Patients are Receiving Too Much Care

Archives of Internal Medicine

Many physicians feel patients are receiving too much medical care, according to a report in the .

According to the survey, physicians feel pressured to do more than they really feel is needed, but there are a number of ways to reduce this: malpractice reform, realignment of financial incentives and having more time with patients.

Health care spending in the U.S. exceeds that of comparable countries, and it’s growing at an “unsustainable rate,” according to the authors. The authors were looking into suggestions that “a substantial amount of U.S. health care is actually unnecessary.”

Nearly half (42%) of the physicians surveyed believed that their own patients received too much medical care and just over half (52%) replied that the amount of care was just right. The remainder thought that their patients received too little care.

While physicians thought they (28%) or others in their community (29%) were practicing too aggressively, a much higher percentage reported that mid-level primary care clinicians and medical subspecialists practice too aggressively — 47% and 61%, respectively.

Of the three factors that cause physicians to practice too aggressively, malpractice concerns were the most important and 83% of physicians believed they could be sued for not ordering a test that was indicated. Three-quarters of respondents identified malpractice, while 52% said clinical performance measures and 40% said not enough time spent with patients.

According to the authors, physicians want to practice more conservatively with how they treat their patients.

“Physicians believe they are paid to do more and exposed to legal punishment if they do less,” the authors wrote. “Reimbursement systems should encourage longer primary care physician visits and telephone, e-mail and nursing follow-up, rather than diagnostic intensity.”