By Patty Wight
November 26, 2014
Medical treatment can cure illnesses and save lives. But too much treatment can cause harm, even death.
The Lown Institute in Boston estimates that between 10 and 30 percent of medical treatment in this country is unnecessary and racks up between $2 billion and $800 billion in extra costs. In Maine, some health care providers are changing their approach to ensure that they give patients what they call “right” treatment.
About eight years ago, nurse practitioner Tom Bartol realized that some of the care he was prescribing may not benefit his patients as much as much as he thought. He was researching statins – drugs that are used to lower cholesterol and prevent heart disease.
“And we looked at the data and we saw a 37 percent risk reduction,” Bartol says. “That’s what all the guidelines are based on – this 37 percent risk reduction.”
Sounds pretty good. But then Bartol wondered – what’s the baseline risk for heart disease for his patients? Some on statins had a risk of between 3 and 6 percent; and when you consider those numbers, that nearly 40 percent reduction in risk doesn’t sound quite as impressive.
“I started questioning the guidelines,” Bartol says. “We have a lot of clinical guidelines we’re supposed to follow. We sort of follow them like a cookbook. I was following them blindly, as I suppose many people do. They have no idea of the data behind it.”
Shannon Brownlee, a former journalist who wrote a book about medical overtreatment, came to a similar conclusion 15 years ago. She was reporting on tests to detect prostate cancer. Turns out, the test catches a lot of non-lethal cancers that don’t need treatment.
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