When More Medicine Is Not Better Care
Introduction: More medicine is not always better care.
A recent newspaper editorial by Dr Chandrakant Lahariya points to something every practising doctor sees: in India, overtreatment and undertreatment exist side by side.
Five Forces That Push Towards Doing Too Much
1. Routine health packages and screening tests These can flag harmless findings, which lead to more tests,more anxiety and sometimes lifelong medicines.
2. Care divided among many specialists Each specialist treats one organ, while the whole persongoes unattended.
3. Healthcare behaving like a marketplace Activity is rewarded more than restraint.
4. Patient expectations Many patients feel reassured only when a pill or a scanfollows the visit.
5. Defensive practice One more test can feel safer for the doctor than explaining why it is unnecessary.
Fixes the Editorial Suggests
- Strong primary care as the first point of contact
- A review date on every prescription, and a structured medicine review for people taking five or more medicines
- India-specific lists of low-value tests and procedures
- Payment systems that reward outcomes and continuity of care, not volume
Four Questions to Ask Before Any Test or Treatment
1. Why do I need this?
2. What happens if we wait?
3. What are the benefits and risks?
4. What are the alternatives?
Conclusion
Good medicine includes knowing when to hold back.
Dr Amandeep Aggarwal| MBBS (PB.)| Cardiac Emergencies Course(Apollo Hospital) | 33 years experience | Family Physician| Sangrur | Punjab Medical Council Reg. No. 27613