ROSEMARY GIBSON | G FORCE
Taking care with treatment
The Boston Globe, March 8, 2010
ELIZABETH COONEY
 | Author Rosemary Gibson says when medical care is overused, it can cost patients their health and their savings. |
"Rosemary Gibson once led a successful national initiative to make palliative care more available to seriously ill patients. Now she has turned her attention to the overuse of medical care and how it can hurt patients as well as drive up health care costs. She will speak about her new book, “The Treatment Trap,’’ at noon tomorrow, at Health Care for All in Boston. In a telephone interview last week, she explained what consumers can do to avoid care that is not only unnecessary, but potentially harmful."
Q. How do you define “overuse’’?
A. Overuse is when the possibility of harm exceeds the possible benefits.
Q. Why is it so important now?
A. Just about everybody’s concerned about how we’re going to take care of whole families and not really break the bank, so a good way is to stop doing these things that cause more harm than good. The cost of overuse, as important as that is, I don’t think is sufficient to motivate us to begin to address it. I believe we have to go look at the impact on patients.
Q. Could you give an example of overuse?
A. We have a narrative from a patient who was one of many patients in California who had heart bypass surgery. Told he had a “widow maker,’’ he had immediate surgery. A year later, he learned he was one of a number of people who had heart procedures when it wasn’t medically indicated.
Q. Don’t Americans usually want more, not fewer, tests and treatments?
A. It’s fair to say that Americans, writ large, believe that more care is always better care. I think there also is the recognition that at some point there are diminishing returns from medical care. If we hear it from insurance companies or politicians, we’ll think it is rationing. But if we hear it from our peers, then it will come across differently.
Q. Aren’t patients and doctors afraid of doing less?
A. Physicians will do extra tests to make sure they don’t get sued, [a fear that is] very legitimate. And there’s the peer factor: If I’m a [specialist] and a primary care practitioner referred a patient to me for a workup, they expect I will do that workup. Combine this with the financial incentives of medicine: The more we do, the more we get paid.
Q. What can a patient do?
A. A patient should know that there are many fine physicians who will do the right thing by them. . . . We encourage people to be aware of the marketing glitz and to realize marketing is no substitute for information about the treatment options and the benefits and risks. They should ask about the risks. It’s important for them to be aware of why they are having the procedure, what it’s going to do for them, and what the evidence is for it.
To attend tomorrow’s talk at Health Care for All, 30 Winter St., e-mail Deb Wachenheim: dwachenheim@hcfama.org.
Interview has been condensed and edited. 
