Overtreatment is Bad Medicine for Seniors
Jul
9
Written by:
7/9/2012 11:27 AM
One of the important medical issues that has often been overlooked in all the recent political debate about health care in the United States is that many of us are over-tested, over-treated or over-medicated. It is true that there are tens of millions who do not have access to adequate medical care, but a lot of the rest of us are getting medical attention that does little to help us and may often risk doing harm. This is all the more true of older adults, because older adults may be more frail and most older Americans were brought up in an era when a person just did not question what the doctor prescribed. And an estimated 30,000 seniors die each year owing to overtreatment.
Nine prestigious, national medical societies representing 374,000 doctors have joined forces to offer some concrete recommendations on when it may actually be healthier to say no. Here are just three of their recommendations:
- Sinus infections: It is true that a viral sinus cold can evolve into a bacterial sinus infection, and bacteria can be treated by antibiotics. The American Academy of Asthma, Allergy and Immunology recommends against taking an antibiotic, because a sinusitis may just be a viral infection (which does not respond to antibiotics), and even if it is, it will usually clear up on its own in about a week. And taking more antibiotics just adds to the risk of developing antibiotic-resistant strains of bacteria.
- Low back pain: This is the fifth major cause of visits to the doctor’s office. The American Academy of Family Physicians recommends against getting an X-RAY for a nonspecific low back pain as most of these aches resolve in one to one and a half months, and among older adults, it may just be the cumulative effect of osteoarthritis. But X-RAYs pose a cumulative risk which is avoidable, so ask the doctor if a six-week wait is in order.
- Heartburn or GERD: If you have gastroesophageal reflux of a heartburn occurring more than twice a week, you may benefit from a proton pump inhibitor (PPI) like Nexium, Prevacid or Prilosec. But as many as seven in ten individuals taking a PPI have not been diagnosed, yet they can easily get the drugs over the counter at the pharmacy. The American Gastroenterological Association cautions that these should be taken only on doctors order as PPIs can be a risk for bone fractures owing to osteoporosis and there can be a rebound effect when a person quits taking them. This rebound, in effect, makes the reflux come back even worse than it initially was. There are alternatives like diet or lifestyle change or other medications.
To learn about other ways to cut back on unnecessary – and sometimes unhealthy – care, please go to the ABIM Foundation.
Charlotte Bishop is a Geriatric Care Manager and founder of Creative Case Management, certified professionals who are geriatric advocates, resources, counselors and friends to older adults and their families in metropolitan Chicago. Please email your questions to Charlotte Bishop.
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