In The News: Reporting on Overuse, Communicating with Older Patients

Washington Health Alliance reviewed low-value health care services across the state and in February published a report, First, Do No Harm: Calculating Health Care Waste in Washington State, which was endorsed by The Washington State Choosing Wisely Task Force.

The Alliance measured 47 common tests, procedures and treatments that clinician-led national initiatives such as Choosing Wisely and the U.S. Preventive Services Task Force have determined are overused. The findings show that more than 45 percent of the healthcare services examined were low value or wasteful, nearly half of the 1.3 million patients in the analysis received low-value care and the overuse of care amounted to an estimated $282 million in unnecessary spending in one year. The report also emphasizes important action steps the community can take to address this critical issue.

By shedding light on the scope of overuse in one state, the report also generated national media coverage. ProPublica and NPR co-published an article about the report and connected it with another major story the same week involving a joint venture between Amazon, Berkshire Hathaway and JPMorgan to lower their healthcare costs. Dr. Marty Makary, a professor of surgery and health policy at the Johns Hopkins School of Medicine, wrote a column in USA Today that also focused on the new venture. In addition, he connected the Alliance report with a growing body of scholarly research that challenges whether non-surgical treatments for knee replacement, appendicitis, thyroid surgery and many other common treatments are always necessary.

The University of Michigan recently released a video and accompanying materials related to its March report: Too much of a good thing? Overuse of health care. The report analyzes findings from The University of Michigan National Poll on Healthy Aging, which surveyed more than 2,000 Americans between the ages of 50 and 80. According to the report, only 1 in 7 older adults think more medical treatment is usually better, but 1 in 4 agreed that their own physician often recommends treatments they don’t think they really need. However, results also showed that nearly 1 in 10 older adults indicated that, in the last year, a healthcare provider told them that they did not need a medication, test or procedure that they thought they needed.

Feedback indicates that improving doctor-patient communication could reduce the mismatch of opinions and reduce the use of unneeded tests and the accompanying costs. Researchers note that the Choosing Wisely website “provides specific examples [of low-value care], based on medical research, and gives explanations using language that both patients and providers can understand.”

The report was also referenced in an NPR story about doctors and patients making decisions about operations at the end of life. The story points out that many Medicare patients undergo an operation in the year before death, though the harms usually outweigh the benefits. Dr. Rita Redberg says, “We have a culture that believes in very aggressive care. We are often not considering the chance of benefit and chance of harm, and how that changes when you get older. We also fail to have conversations about what patients value most.”