The five questions to ask your doctor to avoid ‘over-diagnosis’

Rising concern about over-diagnosis can see healthy people treated as sick.

doctor questions

Expanding definitions of some diseases have led to rising concerns about healthy people being diagnosed as ‘sick’ and receiving treatments they don’t need.

According to the Consumers Health Forum of Australia (CHF), over-diagnosis can often do more harm than good.

To avoid unnecessary treatments, CHF recommends patients discuss any decisions with their doctor to ensure they are well-informed.

CHF has joined other health organisations in endorsing the Wiser Healthcare collaboration promoting the development of a national action plan to prevent over-diagnosis and over-treatment in Australia.

CHF Chief Executive Leanne Wells says the emergence of this issue is a further good reason why patients should feel comfortable asking their doctor about a new treatment and about evidence for its efficacy.

“Medical advances have brought huge benefits, of course, but that has also increased the risk of doctors going a step too far in treating patients,” Ms Wells explained.

“The British Medical Journal has raised concerns about the over-diagnosis of common conditions including pulmonary embolism, chronic kidney disease, depression, high blood pressure and osteoporosis,” she said.

“This not only exposes patients unnecessarily to risk but also generates extra costs at a time when health budgets are under pressure.

“The more patients are engaged and informed about their treatment the more likely their outcomes will be positive.”

The five questions patients should ask their doctors and healthcare providers to avoid being over-diagnosed are:

• Do I really need this test or procedure?

• What are the risks?

• Are there simpler, safer options?

• What happens if I don’t do anything about the condition?

• What are the costs?

Andy Carr, a professor of surgery at the University of Oxford, found that many surgeries don’t perform much better than a placebo.

Mr Carr and his colleagues reviewed 53 trials of less invasive surgical interventions (ones that did not include cutting open entire cavities or lots of dissection) and found that, for half of the surgeries tested, there was little sign that they were any better than a placebo.

Some of the surgical interventions that have been tested worldwide and have failed to convince include: arthroscopy for arthritic knee; spinal cement injections for vertebral fractures; some gastric balloon procedures for obesity; meniscectomy (the surgical removal of all or part of a torn meniscus in the knee); sphincterotomy to reduce pain after gall stone removal; and laser surgery for angina.



    To make a comment, please register or login
    11th Sep 2017
    Seems to me the real issue here is not over diagnoses but over treatment once a diagnoses is made.
    11th Sep 2017
    Yes, and another major problem that never seems to be discussed is when to stop the medication as it may not be needed anymore. So many Doctors very rarely say, come back and see me in a few weeks or months to test if the prescription/s are still needed! We just keep taking the tablets until it produces side effects to other parts of our body, like my Specialists over prescription of statins, causing near kidney failure...
    11th Sep 2017
    Jem, were you on a high dose?
    Which statin?
    11th Sep 2017
    I couldn't agree more, 6 months ago I had a heart attack, I had 3 stents inserted, the last thing I want to do is complain, after all my life was saved for which I am very grateful, but I do have to question the ammount of pills I am taking, I am taking at least 2 types of blood thinners, statins even though my colestral was normal, I am taking 3 other pills that are related to prevention of another heart attack or stroke, now I realise that these pills were given to me immediately after my heart attack, but no one seems to be able to tell me how long I have to continue with all of these pills, with all the blood thinners I am taking I am constantly bleeding, I reported this to my GP who doesn't want to change my medication until I see my specialist in 2 weeks time, I can't see him earlier as he is on holidays. The medication I am on was prescribed when I was in hospital and I haven't been examined since, so how is a determination made if the medication is having the desired effect.

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