Addressing Unnecessary Healthcare: A Comprehensive Report

This report delves into the critical issue of 'too much unnecessary care' within the healthcare system, analyzing its multifaceted impacts and proposing comprehensive solutions. The introduction establishes the problem of excessive and costly healthcare services, including overdiagnosis and overtreatment. The report then explores the primary effects of unnecessary care, such as increased healthcare expenditure, and secondary effects like patient anxiety and potential health harms from unneeded procedures. It also identifies the tertiary effect of increased medical waste. To address these issues, the report suggests short-term steps, such as collaboration between doctors and patients, and medium-term steps, like implementing policies to reduce unnecessary spending. A long-term solution involves shifting the focus from the volume of care to its value. The report also acknowledges potential barriers, such as lack of coordination and political challenges, offering mitigation strategies. The ultimate goal is to improve the quality of care and patient outcomes while reducing overall healthcare costs and waste.

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Name of the Author
Name of the University

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Introduction
Any healthcare which is provided with a higher volume or greater cost than required is
considered to be unnecessary care or too much unnecessary healthcare. The cost of healthcare is
usually higher in the United States of America as a GDP percentage and the most significant
factor that contributes to it is its expense. In the United States of America, too much unnecessary
care also refers to the overtreatment or overdiagnosis of any condition that doesn’t need that
much care or attention (YARLAGADDA, 2017). This type of care is economically associated
with overmedicalization. This unnecessary care is also the major cause of increasing medical
waste in the US. It has been observed that a large number of patients in the US receive lots of
diagnostic tests and treatment procedures that are not actually needed. Even, the screening for
cervical cancer is recommended to be performed every three to five years, many women get it
done every year. A lot of healthy patients are pushed to perform unnecessary lab procedures
whether they require it or not. Various doctors order different heart tests like electrocardiograms
and other tests for heart annually to those people who don’t have actual need of them. All of
these activities cost a lot of expenditure to the healthcare system and the people going through
them. According to the data, around six lakh patients went through treatment which is not really
needed and the cost of these treatments is estimated at around two hundred and eighty-two
million dollars. Additionally, some reports suggest that a large portion of the money spent on
these lab procedures went to unnecessary care. Around three in four women perform cervical
cancer screening unnecessarily even when their prior screening tests were adequate (ALLEN,
2018).
Effects of this Problem:

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The primary effect of too much unnecessary care is the higher range of expenditure spent
on the tests and procedures performed on the patients unnecessarily. According to a study
conducted by Aaron Carroll, of overall medical care provided to the patients around twenty
percent was not actually required. This overall medical care comprises one-fourth of diagnostic
test procedures, around a fifth of prescriptions, and more than a tenth portion of laboratory
procedures. According to his studies, mostly doctors ordered these tests and procedures because
of fear of being sued for malpractice. This practice is known as defensive medicine which is
ordered to lower the risks of lawsuits. Also, there are many patients who want to be extra
cautious about their health and they want no risk and ask doctors to perform various tests and
procedures to double confirm the occurrence of any condition. As suggested by some researches
that usually doctors overestimate the amount of care required by the patient and believe that the
patients actually needed it. Hence, they assure patients that they actually need it. This is the
reason that a large amount of money spends on these procedures unnecessarily and the primary
cause of bankruptcy in the United States of America is medical bills that affect financially to
patients and their families (Carroll, 2017).
The secondary effect of unnecessary care in healthcare is the harm to the health of
patients due to non-essential diagnostic tests and laboratory procedures performed in order to just
confirm the occurrence of any medical condition. Due to a large number of treatment procedures
or follow-ups recommended by the doctors just to prevent themselves from being sued for
malpractice, patients going through these tests have to face anxiety. Anxiety and depression are
the most common factor in most of the cancer patients and survivors. The common triggers for
the anxiety and depression in these patients and survivors are the costs and surveillance scans
performed to understand the actual condition of these patients. However, sometimes, these tests

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and procedures are not actually required. The results of the tests and treatments affect the
confidence of the patients and can have long-term implications for employment and insurability.
Additionally, when these tests are performed repeatedly on the patients, they can also cause harm
to the health of the patients. Sometimes, the tests are performed for scanning a particular medical
condition, but several times due to the constant repetition of these tests, patients develop a totally
new and different infection which can be hazardous to the health of patients (Hicks, 2015). As
evidenced by several studies, due to the overtreatment of patients, there are higher chances of
harm to the patients’ health. For example, when antibiotics are provided in a higher amount, it
can cause resistance to that antibiotic in the patients due to the overuse of that antibiotic.
Additionally, there is a higher chance of developing an infection of Clostridium difficile if
diagnostic testing like colonoscopy and pap smear is performed regularly or overly. Also, many
patients suffer from inherent postoperative complications due to the overuse of unnecessary
surgical procedures (Lyu et al., 2017).
The tertiary effect arising from the problem is the increasing amount of medical waste.
According to a study conducted by Bryn Nelson, there are a lot of cases where the doctors
utilized repetitive medical tests for diagnosis and treatment. However, these tests were actually
not required at that time and lead to a large amount of medical waste. Sometimes, the doctors
prescribe a troponin blood test for a longer period of about twenty to twenty-five days to the
patient who didn’t have any cardiac condition. However, only three consecutive tests are
required to rule out the condition of the heart attack. There are many cases in which doctors
recommended patients to perform unnecessary CT scans just for a simple abdominal pain.
Additionally, some cases showed the delayed treatment for the actual condition due to the over-
diagnosis of the condition (Nelson, 2015). All of these diagnostic tests and treatment procedures

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result in the generation of a large number of wastes of medical resources which can be utilized
for some truly essential medical conditions. This can affect patients in all ways emotionally,
physically, and financially (WELCH, 2017).
Steps to Address This Problem:
To address the problem of too much unnecessary care, the short-term step should be the
association of doctors and patients to lower the healthcare waste. It has been observed that a
large number of decisions for healthcare are taken every day such as visiting a doctor,
performing a medical test, filling the prescription, or going through a procedure. All of these
activities have been associated with several benefits, costs, and risks. Numerous of these choices
are properly evidenced by clinical proofs and expertise. However, sometimes, these are driven by
habit or misaligned economic motivations that lead to considerable overuse of unnecessary and
harmful services (Saini, Brownlee, Elshaug, Glasziou & Heath, 2017). The American Board of
Internal Medicine Foundation has launched a campaign named Choosing Wisely in 2012 where
healthcare providers and patients discussed the problem of unnecessary care in healthcare or
overuse of tests and treatments (Crema & Verbano, 2017). For this purpose, several videos and
brochures can be utilized to educate patients and healthcare providers so that they can understand
why it is important to address this issue and how they are wasting medical resources. Through
this step, they will understand how these resources can be utilized where they are actually
needed. This step will be beneficial in changing the culture of healthcare in the United States of
America (Kerr & Ayanian, 2014).
The medium-term step to address this issue is to make some policies that will help in
reducing financial expenditure on unnecessary care. It has been observed a large amount of
expenditure spent every year on medical resources and it has been found that most of this

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expenditure is not actually needed. Therefore, the government should make some policies so that
the patients and healthcare providers should understand where they have to stop the spending
over-diagnosis or treatment (Stadhouders, Kruse, Tanke, Koolman & Jeurissen, 2019). For
example, for cervical cancer screening, the government should mandate that women will go for a
pap smear test every five years instead of every year as cervical cancer screening is needed every
three to five years. However, most patients and doctors perform it every year just because of
fear. Additionally, if a patient needs to go through some surgery, only required tests should be
performed. If this step will be followed properly, it will help in reducing a lot amount of money
spend on medical testing and treatment, which will ultimately help patients and their family from
getting bankrupt. Also, according to certain guidelines, after any car accident, CT scans are not
essential. However, mostly, healthcare providers prescribe it to safeguards themselves from
being sued for malpractice. This can be avoided (Kolata, 2010).
The third and long-term step to be taken to address this issue is to shift focus from the
volume of care provided to the value of care provided to the patients. Currently, most of the
doctors focus on the only volume of care given to the patients. They just recommend a large
number of tests and treatment procedures to confirm or cure any medical condition. However,
they need to understand that in spite of the amount of care provided to the patients is not that
significant. Rather it is important to provide quality of care to the patients so that they can be
cured easily and appropriately in the minimum possible time with minimum possible
expenditure. Ultimately, this shift of focus will improve the coordination of care and provision of
services so that it can manage the population efficiently. This will help in getting better outcomes
and quality of care for the patients. This step is strongly recommended to improve unnecessary
care issues and the performance of healthcare services in the long-term. When high-quality care

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will be given to the patients, this will improve the infrastructure of the healthcare system, which
will improve ultimately resolve the problem of too much unnecessary care given to the patients
(Bhatt & Bathija, 2018).
Barriers in Addressing This Problem:
There are many barriers or challenges that are expected to arise when these steps will be
followed to address the issue of unnecessary care in healthcare. When the doctors and patients
will work together to improve this issue, lack of coordination will be the primary barrier that will
affect the resolution of this issue. At an organizational level, it is quite possible that the proper
follow up of this step will not take place due to certain barriers like the absence of appropriate
leadership, lack of proper interaction between healthcare providers and patients, and improper
uniformity in the activities of physicians. Another barrier will be the duplicity of diagnostic tests
and laboratory procedures as well as treatment procedures. If repetitive blood draw will be
applied to an elderly patient, it will cause anemia to the patient. Hence, to resolve this challenge,
it is important that every healthcare provider and patient must be in proper coordination so that
the problem of unnecessary care can be resolved (Osorio et al., 2019).
The secondary barrier which would come if policies will be made to improve this issue is
the involvement of politics. It can be expected that when any healthcare provider tries to provide
low-cost quality of care, he has to face certain political challenges that limit services or shut
down that services. To resolve this challenge, it is important that the government should take
quick and strict actions. Also, the government should make policies for this purpose by just
considering the quality of care given to the patients and expenditure expected to be spent so that
it will benefit the patients in every way (Khan & Hashmani, 2018).

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Language can be another barrier to resolving the issue of unnecessary care in healthcare.
There are a large number of people in the United States of America who speak other languages
than English. In providing effective and quality of care to the patients, sometimes, it is expected
that healthcare providers will be unable to understand the exact medical condition of the patients
or patients will be unable to communicate their exact problem to the physician. This will
ultimately affect the quality of care given to the patients and leads to the provision of
unnecessary care because of a lack of communication between patients and doctors. To resolve
this challenge, every healthcare organization must have an interpreter who can communicate the
medical condition and requirements of patients to doctors and other healthcare professionals
(Wolz, 2014).
How are the Solutions Suggested Create Better Overall Value for the Patients?
The solutions suggested above are of great value to the patients in terms of unnecessary
care given to the patients as to when patients and healthcare providers will be educated about
hazards of the unnecessary care, they will try to improve it. For example, when patients will
understand the ill-effects of consuming overdose of antibiotics, they will not ask doctors to
prescribe it unnecessarily (Moriates, Arora & Shah, n.d.). Also, when healthcare providers will
understand that there will be no actions taken on them for malpractice, they will not recommend
tests or procedures which are not required to diagnose the medical condition (Evans, 2017).
When doctors will not recommend over-use of diagnostic tests and laboratory procedures and
patients will understand that it is not actually required then it will also reduce the amount of
medical resource wastage and expenditure spent on these medical resources. This will also help
in improving federal funds and finally, the economy of the nation (MARTINEZ, KING &
CAUCHI, 2016).

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When the above-suggested solution will be implemented properly, it will also help in
improving the quality of care provided to the patients. When unnecessary care and treatment are
provided to the patients, most patients are prone to develop a new infection or any other
complication. However, when doctors focus on the value of care provided to the patients, it will
reduce the mortality rate and medical complexity. Thus, it enhances the level of treatment or care
given to the patients so that more and more patients will be cured in the provided time with
limited medical resources. This will also improve the efficiency of the healthcare providers as
they will understand how to provide effective healthcare to the patients without focusing on the
volume of care given (Maruthappu, Hasan & Zeltner, 2015).
Conclusion
Unnecessary care in the United States of America and other parts of the world is the
major concerning issue as this issue is affecting the patients and their families in every way
physically, financially, and emotionally. Many patients have to face bankruptcy and anxiety
because of non-essential diagnostic tests and laboratory procedures. The rate of mortality is also
increasing day by day because of this issue. Hence, it is essential to resolve this issue as soon as
possible. The government should make some policies to limit the use of medical resources and
educate patients and doctors about the hazards of unnecessary care or treatment given. Also,
there must be proper coordination between patients and healthcare providers so that quality of
care will be provided to the patients.

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