways to bring about change.

1. Provide all patients with decision-making tools, such as videos and podcasts that will help them understand procedures.
2. Shift to value-based pay practices rather than ones based on the volume of services to eliminate skewed incentives of the fee-for-service payment system.
3. Require companies to compare new procedures, devices, and drugs to lower-cost alternatives to determine whether newer is better.
4. Reduce medical malpractice suits to lessen unnecessary care delivered by physicians practicing “defensive medicine.”

Doing right by patients, Dr. Pearl writes, means prescribing interventions that have been proven to work, and recognizing how often less is more. Read the full post here.