Editorials

Too much medicine: the challenge of finding common ground

BMJ 2015; 350 doi: http://dx.doi.org/10.1136/bmj.h1163 (Published 04 March 2015) Cite this as: BMJ 2015;350:h1163
  1. Helen Macdonald, analysis editor,
  2. Elizabeth Loder, acting head of research
  1. 1The BMJ, London, UK
  1. Correspondence to: E Loder eloder{at}bmj.com

Imprecise terminology and lack of evidence based solutions are hampering progress

MALCOLM WILLETT

Over the past few decades a “global, progressive, and activist health movement” has coalesced that broadly aims to “challenge the selling of sickness” and confront the problem of “too much medicine” in all its forms.1 2 There is consensus within this movement that far too often patients are injured by unnecessary or excessive medical care, and that too much medicine fuels waste and rising healthcare costs. The BMJ’s Too Much Medicine campaign (www.bmj.com/too-much-medicine) and this special theme issue aim to shed further light on the problem.

But what is too much medicine and who gets to decide? The phrase itself is a catchall term used to describe a variety of problems, including overdiagnosis, overtreatment, and medicalisation. It works well for advocacy, say Stacey Carter and colleagues in their article (doi:10.1136/bmj.h869), because it is broad and inclusive.3 More precise definitions, though, are needed for specific …

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