Panel 4 — Overtreated?
To help you get ready for the panel, here’s a list of questions to think about as you go through the book chapter and the Physician Agency, Training, and Location slides. There’s nothing to turn in — just look them over so you’re ready to join in. The questions I put to the panel come from this list.
From the reading
You can find these in the chapter and slides.
- How does where and how a physician trains shape the way they practice later on?
- What are peer effects among physicians, and how can the local practice environment influence treatment decisions?
- Why might two similar patients receive very different care depending on which physician, or which region, they end up in?
- Besides the patient’s actual needs, what else can drive how much care a person receives?
Bigger questions
No single right answer here — these are the ones we’ll talk through together.
- “Overtreatment” means care beyond what a patient benefits from. How would you actually tell too much care from just enough?
- If treatment varies because of local practice styles and peer effects rather than patient needs, is that a problem worth fixing, and how?
- How much of the variation do you think comes from training, from financial incentives, and from local culture — and does the source change what we should do about it?
- More care is not always better care. Where have you seen or heard about that tension?
- If you wanted to reduce overtreatment without discouraging care people actually need, what would you try first?
Your take
Have you or someone you know ever gotten care that felt like too much — an extra test, a referral that went nowhere, a treatment that didn’t help? What did it look like? Anything from your own experience is welcome.
Beyond the textbook
Not required, but they’ll make the discussion current — skim one or two.
- Pain, Fear and Waste: The Costs of Unnecessary Care — Tradeoffs podcast (2022). How one unnecessary test can set off a cascade of follow-up care, and why fee-for-service, liability fears, and medical culture keep low-value care going. Audio with a full transcript.
- Why Do We Pay For so Much Worthless Health Care? — KFF Health News (2023). A short piece on why so much U.S. health spending goes to care of little value, despite campaigns like Choosing Wisely.
- Use of low-value care in Medicare is substantial — MedPAC (2015). The Medicare advisory body defines low-value care and estimates how common it is among beneficiaries.