Ask practically any doctor, nurse, or other healthcare professional if they’ve ever seen a patient undergo an unnecessary medical service, the answer will be, “Of course.” Overuse is now widely recognized by healthcare professionals who have contact with patients, and it’s a hot topic among policy wonks looking for ways to trim healthcare spending. Even the press has begun to catch on.
So where are the data?
The answer is, they’re coming faster than ever before. Today, we’re witnessing the birth of a new research agenda, which has produced greater insight into the scope of medical overuse, its effect on patients, providers, health systems and budgets. Overuse, it seems, is rampant in all health systems, afflicting systems around the world. It occurs in all sites of practice including hospitals, clinics, nursing homes, skilled nursing facilities, and perhaps even hospice care.
This pervasive problem has profound implications for other failings in care delivery, including underuse and misuse. And not just because it consumes money that could be better spent on things like covering the uninsured. Overuse distracts professionals from attending to patients’ needs, and causes considerable moral distress for caregivers and professionals. From the still-limited evidence that has accumulated, it is clear that unnecessary or unwanted services result in significant physical and psychological harm to patients, and we have only scratched the surface in terms of devising, implementing, and measuring strategies that can be employed to address it.
Research Day, April 15, 2016 in Chicago, IL, which precedes the 2016 Annual Lown Conference, is an opportunity for people from around the world to gather and talk about the work on overuse that has been done and is underway, to share ideas, to spark new approaches, and to discuss what the research agenda should be going forward.
We are thrilled to have AcademyHealth as a partner in this endeavor, and look forward to working with Lisa Simpson, MB, BCh, MPH, President and CEO of AcademyHealth, on the selection of abstracts. Adam Elsahug, PhD, MPH, Deborah Korenstein, MD, and Daniel Morgan, MD, MS, are the research chairs.
We have solicited abstracts on prevalence and drivers of overuse, harms of overuse (physical, psychological or system-related), shared decision-making and patient-reported outcomes, areas of concurrent overuse and underuse, and overuse in the care of the elderly and at end of life. To learn more, visit: http://conference.lowninstitute.org/call-for-abstracts/.
Keynote speakers on Research Day include Rita Redburg, MD, Editor of JAMA Internal Medicine (the only American medical journal with a dedicated section on overuse), and Gordon Guyatt, MD, one of the fathers of evidence-based medicine. For more information about other keynote speakers and workshops at the conference or to register, visit our conference website.
Anyone is welcome to attend both Research Day, and the main conference. Given some of the provocative entries we’ve seen so far, this event is sure make a splash. We hope it also provides attendees with the inspiration and opportunity to develop new collaborations and continue to produce work that moves healthcare closer to providing the right care for all.
Shannon Brownlee is senior vice president of the Lown Institute, a Boston-based think tank focused on finding ways to transform our health system. She’s the author of Overtreated: Why Too Much Medicine is Making Us Sicker and Poorer