This theme is focused on a common problem in healthcare systems: overuse of tests, treatment and services. There are different types of overuse in healthcare. These include doing unnecessary tests (over-testing), giving people diagnoses that they don’t need (overdiagnosis), or providing treatments or services that don’t work or make things worse (overtreatment or medical overuse). Unnecessary interventions can harm people and waste valuable healthcare resources that should be spent in areas of need. In this theme, we ask questions about how to understand the problem of healthcare overuse, and what to do about it, especially when people disagree.
Questions of medical overuse hinge on evidence about whether a condition or treatment is likely to produce more benefits than harms, but also bring in other complex ethical problems. People often care about some benefits and harms more than others (for example, harms that affect a person’s kin, or are perceived as serious, might be considered more important), and people value things other than benefits and harms (like rights, or being able to make our own choices).
With our colleagues at Wiser Healthcare, we are exploring these complex problems to contribute to better communication strategies and solutions. Our work focuses on diverse examples, including transvaginal mesh, direct to consumer pathology testing, and screening for disease. Our goal is to understand the diversity of people’s views on these complex problems, and to help make healthcare less harmful and more equitable.