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Doctors say they are delivering unnecessary care
10/13/2011
 
The U.S. healthcare system is primed to deliver unnecessary care to patients, because of defensive medicine or quality measurement requirements or because of financial incentives, according to a survey of primary care physicians by Archives of Internal Medicine.

The survey found that 42% of the 627 respondents believed patients in their own practice were getting too much care. Only 6% of doctors believed their patients were getting too little care. (The rest thought the level of care was just right.) And 28% of the doctors thought they themselves were practicing more aggressively than they would prefer to, according to results reported by the Wall Street Journal.

Dr. Brenda Sirovich, an author of the study, noted 83% of physicians thought they could easily be sued for failure to order a test that was indicated, but only 21% thought they could be sued for ordering a test that wasn’t indicated. The incentives point toward “when in doubt, do more,” she told the newspaper.

The Journal added that 52% of physicians cited clinical-performance measures as a reason for excessive care. “Almost universally, they’re in place to make sure you’re doing enough for the patient,” Dr. Sirovich commented. Rarely do they attempt to make sure physicians aren’t doing too much.

The survey also revealed that physicians believe financial incentives sway decisions about care, but most thought they affected other physicians. “Only 3% said financial considerations influenced their own care decisions while 39% said they affected other primary-care doctors and 62% thought they affected sub-specialist physicians,” the Wall Street Journal reported.