Many in US get too much medical care

Forty-two percent of US doctors believe that their patients are getting too much medical care, according to a survey published Monday which suggests fears of malpractice suits may be to blame. A total of 28 percent said they felt they were treating their patients too aggressively, while 45 percent said one of every 10 patients they saw daily had issues that could have been dealt with by phone, by email or by a nurse. Fifty-two percent said they felt their patients were receiving just the right amount of care and six percent said their patients were receiving too little, said the study in the Journal of the American Medical Association. "Our findings show that many primary care physicians believe there is substantial unnecessary care that could be reduced, particularly by increasing time with patients, reforming the malpractice system, and reducing financial incentives to do more," it said. The United States has the world's highest health spending per capita among developed nations, at $5,475 compared to the next-highest country, Switzerland at $3,581, according to a separate US study published in 2007 in the journal Health Affairs. Health care in the United States is a hot political issue, and President Barack Obama's moves to reform the system and extend insurance coverage to an extra 32 million people has faced opposition from Republicans and sparked court challenges. Seventy-six percent of survey respondents said that concerns about possible malpractice suits were the main reason why they gave patients more aggressive treatment. "Physicians believe they are paid to do more and exposed to legal punishment if they do less," said the article. "The extent to which fear of malpractice leads to more aggressive practice (so-called defensive medicine) has been hotly debated; based on our findings, we believe it is not a small effect." Forty percent said they did not have enough time to spend with patients. While only three percent said their own style of practce was influenced by financial considerations, 39 percent "believed that other primary care physicians would order fewer diagnostic tests if such tests did not generate extra revenue," said the study. "Almost two-thirds (62 percent) said that medical subspecialists would cut back on testing in the absence of a financial incentive." The results are based on a mail survey that was filled out by 627 doctors in the United States. Seventy percent of the doctors included in the initial mailing replied, which the authors called "exceptional for a survey of American physicians." The study was led by Brenda Sirovich and colleagues from the VA Outcomes Group in Vermont and the Dartmouth Institute for Health Policy and Clinical Practice in New Hampshire.