Peggy Salvatore did an excellent job hosting the most recent Health Wonk Review – the Valentine’s Day Edition. I found this article by David Rothman, published at Health Affairs, to be particularly interesting. Although there has been much talk over the past few years about comparative effectiveness research, evidence-based medicine, and over-utilization of healthcare, patients apparently are not always impressed by the notion that perhaps less is more when it comes to some types of testing and treatment. We’ve touched on the topic of over-utilization of healthcare many times here on our blog, and the fact that some care – especially preventive care – is often seen as a sacred. To even suggest eliminating parts of it borders on heresy. Rothman’s article highlights that view in terms of how patients see it. The general consensus among educated, 40 – 60 year-olds with private health insurance was that any attempts to scale back preventive testing (along evidence-based guidelines) was just a sneaky way of rationing care and/or cutting costs. The patients who were surveyed felt that doing so would be detrimental to their own health and some considered it “stupid” or “dumb” to go along with such guidelines and postpone or skip preventive testing that used to be recommended.
Personally, I’m in the less-is-more camp, and I don’t consider new guidelines regarding preventive care to be an attempt to save money at the expense of my life and wellbeing. Rather, I see them as an attempt to save money by not spending it on something that maybe should never have been the standard of care in the first place, as well as an effort to avoid potential pitfalls like false positive, unnecessary radiation exposure, etc. But Rothman’s article is a fascinating look at patient perceptions on this topic. It will be especially interesting to watch over the next few years as we have improved access to preventive care thanks to ACA rules, juxtaposed with changing guidelines in terms of recommendations for preventive care.