April 21, 2019


Why Do Doctors Overtreat? For Many, It's What They're Trained To Do (MARA GORDON, APR 19, 2019, NPR)

When family physician Jenna Fox signed on for a yearlong advanced obstetrics fellowship after her residency to learn to deliver babies, she knew she'd need to practice as many cesarean sections as possible.

The problem was, she also knew C-sections aren't always good for patients. Many women's health experts argue they're often unnecessary and increase health risks for mom and baby. Doctors are working to decrease high C-section rates in hospitals around the country. Fox and her colleagues on the labor and delivery floor at the University of Rochester try hard to prevent them, particularly primary C-sections, when a woman needs one for her first baby.

"I want to avoid primary C-sections. But also in this one year of my life I want all the primary C-sections in the world," Fox says. "It's me feeling conflicted, internally, all day, every day."

During her fellowship, she says, the more C-sections she does, the better prepared she'll be to practice independently.

Medical education is built on the assumption that the more procedures or treatments doctors see and do, the more competent they'll be when they're independent. It can feel tempting to do more rather than less.

But excessive medical tests and treatments can have financial and personal costs. They contribute to this country's rising health care spending and subject patients to anxiety and the risks of extraneous procedures. A group of medical educators thinks this epidemic of overtreatment, as they call it, starts with the habits that doctors develop during training -- habits they're hoping to break with new approaches to medical education.

Patients want treatment and doctors get paid for procedures and the costs fall elsewhere.  

Posted by at April 21, 2019 8:28 AM