A recent survey found that nearly 72% of U.S. adults indicated that they perceived that patients who have medical conditions experienced problems because they were overtreated (either because they received too many treatments or treatment that was too aggressive for their respective conditions). This survey of 2,286 people by the Wall Street Journal/Harris Interactive Health-Care Poll also found that about half of the respondents were somewhat or very concerned, personally, about being overtreated when they are sick or in need of medical care.
It’s easy for healthy people to think that patients are being overtreated. Once you are a patient, though, you want the best possible care. We know from our psoriasis patients that they frequently believe their disease isn’t being treated aggressively enough. In light of the development of new technology, treatments and medications, determining what’s most appropriate can be a difficult decision sometimes.
It’s important to me to be a responsible steward of resources. If there are two treatments of equal efficacy and safety, I will recommend the less expensive of the two. Frequently, though, there is a marginal benefit for one of multiple treatment alternatives, and it is appropriate to offer the option of that superior treatment to patients. But sometimes the choice isn’t so clear-cut.
Choosing the Right Drug
When it comes to some of the new drugs, I wonder if responsible stewardship should make me think twice before prescribing a $20,000 per year drug that offers only marginal benefits over existing, less expensive options — particularly for patients who seem to have a relatively mild form of disease that simply doesn’t seem to justify such expense.
If patients are willing to pay the price themselves, of course I’m happy to prescribe them an expensive drug. According to principle, though, I should also be happy to prescribe that expensive drug even if insurance is paying for it. After all, the patient paid for that insurance for the purpose of paying for their medical treatment.
Cost Versus Benefit
And, if there is a benefit to the more expensive drug, should cost matter?
I’m not sure whether or not obligations to be a good steward of society’s medical resources exist or, if they do, trump our clear obligation to offer patients the best treatments available. The situation is ever more complicated because new treatments always come with unknown risks.
When it comes to patients who seem to have too mild a disease to justify expensive treatment, we should ask ourselves if it isn’t really our safety concerns that make us reluctant to prescribe aggressive treatment. While we may not have an overriding requirement to be good stewards of resources, hopefully our superseding obligation to do no harm should and will limit our use of potentially risky medications when those risks outweigh potential benefits.
A recent survey found that nearly 72% of U.S. adults indicated that they perceived that patients who have medical conditions experienced problems because they were overtreated (either because they received too many treatments or treatment that was too aggressive for their respective conditions). This survey of 2,286 people by the Wall Street Journal/Harris Interactive Health-Care Poll also found that about half of the respondents were somewhat or very concerned, personally, about being overtreated when they are sick or in need of medical care.
It’s easy for healthy people to think that patients are being overtreated. Once you are a patient, though, you want the best possible care. We know from our psoriasis patients that they frequently believe their disease isn’t being treated aggressively enough. In light of the development of new technology, treatments and medications, determining what’s most appropriate can be a difficult decision sometimes.
It’s important to me to be a responsible steward of resources. If there are two treatments of equal efficacy and safety, I will recommend the less expensive of the two. Frequently, though, there is a marginal benefit for one of multiple treatment alternatives, and it is appropriate to offer the option of that superior treatment to patients. But sometimes the choice isn’t so clear-cut.
Choosing the Right Drug
When it comes to some of the new drugs, I wonder if responsible stewardship should make me think twice before prescribing a $20,000 per year drug that offers only marginal benefits over existing, less expensive options — particularly for patients who seem to have a relatively mild form of disease that simply doesn’t seem to justify such expense.
If patients are willing to pay the price themselves, of course I’m happy to prescribe them an expensive drug. According to principle, though, I should also be happy to prescribe that expensive drug even if insurance is paying for it. After all, the patient paid for that insurance for the purpose of paying for their medical treatment.
Cost Versus Benefit
And, if there is a benefit to the more expensive drug, should cost matter?
I’m not sure whether or not obligations to be a good steward of society’s medical resources exist or, if they do, trump our clear obligation to offer patients the best treatments available. The situation is ever more complicated because new treatments always come with unknown risks.
When it comes to patients who seem to have too mild a disease to justify expensive treatment, we should ask ourselves if it isn’t really our safety concerns that make us reluctant to prescribe aggressive treatment. While we may not have an overriding requirement to be good stewards of resources, hopefully our superseding obligation to do no harm should and will limit our use of potentially risky medications when those risks outweigh potential benefits.
A recent survey found that nearly 72% of U.S. adults indicated that they perceived that patients who have medical conditions experienced problems because they were overtreated (either because they received too many treatments or treatment that was too aggressive for their respective conditions). This survey of 2,286 people by the Wall Street Journal/Harris Interactive Health-Care Poll also found that about half of the respondents were somewhat or very concerned, personally, about being overtreated when they are sick or in need of medical care.
It’s easy for healthy people to think that patients are being overtreated. Once you are a patient, though, you want the best possible care. We know from our psoriasis patients that they frequently believe their disease isn’t being treated aggressively enough. In light of the development of new technology, treatments and medications, determining what’s most appropriate can be a difficult decision sometimes.
It’s important to me to be a responsible steward of resources. If there are two treatments of equal efficacy and safety, I will recommend the less expensive of the two. Frequently, though, there is a marginal benefit for one of multiple treatment alternatives, and it is appropriate to offer the option of that superior treatment to patients. But sometimes the choice isn’t so clear-cut.
Choosing the Right Drug
When it comes to some of the new drugs, I wonder if responsible stewardship should make me think twice before prescribing a $20,000 per year drug that offers only marginal benefits over existing, less expensive options — particularly for patients who seem to have a relatively mild form of disease that simply doesn’t seem to justify such expense.
If patients are willing to pay the price themselves, of course I’m happy to prescribe them an expensive drug. According to principle, though, I should also be happy to prescribe that expensive drug even if insurance is paying for it. After all, the patient paid for that insurance for the purpose of paying for their medical treatment.
Cost Versus Benefit
And, if there is a benefit to the more expensive drug, should cost matter?
I’m not sure whether or not obligations to be a good steward of society’s medical resources exist or, if they do, trump our clear obligation to offer patients the best treatments available. The situation is ever more complicated because new treatments always come with unknown risks.
When it comes to patients who seem to have too mild a disease to justify expensive treatment, we should ask ourselves if it isn’t really our safety concerns that make us reluctant to prescribe aggressive treatment. While we may not have an overriding requirement to be good stewards of resources, hopefully our superseding obligation to do no harm should and will limit our use of potentially risky medications when those risks outweigh potential benefits.
