CAN TOO MANY DOCTORS SPOIL YOUR CARE?

    This question is posed by Orly Avitzur, M.D., M.B.A., medical advisor to Consumer Reports, Board certified in neurology, a fellow in The American Academy of Neurology and clinical instructor at the Yale University School of Medicine.  She is also a medical consultant to the New York Rangers.

    A colleague had referred her father to me with apologies.  He was a 78 year old business man visiting from Florida for the month and asked me to set up appointments with half a dozen specialists.   He had well-controlled blood pressure, an enlarged prostate and occasional bouts of pneumonia, but otherwise was in good health.  He came to see me complaining of recent headaches.  He already had seen a cardiologist, an internist, and an urologist during his visit and was taking a variety of painkillers and muscle relaxants.

    It is common to find people who are already on the same drugs, such as the patients I see after car accidents.  A doctor may then order another test.    In a health survey last year, 87 percent respondents said they somewhat agreed that “it’s better to have a scare that turns out to be nothing than not get tested at all.”  Only 18 percent recognized the risk of having a false alarm.  While genuine medical problems should never be ignored, overtreatment takes time away from more pleasurable endeavors.  It is estimated that overtreatment alone was responsible for “158 billion to 228 billion in wasteful spending in 2011, while failure to coordinate care cost 25 to 45 billion.  Besides the overall implications for health care spending and the threat to worthy government programs, your own pocket book is affected.  Even with the best insurance plans copayments for office visits, tests, procedures and pharmacy bills can add up quickly. 

    Undergoing frequent tests, waiting for results, and trying to make sense of conflicting opinions can cause undue tension.  In the case of my colleague’s father, stress undoubtedly contributed to his headaches.  The multiple painkillers he was taking had contributed to a rebound effect.  With reassurance and gradual discontinuation of the drugs, the headaches were eventually resolved.