Intended for healthcare professionals


Covid-19: an opportunity to reduce unnecessary healthcare

BMJ 2020; 370 doi: (Published 14 July 2020) Cite this as: BMJ 2020;370:m2752

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  1. Ray Moynihan, assistant professor1,
  2. Minna Johansson, director2,
  3. Alies Maybee, patient partner3,
  4. Eddy Lang, professor4,
  5. France Légaré, Canada research chair in shared decision making and knowledge translation5
  1. 1Institute for Evidence-Based Healthcare, Bond University, Australia
  2. 2Cochrane Sustainable Healthcare, Sweden
  3. 3Patient Advisors Network, Canada
  4. 4Department for Emergency Medicine, Cumming School of Medicine, University of Calgary, Canada
  5. 5Department of Family Medicine and Emergency Medicine, Laval University, Canada
  1. Correspondence to: R Moynihan rmoyniha{at}

Recovering health systems can prioritise genuine need

Alongside the human suffering, covid-19 is also threatening the sustainability of health systems. The continuing costs of the pandemic combined with the impending financial crisis will inevitably mean having to do more with less. The tragedy of the pandemic has paradoxically produced an opportunity to tackle the increasingly recognised challenge of “too much medicine” safely and fairly—to help improve both sustainability and equity in healthcare. This well described problem of unnecessary tests, diagnoses, and treatments causes harm and wastes resources that could be better used for those in genuine need.12

The case for tackling too much medicine was clear before covid-19.1234567 Reports from the US and the Organisation for Economic Cooperation and Development suggest that at least a fifth of routine healthcare spending may be wasted, including on overdiagnosis and overuse.34 In Canada, patients receive more than a million potentially unnecessary tests and treatments each year, according to recent estimates.5 The threats from overuse and overdiagnosis may be even more serious in …

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