overtreatment

Overtreatment refers to medical care that provides little or no benefit relative to its risks, or that exceeds what would be medically appropriate given a patient’s circumstances, preferences, and evidence. It can arise from pursuing interventions that offer minimal net benefit or from treating conditions that would not have caused symptoms or harm if left alone. Overtreatment often involves excessive testing, imaging, medications, or procedures.

Causes are multifaceted. Defensive medicine, financial incentives, and patient expectations can drive clinicians to order unneeded tests or treatments. Guideline structures, fear of malpractice claims, and fragmented care can hinder appropriate de-implementation. In some cases, overtreatment follows overdiagnosis, when a condition is identified that would not have affected the patient, yet triggers further intervention.

Common examples include unnecessary antibiotic prescribing for viral infections, imaging for acute uncomplicated back pain or headaches, screening tests whose net benefit is marginal in certain populations, and polypharmacy or invasive procedures in frail elderly patients.

The consequences include adverse drug events, procedural complications, anxiety from false positives, unnecessary anxiety, and substantial waste of healthcare resources. In addition, overtreatment can undermine patient trust when benefits fail to materialize.

Efforts to reduce overtreatment emphasize patient-centered care and evidence-based de-implementation. Approaches include shared decision-making, decision aids, value-based care, appropriate-use criteria, and audit and feedback to curb low-value services.