Excessive medical treatment is a worldwide problem. The content is very complicated and it is not easy to explain it clearly. However, the main body to discuss this problem can only be professional doctors. Layman patients do not even know what is [moderate medical treatment]. How can we discuss [excessive medical treatment]?
To say that the problem is complicated, First of all, it is not clear how to define it. Analyzing from different angles, There can be different definitions. For example, from the perspective of the patient’s personal interests, If it exceeds the examination and treatment (including medication, surgery, etc.) given in the diagnosis and treatment scope of this disease, They are all over-medicated. From the perspective of medical resources, Consumption of medical resources due to diseases, Is overtreatment. For example, To take an extreme example, I got a mosquito bite on my thigh, You said it was a tumor, I had my limb amputated, Give me chemo, I spent a lot of money and time, Suffered great pain, The treatment received far exceeds the scope of the disease. This is excessive medical treatment. For example, patients have no hope of treatment and can only rely on ventilators to maintain their vital signs. However, continuing to use ventilators and a large amount of drugs every day has actually consumed more medical resources than the disease should have. Although emotionally understandable, this is also excessive medical treatment.
Why does excessive medical treatment occur, The reason is also very complicated, The most fundamental reason should be the complexity of life and the progress of medicine. In the past, when we only relied on watching, hearing, asking and cutting to see a doctor, Doctors prescribe drugs for you according to your illness, and it belongs to conditioning imbalance and relies on natural forces to cure diseases. At this time, there is no excessive medical treatment, but the medical level is also low. The development level of medicine now is turned upside down compared with 100 years ago. The medical level has improved significantly, but at the same time it also brings about the problem of excessive medical treatment.
In the past, problems that could be diagnosed by looking, hearing, asking and cutting should now be examined by drawing blood and taking films. In the past, problems that could be treated by grasping a pair of traditional Chinese medicines now require taking various medicines and performing various operations. The quality has improved and the procedures are much more complicated. Because of the specificity of each person, excessive medical treatment has also occurred.
To make an inappropriate analogy about excessive medical treatment, It’s like when you go to a restaurant to order food, you have a little shortage of one dish and one soup, and a little support for two dishes and one soup. It’s hard to get it right. Even if you let yourself cook for yourself, it’s hard to hold it right. If you don’t support it, it’s just right. So in order to fill your stomach, [eat well], then a little more, so there is excessive medical treatment.
To talk about it in detail, I think about it roughly. There may be several reasons for excessive medical treatment:
1. Protective over-treatment by doctors
This protection, In addition to protecting the doctor himself, Some are actually protecting patients. When doctors are engaged in medical activities, To preserve the evidence, Prove that his medical behavior is appropriate, This is mainly reflected by some objective indicators checked, You may have disease A, The doctor also judged that you had disease A, And judging that your chances of getting B disease are very small, With [proper medical treatment], Then treat it according to disease A. However, Low probability does not mean impossible, In case you do have B disease, The doctor knows that you may be suffering from disease B, The method of treating A disease was adopted, The delay even exacerbated your illness, Then it is the doctor’s medical accident. So in order to protect themselves, the doctor added some examinations to exclude disease B, so there is objective evidence to prove that his treatment is correct. From another perspective, the possibility of another disease has been ruled out for the patient without delay in treatment, and the patient is actually profitable. This is excessive examination.
2. Overtreatment due to medical development
The current trend of medical development, Is to treat the disease at the lowest cost, This is especially evident in the treatment of tumors. For example, the scope of breast cancer surgery, From the past radical mastectomy, To modified radical mastectomy, To breast-conserving surgery, The scope of the operation is getting smaller and smaller, From the present perspective, In the past, large-scale surgeries were over-treated. Don’t think this is criticizing the predecessors. This illustrates a problem, The scope of surgery for malignant tumors may not need to be as large as it is now, Maybe in another 50 years, The surgery you’re doing is overtreatment. But, You still have to follow this range, Because, the current statistics tell me, The survival rate after such a large-scale operation is higher than that after a small-scale operation. And the survival rate is this thing, For an individual, it is meaningless. Patients undergoing small-scale surgery have a low probability of living for a long time and patients undergoing large-scale surgery have a high probability of living for a long time. But how do you know that I am not the one who lives for a long time in small-scale surgery, or I am the one who lives for a short time in large-scale surgery? However, all of them have used a wide range of surgical methods, which have caused me such great pain and poor quality of life.-Is there any solution to this excessive medical treatment?
3. Excessive medical treatment caused by doctors’ interests
This is the most talked about, It seems that when it comes to Chinese doctors’ medication, examination and surgery, It is all driven by interests. I want to say, This is a worldwide phenomenon, As long as the doctor’s income is linked to his own labor, Then this phenomenon is inevitable. Half of cesarean sections, a quarter of hysterectomy and a fifth of pacemaker operations in the United States are unnecessary. For this kind of excessive medical treatment, Because of serious information inequality, As a patient, there is no way to identify and find it. However, there is not much discussion about this kind of excessive medical treatment among foreign patients. It seems that all the countries in China are concentrated in this area. In the end, money is still in trouble. For example, the United States relies on the supervision of insurance companies. Canada relies directly on government supervision (because doctors don’t ask patients for their money, but directly ask the government for it). Whoever pays for doctors will stare at the excessive medical treatment in this area. In China, patients pay for it, and of course they have to stare at it themselves. However, as mentioned earlier, the information is not equal. Can patients keep a firm eye on it? Can you have the power of an insurance company or the government to restrict doctors? Therefore, the domestic has adopted the method of depressing the doctor’s diagnosis and treatment expenses. Anyway, you don’t have much money to do it, thus suppressing the doctor’s demand in this respect. Therefore, domestic doctors have low income and lack enthusiasm. Therefore, as patients, they don’t have to worry too much about excessive medical treatment caused by this aspect.
4. In addition to the reasons of doctors, the patients themselves have also caused excessive medical treatment.
Because of the concern for one’s own health, When many patients go to see a doctor, Ask doctors to use the best examination methods, the best medicine, There are also those who ask for surgery (such as cesarean section), There are also family members who request continued treatment for patients with no hope of treatment, as mentioned earlier. Every year in Canada, similar lawsuits occur in which doctors request to remove ventilators and their families refuse (because the government provides medical resources and doctors are also paid by the government, doctors have the requirement to save medical resources and costs). These are all patient-led over-treatment.