Too much medicine?

Australian health and consumer groups have banded together to release a statement calling for an end to overdiagnosis and overtreatment

A group of clinicians, consumers and policy makers have released a statement this month calling for action to address the problems of overdiagnosis.

Developed over the past year, the statement argues that overdiagnosis and the related overuse of medical tests and treatments not only causes harm, but also diverts resources from addressing underdiagnosis and undertreatment in other areas.

It also highlights the need to “identify the causes of too much medicine”.

The launch of the statement follows a National Summit on Overdiagnosis hosted by Wiser Healthcare last month at the University of Sydney, which was attended by leading stakeholders and researchers.

It has been endorsed by five leading health organisations including the Consumers Health Forum (CHF), the Royal Australasian College of Physicians (RACP), the Royal Australian College of General Practitioners (RACGP), the Royal Australian and New Zealand College of Radiologists (RANZCR), and the Australian Commission on Safety and Quality in Healthcare (ACSQHC).

“This is the first coordinated national effort to address a problem now recognised worldwide as a significant threat to healthcare,” says Professor Kristen McCaffery, a behavioural scientist at the University of Sydney Medical School and member of Wiser Healthcare, a research collaboration that facilitated the action.

“The problem of too much medicine is driven by many factors – including the best of intentions,” says Dr Ray Moynihan from Bond University, another member of the Wiser Healthcare team.

“But there is now a growing global consensus to start addressing the problem of too many unneeded tests, treatments and diagnoses, which not only threaten human health but also health system sustainability.”

The statement to underpin the development of a National Action Plan to Prevent Overdiagnosis and Overtreatment in Australia:

1. Alongside the undisputed ability of healthcare to extend human life and ameliorate suffering, there is growing evidence and concern about the problem of too much medicine. Overdiagnosis and the related overuse of medical tests and treatments not only causes harm, but also divert resources from addressing underdiagnosis and undertreatment.

2. There is need in Australia to identify the causes of too much medicine, the extent of the problem, and to develop responses to address it.

3. There is an urgent need to better inform consumers, clinicians, decision-makers and the public about the evidence for, and the consequences of, overdiagnosis and related overtreatment, as part of a broader approach to inform people about the potential harms, as well as the benefits of medical tests and treatments.

4. Expanding disease definitions and lowering diagnostic thresholds are recognised as one driver of the problem, and the processes for changing definitions require meaningful reform.

5. We are committed to evaluation, to ensure that attempts to address too much medicine are both safe and fair for healthcare consumers and their families, and in turn help to optimise the Australian health system’s safety, efficiency and equity of access.

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