We usually assume that the primary problem with health care in the U.S. is that so many people don’t have good access to it. But while many Americans suffer because of lack of medical care, others undergo unnecessary procedures or take potentially dangerous drugs they don’t really need. How does the health care system lead to overtreatment and what are the consequences?

Guest: Shannon Brownlee, essayist and writer, has written for The Atlantic Monthly, the New York Times, The New Republic, Slate, Time, Washington Monthly, the Washington Post, and the Los Angeles Times, among other publications.

Ms. Brownlee is a Schwartz Senior Fellow at the New America Foundation, a non-partisan think tank in Washington, D.C. Overtreated: Why Too Much Medicine Is Making Us Sicker and Poorer,  is her first book.

She is the winner of several prestigious journalism awards, including the 2004 Association of Health Care Journalists Award for Excellence in Health Care Journalism, the Victor Cohn Prize for Excellence in Medical Science Reporting, the National Association of Science Writers Science-in-Society Award, and the Sigma Delta Chi Award from the Society of Professional Journalists.

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  1. Richard C
    Reply

    I couldn’t agree more with the theme of this article. Our health care incentives are to overuse health resources for those with insurance and other assets.
    I think all are involved but the hospitals are the largest offenders particularly the “not for profits”.
    From my perspective in Utilization Management, perhaps a third of hospital full admissions are not necessary. In the meantime the hospital contracts with doctors who churn out many unnecessary outpatient tests.

  2. harriet
    Reply

    I enjoyed listening to this program. I am a very healthy 56 year old female. A couple of months ago I experienced lower right quadrant abdominal pain with diarrhea, nausea, anorexia and low grade fever. The pain began around my navel but gravitated to my right side.
    Given that I almost never get sick, and it was a Saturday, I took myself to the ER and was admitted. My blood work showed an elevated white blood cell count. After seeing at least two different physicians, the second one ordered a CT scan. Before the scan, I had to drink 20 liters of dye.
    This took me about 3 hours to get down, given my nausea. During this time my fever spiked to 104, which I believe was caused by the pressure of all that extra liquid in my abdomen. I also vomited several times. To no surprise, the CT scan showed that I had appendicitis! The cost of the scan was over $2000. Was it necessary? I’ll let you decide.

  3. pvh
    Reply

    What an interesting program. As a childbirth educator/lactation consultant I have observed over 25 years, the increase in use of Cesarean delivery. With a probable “natural” incidence of 8-15%, the national stats now are around 25-30% at last glance. The complicated reasons for this surgery too many to discuss here. Risk/benefit/alternatives and good communication with caregivers is one way parents are encouraged to participate in obstetric (medical or management) decisions. I anxiously await reading Ms Brownlee’s book.

  4. mariane
    Reply

    What about pts who have been on multiple Rx that all present disease interactions for same disease which causes a risk for the pt-esp those over 65yrs? I have been on 8 that I now find have disease interactions re kidney disease (1 in 9 of us have) and I now am in a Cl 3 of KIDNEY DISEASE! Use same dr and same pharmacy…. and had to look Rx up in John Hopkins Drug bk for over 50 yr folks.

  5. JLS
    Reply

    One source of waste is physician self-referral. Doctors with imaging equipment in their offices order 2 to 10 times the number of studies as physcians who do not own equipment. Dr David Levin in the Journal of the American College of Radiology 2004 1:169-172 estimates 16 billion dollars per year in unnecessary exams.The majority are read by under-trained doctors!

  6. Gina
    Reply

    Please note that federal law prohibits physicians from benefiting directly in terms of their compensation from the ancillary services they order such as imaging, labs, and medications. Ms. Brownlee suggested otherwise on your program. The implication that increased physician compensation is the driver of overuse is not accurate and misleading.

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