Health leaders launch call to action on too much medicine

Australians are being overdiagnosed and overtreated and it needs to change, say leading Australian clinicians, consumers and policy makers.

In a statement, endorsed by the Consumers Health Forum, The Royal Australasian College of Physicians, the Royal Australian College of General Practitioners, the Royal Australian and New Zealand College of Radiologists and the Australian Commission on Safety and Quality in Healthcare, the Wiser Healthcare research collaboration said that there is growing evidence and concern about the problem of too much medicine.

“Overdiagnosis and the related overuse of medical tests and treatments not only causes harm, but also divert resources from addressing underdiagnosis and undertreatment,” the statement read. “There is a need in Australia to identify the causes of too much medicine, the extent of the problem, and to develop responses to address it.”

Wiser Healthcare team member and University of Sydney professor Kirsten McCaffery said this is the first coordinated national effort to address a problem now recognised worldwide as a significant threat to healthcare.

McCaffery’s Wiser Healthcare colleague and Bond University academic Dr Ray Moynihan said unneeded tests, treatments and diagnoses not only threaten human health, but also health system's sustainability.

“The problem of too much medicine is driven by many factors – including the best of intentions,” Moynihan said.

The group’s statement pointed to expanding disease definitions and lowering diagnostic thresholds as drivers of the problem. “The processes for changing definitions require meaningful reform,” it read.

Released at the same time as the statement, an article from Bond University researchers in The British Medical Journal (BMJ) said other factors at play include the cultural belief that in medicine more is better as well as financial incentives for doctors to perform tests and treatments.

Lead author Dr Thanya Pathirana, along with Bond’s Justin Clark and Moynihan, said potential solutions include public awareness campaigns, changes to educational curricula for health professionals and a move towards shared decision-making.

Wiser Healthcare said there is an urgent need to better inform consumers, clinicians, decision-makers and the public about the evidence for and the consequences of overdiagnosis and related overtreatment, as part of a broader approach to inform people about the potential harms as well as the benefits of medical tests and treatments.

Overdiagnosis and related overuse. Mapping possible drivers to potential solutions. COI=conflict of interest; OD=overdiagnosis; OU=overuse. Source: BMJ

Click here to view the BMJ article.

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