Examples Where Harms May Result from Medical Overuse
The Do No Harm Project
- Screening tests. "All screening programmes do harm; some do good as well, and, of these, some do more good than harm at reasonable cost." - Sir Muir Gray
- Older patients - especially those who are not ill
- Incidental findings on imaging or labs.
- Diagnosis and treatment of mild abnormalities (i.e. A1c of 6.5%, blood pressure of 145/88).
- When the patient voices regret about a past test or treatment decision - this may indicate that they were not fully informed of the potential downsides of testing or treatment when the decision was originally made. This is a harm. Many patients opt for less testing and treatment when fully informed and experience less regret after the decision has been made.
- Pre-operative testing in patients who are not ill
- Treating to an arbitrary target (eg blood pressure, lipids)
- The Choosing Wisely Campaign has many excellent tips on avoiding overuse