Today I offer you an exclusive preview of a forthcoming late summer blockbuster. Due for premiere later this year, it will be a medical drama billed to be more engaging than Terminator: Genisys and more disturbing than Paranormal Activity: The Ghost Dimension. Directed and produced by an internationally respected team from America, Canada and the UK, the drama will be called ‘Choosing Wisely’ and the star of the show will be… you. ‘Choosing Wisely’ isn’t a movie but it is a health campaign that promises to reveal all about an ongoing medical scandal – and a scandal in which you may unwittingly be a part of.
‘Choosing Wisely’ tells the tragic tale of how today doctors routinely dole out medicines and order expensive tests unnecessarily. A recent survey has revealed that eight out of ten GPs admit to having given patients treatments they didn’t need. Perhaps it is to appease demanding patients; perhaps it is because it feels better to do something rather than nothing at all. It is an increasingly costly problem – an estimated £2bn a year is wasted every year sending people for unneeded X-rays, MRI scans and blood tests or for medicines that almost certainly won’t help. And that’s before you consider the stress and anxiety brought on by these unnecessary procedures.
This isn’t a new issue though and our expectations can be partly to blame. Go into any GP practice waiting room and most people will tell you what they want from their appointment – a test, an antibiotic, a sick note, or perhaps just an understanding ear. Sometimes we can think that a modern medical test will offer us the answers and the reassurance we need. Rarely is this true. No test is perfect and a false or indeterminate reading can cause weeks of worry and anxiety. An inappropriate investigation can even lead you down a rabbit hole that goes nowhere good. In the USA, for example, the number of people receiving MRI scans for back pain has been going through the roof in recent years – mostly just because the test exists. As a result, rates of back surgery and pain-killer injections are soaring. Faced with a scan result, orthopaedic surgeons want to help but evidence shows that many of the treatments they offer don’t work well – if at all. Many back pain sufferers would ultimately be better off without ever receiving the test.
We who are in the UK may not yet have the problems of over-testing that there is in the United States, where almost a third of all healthcare spending is estimated to be wasted on unnecessary procedures. We are catching up and have already learnt a thing or two about how to sue healthcare professionals when they miss a diagnosis. Right or wrong, doctors often say that fear of missing a one-in-a-million diagnosis – and being taken to court for it – causes them to order unnecessary blood tests and x-rays.
The ‘Choosing Wisely’ campaign started in the USA and hopes to put the brakes on out-of-control testing and prescribing. It will see experts being tasked with dumping treatments that don’t really help – just like how tonsil removal for kids was abandoned about thirty years ago. Your doctor will also be tasked with trying to better explain the potential harm any treatment or test may cause.
Importantly, all healthcare professionals will be on a mission to only recommend what is truly necessary.
Your job is to simply decide whether you really need that test or tablet. So just choose wisely.
Thanks for reading – all opinions expressed are my own. Feel free to add your thoughts in the comments below. Follow @realdoctorstu