At a time when our doctors, nurses and medical technicians are overwhelmed, the statistic attracts attention: up to 30% of the medical examinations and treatments carried out in Canada are unnecessary.
This is as much an aberration to understand as a possible solution to better care for our patients and reduce the congestion of our health systems.
The figure of 30% was put forward in 2017 by the Canadian Institute for Health Information. This week, doctors met at the invitation of the Quebec College of Family Physicians to discuss it.
The main conclusion of the exercise: both doctors and patients have an important awareness to raise.
We have all understood the notion that the earlier a disease is diagnosed, the better the chances of recovery. We think of cancers, for example.
This generally remains true. But problems can arise when we start multiplying examinations and blind screening tests, “just in case”.
In particular, the Canadian Institute for Health Information has identified 12 medical procedures that it considers “overused”. An example: send a patient who has pain in the lower back, without other worrying signs, to undergo a medical imaging examination.
Or give an X-ray to a child who has asthma or bronchiolitis.
These procedures expose patients to radiation. They take their time. They cause them concern.
Sometimes you find something unexpected with a test. A nodule on a lung. An indicator in the blood that is abnormally low or high. Most of the time, we then embark on a spiral that will lead to a multiplication of investigations, all to finally say to the patient: “We worried for nothing. »
“It’s the test cascade. We find something, we have to do other tests to investigate this finding, we find something else and so on. Statistically, however, we know that most fortuitous finds are not dangerous, ”describes the Dr René Wittmer, President of Choosing Wisely Québec, a campaign that aims to reduce unnecessary examinations and treatments.
The same is true for treatments. Prescribe antibiotics “just as a precaution”. Perform a caesarean section for a childbirth that is not at risk. Recommend psychostimulants to a simply turbulent child – we have long suspected an overdiagnosis of ADHD in Quebec.
This also puts patients at risk.
In addition to patient well-being, there is the issue of relieving overworked professionals. Physicians who advocate for better use of medical procedures are reluctant to use this argument for fear of appearing to want to work less at the expense of patient health.
We will therefore do it here for them: considering the current congestion of the network, it is imperative to tackle the useless.
There are many possible solutions.
First, we know that medical information circulates badly in the health network. Often, a professional who intervenes with a patient does not know what has been done previously. This can lead to duplication of procedures. The Minister of Health, Christian Dubé, has just passed a law on health information. We hope for improvements.
We then see more and more private companies offering comprehensive medical check-ups for a fee. Their financial interest is clear. That of patients and the health system, much less.
We must denounce these fishing trips which cost everyone dearly and bog down the system for nothing.
Drug advertisements such as “talk to your doctor” can also lead patients to demand unnecessary treatments.
Finally, we need to raise the awareness of patients and doctors. The latter are already in the process of establishing guidelines aimed at defining the use of various procedures. So much the better.
As for patients, they must resist the urge to ask their doctor for all the procedures they learned about on “Doctor Google”. And realizing that the good old saying “too much is like not enough” can also be applied in medicine.