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When it Comes to Medical Care, Sometimes Less Is More

Medical mistakes can take many forms, which makes them difficult to track and even harder to prevent. Many doctors respond to the possibility of errors by ordering more tests to confirm their diagnoses or to make sure they've covered every possibility in their patients.

This kind of defensive medicine is meant to prevent medical mistakes and shield doctors from medical malpractice claims. After all, running more tests and trying to anticipate medical problems should help healthcare professionals catch things they might otherwise miss.

But, as the data regarding medical errors has shown time and time again, defensive medicine is not reducing these preventable errors. Medical mistakes still kill about 200,000 Americans every year, making them a leading cause of death in the United States.

According to neurosurgeon and medical correspondent Sanjay Gupta, this excess caution hurts patients instead of helping them. Each new test, prescription or procedure provides another opportunity for mistakes or adverse reactions.

Unnecessary care can unexpectedly introduce problems, not solve them, for patients.

  • Scans like CTs and M.R.I.s can cause false positive diagnoses and lead to unnecessary surgery or medication.
  • Prescribing multiple medications increases patients' likelihood of overdose, dependency or allergic reaction, particularly when those medications are incompatible or play off of each other's side effects.
  • Even basic surgical procedures require anesthesia, which increases a patient's risk of heart problems.
  • Perhaps most troubling, doctors practicing defensive medicine sometimes admit to turning down high-risk patients to avoid potential mistakes and medical malpractice claims. Defensive medicine leads to some patients being over-treated while others can't get the care they need.

When efforts to curb medical errors result in more mistakes, both doctors and patients are in a difficult position. Fortunately, there are measures to help curb these serious errors and foster a healthy, patient-focused environment in clinics and hospitals. Instituting time-outs and extra checks to ensure that the right procedure is being done on the right patient can help, as can an open environment in which hospital staff feel safe questioning decisions and procedures.

"When doctors are asked by their colleagues to justify the tests they ordered the procedures they performed, perhaps they will be reminded that more is not always better," said Gupta.

Source: The New York Times, "More Treatment, More Mistakes," Sanjay Gupta, July 31, 2012

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