5 Ways to Protect Yourself From Overtreatment

By Everyday Health Guest Columnist

Published Sep 1, 2015

By Leslie Michelson, Special to Everyday Health
The United States spent $3.1 trillion on healthcare in 2014. And according to experts, about 30 percent of healthcare spending — almost $1 trillion — is regularly wasted on unnecessary tests, treatments, and procedures each year.
In my 30 years of helping people better navigate our medical system, I’ve seen overtreatment that’s as simple as a doctor’s prescribing antibiotics for the common cold or flu (which are caused by viruses, not bacteria that antibiotics fight), and as disastrous as a patient rushing into chemotherapy, only to learn she was diagnosed with the wrong cancer and must begin anew with a different therapy.
Staying keenly attuned to your physician’s recommendations, and to your emotional responses to them, can help you protect yourself from overtreatment. And to determine if you may be at risk of overtreatment, be aware of these five signs:

1. Your Physician Wants You to Start Treatment Immediately

Even if you’re facing a serious medical problem, there’s still usually at least a small window of time to do more research and consult with other experts. So take a step back and ask your doctor:

• What are the side effects of this treatment, and are they reversible?
• What will happen if we don’t do it?
• Are there less invasive options we can try first?

Then listen to your gut: Are you being sold something you may not need?

2. You’re Sent for Surgery or Imaging Tests Before the Doctor Has Even Seen You

A physician needs to examine you, listen to your medical history, and thoroughly review your records in order to come to an educated hypothesis about your problem. Only then should he or she prescribe an MRI, CT scan, or exploratory surgery to potentially confirm or deny a diagnosis.
If you’re being asked to undergo these procedures first, or if you’ve recently undergone them at another physician’s behest, be wary. Ask:

• How will the results of this procedure affect my treatment plan?
• Will they help rule out or confirm a diagnosis?
• I’ve already had this procedure and don’t want to repeat it if I don’t need to. Have you reviewed my previous results?

It’s possible that your doctor has a good reason, but hasn’t explained it to you properly. Give your doctor the chance. And if you’re not confident in the response you get, let the doctor know that you’d like to do some research first. The Choosing Wisely lists, created by the American Board of Internal Medicine, provide excellent talking points about certain types of commonly overused procedures.

3. You’re Upset That Your Physician Isn’t Prescribing Treatment

Sometimes we are in such a rush to get a medical problem behind us that we encourage our doctors to prescribe interventions we may not need.
Pay close attention to your emotional state. Are you seeking a quick fix? Do you feel disappointed when your doctor wants to wait, watch, and think it through?
Some health problems warrant progressive care relative to the symptoms you’re experiencing, and what’s been found on physical exams and diagnostic tests. For instance, with back pain you’d want to move slowly, first trying rest, then physical therapy, then maybe steroidal injections to see if the pain subsides. You’d resort to surgery last, and only when absolutely necessary.
On the other hand, if there’s a lump in your breast, it requires intervention sooner. But even then, you still have time to look up the treatment guidelines at the National Comprehensive Cancer Network and become more informed.

4. Your Doctor Is Dismissive of Your Viewpoint

Your physician needs to respect that you are the decision maker when it comes to your care. That means he or she takes the time to share the reasons for any recommendations, what the side effects might be, and what the less-invasive options are.
Ask your doctor to speak honestly with you about the risks and benefits of each intervention or treatment so that you’re making intelligent decisions. If you get curt answers — you have to do this; there’s no alternative option; there’s a range of side effects — you should consider getting additional opinions from specialists who are experts on your specific condition.

5. You’re Not Convinced That Living With Your Disease Is Worse Than the Side Effects of Treatment

Sometimes physicians are so focused on a single condition that they fail to consider the whole human being in front of them, who may have a multitude of other health problems or personal issues that complicate a treatment decision. This is especially true when the patient is elderly or frail.
A July 2015 study in the Journal of the American Medical Association, for example, found that end-stage cancer patients who were given chemotherapy to make their last few months more bearable actually did not benefit, and some patients suffered much worse than if they’d received no treatment at all.
The decision about how, when, or if to treat is yours alone. As a patient, remember that as long as you are making informed and thoughtful choices about what you want, there is no wrong approach.
Leslie Michelson is the founder and CEO of Private Health Management, and the author of The Patient’s Playbook: How to Save Your Life and the Lives of Those You Love.
Photos courtesy of Penguin Random House