Americans spend at least $3.2 trillion on health care each year. That's well beyond any other country in total and per capita. A great many factors feed the glut, but a primary contributor is overtreatment. Unnecessary tests and procedures account for at least $200 billion in spending every year. That's ten NASA budgets spent on health care that doesn't make anybody healthier.

Doctors are well aware of this problem, and yet, it persists. According to a new survey of 2,106 physicians conducted by researchers at Harvard and Johns Hopkins University, 20.6% of of medical care is unnecessary.

The survey is published in PLoS ONE.

The responding physicians were randomly selected from the American Medical Association master file. Just over half were primary care physicians and the rest were specialists. Four in ten of the specialists focused on general internal medicine. All of the doctors answered the question, "In your specialty, what percent of overall care do you think is unnecessary?" The group collectively replied that 22.0% of prescribed medications, 24.9% of conducted tests, and 11.1% of completed procedures were not needed.

The most cited reason for overtreatment was "fear of malpractice." An astounding 84.7% of the responding physicians feared a lawsuit if they didn't exercise every treatment precaution. "Patient pressure/request" and "difficulty accessing prior medical records" were the next most common reasons, at 59% and 38.2% respectively.

Just over half of respondents suggested additional training and guidelines to help curtail overtreatment. Interestingly, only one in ten doctors thought that more government regulation could solve the problem.

The researchers who conducted the survey were perplexed that "fear of malpractice" seemed to be the primary motivator for unnecessary medical care.

"Only 2–3% of patients harmed by negligence pursue litigation, of whom about half receive compensation. Paid claims have declined by nearly 50% in the last decade..." they wrote.

Ultimately, physicians may be the most important arbiters of medical spending. If we want to begin cutting into the massive waste plaguing or medical system, and thus drive down costs for all, doctors will need to lead the effort.

Source: Lyu H, Xu T, Brotman D, Mayer-Blackwell B, Cooper M, Daniel M, et al. (2017) Overtreatment in the United States. PLoS ONE 12(9): e0181970. https://doi.org/10.1371/journal.pone.0181970