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How Much Healthcare Do You Need?

More care isn’t always better, and too much may be harmful

May 8, 2012 RSS Feed Print

It's also wise to be wary when your doctor recommends that you undergo surgery or some other procedure. Medical journals are littered with studies of procedures—some of them involving major surgery—that were once thought to be beneficial but bring no benefit and may cause harm. One glaring example is surgery for osteoarthritis of the knee, so popular in the 1990s that more than 650,000 procedures were performed per year without scientific evidence of any benefit. Numerous studies have since documented that patients were subjected to the pain and risks for nothing.

The list goes on. Renal artery stenting, a procedure designed to relieve high blood pressure by propping open the kidney's main artery with a spring-like device called a stent, has also been shown to provide little benefit and cause harm. Surgery for low back pain and tubes through a child's eardrum to relieve middle-ear infections.

One of the biggest controversies now unfolding in medicine centers on angioplasty and stenting, an alternative to coronary artery bypass surgery performed in more than 500,000 people a year. Mounting evidence suggests that, for many patients—other than those having heart attacks— optimum drug therapy offers the same benefits with less risk. "Honestly, I believe that most doctors think that doing something is better than doing nothing," says Deborah Korenstein, an internist at Mount Sinai Medical Center in New York, who has studied inappropriate care. "Just because you can do something doesn't mean you should."

A principle worth committing to memory: The body takes care of itself. It can fend off colds and most infections on its own, without a boost from antibiotics and other medicines. Overreliance on drugs to kill bugs just beefs up the bugs, and study after study has concluded that antibiotics do little or nothing to treat colds, flu, sinus infections, ear infections, and most other routine conditions.

Cardiologist Rita Redberg, editor of the Archives of Internal Medicine, and Deborah Grady, her colleague at UCSF Medical Center in San Francisco, grew so concerned about patients undergoing questionable procedures that they launched a series in the journal titled "Less is More" to highlight research on unnecessary, inappropriate, and inadequately tested medical care.

"Before you agree to any procedure, ask a few questions," Redberg says. "'What are the benefits to me?' They can be very different for different people, depending on age, sex, and health history. 'What are the risks? Are there alternatives?'"

[See: 10 Overhyped Health Products]

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