Dr. John Mandrola, a cardiac electrophysiologist practicing in Louisville KY, writes in Medscape about why less health care is often better care. As a physician, he believes that simplifying care, prescribing fewer medicines and providing fewer procedures is the essence of good medicine. He is a member of the Right Care Alliance and the Lown Institute, whose members believe that healthcare should be affordable, effective, rational and available to all.
There is no evidence to support the notion that spending more on health care delivers better health outcomes. But, the broken US health care system promotes overuse of unnecessary tests and procedures. The United States spends a lot more than every other industrialized country, and we have shorter life expectancies and less good health outcomes.
Dr. Mandrola makes the case that there is a tremendous amount of waste in the US health care system. Research by Dartmouth Atlas shows that up to 30% of health care dollars are wasted. Kaiser Health News exposes the high number of unnecessary cancer screenings for older adults in nursing homes. Dr. Mandrola sees the waste firsthand in older adults getting unnecessary myocardial perfusion scans and other inhumane treatments they do not need and that undermine their quality of life.
Dr. Mandrola sees other waste, including giving statins to 90-year-olds with cancer, doing yearly echocardiograms for mild valve disease, delivering “palliative” chemotherapy, prescribing an MRI for low-back pain, arthroscopy, vertebroplasty. He sees a tremendous number of unnecessary interventions. The ABIM Foundation’s Choosing Wisely initiative documents scores of evidence-based unnecessary treatments in a wide range of specialty areas.
To learn more about right care, check out the Right Care Alliance, a grassroots coalition of doctors, patients and individuals organizing to make health care institutions accountable to their communities and put patients, not profits, at the heart of health care.
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