Feature Overtreatment

Is the USA’s problem ours too?

BMJ 2012; 345 doi: http://dx.doi.org/10.1136/bmj.e6617 (Published 03 October 2012) Cite this as: BMJ 2012;345:e6617
  1. Margaret McCartney, general practitioner
  1. 1Glasgow, UK
  1. margaret@margaretmccartney.com

The United Kingdom is fortunate that it is insulated against some of the needless overtesting, overtreating, and overdiagnosing that doctors in the United States are rising up against. Instead, we have the National Institute for Health and Clinical Excellence (NICE), which offers evidence based appraisals of healthcare interventions and screening and which protects against treatments of little or no efficacy being offered on the NHS. We also have the UK National Screening Committee, which provides critical reviews and recommendations of what screening is effective and useful.

Does this mean that we can relax? Unfortunately not. The general practice contract has improved the quantification of what we do, but the price of this is that more patients are exposed to guidelines rich in pharmaceutical recommendations. Some may be beneficial. However, most lack guidance about when …

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