Why 'Too Much Medicine' is a Problem

The RACGP released a Statement about 'Too Much Medicine' - supporting the use of optimal medicine and highlighting the potential harmful impacts to patients from over-diagnosing. 

Why 'Too Much Medicine' is a Problem

The RACGP released a Position Statement: 'Too Much Medicine' to support the use of optimal medicine, which resulted from testing and treatments being carefully weighed against any harms to prevent injury and waste for patients. 

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They raised concerns within the medical community about the excessive and unnecessary use of tests, medicines, and procedures. This may result in problems that cause real harm to patients and to the healthcare system.

The harm from too much medicine includes the concepts of over-diagnosis, over-detection, over-treatment, over-utilisation, disease mongering, medicalisation, false positives and misdiagnosis.

A coordinated response from medical practitioners, the healthcare industry and government is required.

Serious doctor listening to patient explaining her painful in his office

Unnecessary testing and treatments can carry risks of complication that can affect a patient's quality of life, or in extreme cases also trigger life-threatening problems for patients.

Some issues may happen almost immediately, such as adverse drug reactions and unplanned hospitalisation. Others issues can happen more insidious, such as the increased risks from exposure to radiation as a result from extensive treatments.

Other times, receiving abnormal test results, even if they are harmless, or being labelled as having a disease, or undergoing an invasive procedure for a minor issue, may have a high potential to provoke anxiety and stress to the patients.

Unnecessary care is also expensive for patients in many cases, who may need to pay out-of-pocket for treatments that are not covered under the Medicare Benefits Schedule (MBS). These indirect costs can also be affected through life insurance exclusions and insurance loading. 

General Practitioner Dr Paul Glasziou, a Professor of Evidence-Based Medicine at Bond University, told newsGP the problems are especially prevalent in the case of over-detection of cancers.

According to Dr Paul, over-diagnosis is when a patient is labelled with a condition that would never have caused them health problems normally in their life. 

Specifically he mentions with prostate, breast, thyroid and renal cancers, all have over-detection rates that vary between 40% and up to 100%. Only one out of three diagnosis for thyroid cancer for example may be real cancer, not getting it right will several impact a patient's life. 

Senior male doctor talking with worried patient

Using too much medicine is also wasteful in that it diverts valuable resources away from the people who really need care. Such as patients with serious, chronic or threatening conditions who will benefit from medical intervention.

The inappropriate use of particular drugs can also contribute to the bigger and global problem of antimicrobial resistance, which is a serious threat to human being's defences against infections.

The Statement from the RACGP suggested a number of potential solutions to the problem, including Clinician governance, Evidence-based medicine, Industry regulations, Community education as well as GP strategies to combat the problem as a whole.

General Practitioners are also encouraged to employ a variety of approaches to monitor and reduce the use of particular interventions when necessary.  

In applicable cases, they should try to reduce inappropriate polypharmacy, particularly in older patients This is an area where behavioural change on the part of GPs could significantly take away the burden of too much medicine.

We mentioned the potential harms to the elderly patients from polypharmacy in our previous Gorilla Jobs blogs, the solutions require strong collaborations between GPs and pharmacists. 

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What do you think about what General Practitioners in Australia could do to minimise the impact of over-diagnosis?  Please contact one of our friendly team of consultants Today  and let us tell you what GP jobs are available around Australia and whether they could be exactly what you are looking for.

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