With all the vendors, providers, and manufacturers urging us to get more medical care (always somehow “showing savings” in the process), isn’t it nice to know there is one vendor dedicated to putting guardrails around employees’ tendencies to overuse medical care?
After all, you are subsidizing most of their purchases, and Economics 101 says that the less someone pays for something, the more of it they buy. And buying healthcare is good for us, right? Isn’t that why they call it healthcare? [SPOILER ALERT: Answer is below.*]
We’ve written posts and of course quizzes on all the ways in which people overuse the medical system. As one example, we educate employees/members not to demand unneeded and expensive (meaning highly profitable) scans. Not just because of the radiation (in CT scans) but also because of the strong potential for overdiagnosis, meaning “findings” that are unrelated to the reason for the scan, and are ultimately harmless but nonetheless are disconcerting and might cause a patient or a doctor to want to follow up. These findings are so common they even have a name: “Incidentalomas.”
Overdiagnosis of incidentalomas leads inexorably to overtreatment…especially for back pain. We blog and quiz on this topic extensively as well. Longtime Quizzi-fans no doubt recall our mantra: “80% of back pain goes away on its own, but 80% of people with back pain are convinced they are in the other 20%.” Americans lacking access to Quizzify (which is, sadly, still the majority) treat back pain far more aggressively than they should.
We are far from alone in identifying this “epidemic of overuse” as Atul Gawande calls it. Books have been written on each. We recommend Overdiagnosed by Gilbert Welch and Overtreated by Shannon Brownlee.
Too many drugs
Another topic we address is overuse of drugs. Once again, we are far from the first to note this. Our colleague Alan Cassels described it almost 20 years ago in Selling Sickness: How the World's Biggest Pharmaceutical Companies are Turning us All into Patients.
In particular, Quizzify focuses on the hazards of popular over-the-counter remedies that are safe when used as directed for a limited period...but not when used for an unlimited period. Heartburn meds, antihistamines/decongestants, sleep aids, laxatives and pain relievers – the five most popular categories of OTC drugs – are all overused by segments of the population, and all have underappreciated hazards of overuse. But many people assume that the ready availability of those drugs means they are safe. Often the hazards of long-term overuse don’t get noted on the label, because only the side effects of drugs when used as directed
Prescription drugs are overused as well. 20% of Americans over 40 take 5 prescription drugs every day. Quizzify has specific (antibiotics, painkillers) and general quizzes on prescription drugs, which should lead people to their own conclusion that they get enough drugs without demanding more of what they see on TV.
The latest on drug overuse and misuse
That statistic and this blog post (along with their cover picture at the top) was inspired by an excellent article in last week’s Economist, “Too Many People Taking Too Many Pills.” Many of the key concerns in this article are addressed in Quizzify. The concerns include:
“Advertising oversells the benefits of medicine.” You think? They didn’t include any statistics, but a Journal of the American Medical Association study showed that the large majority of advertised drugs did not provide better therapeutic value than less expensive non-advertised alternatives.
People tend to be “unaware of the consequences of long-term use.” This is especially true of over-the-counter (OTC) drugs, which people assume are safe because, well, there are no restrictions on sale.
Doctors can also be unaware of hazards of drugs. Partly because there are a ton of drugs to keep track of. And partly because even though they are usually aware of the side effects and drug interactions on the FDA Insert, the label itself often falls short, as it is initially based on trials only. Later, in a voluntary, cumbersome, time-consuming and hit-or-miss process, the label may be updated, if enough doctors report “adverse events.”