Flutterby™! : Unnecessary medical care

Atul Gawande in the New Yorker: Overkill: An avalanche of unnecessary medical care is harming patients physically and financially. What can we do about it?

It didn’t occur to Bruce until later to question what the doctors meant by “successful.” The blockages weren’t causing his father’s fainting episodes or any other impairments to his life. The operation would not make him feel better. Instead, “success” to the doctors meant reducing his future risk of a stroke. How long would it take for the future benefit to outweigh the immediate risk of surgery? The doctors didn’t say, but carotid surgery in a patient like Bruce’s father reduces stroke risk by about one percentage point per year. Therefore, it would take fifteen years before the benefit of the operation would exceed the fifteen-per-cent risk of the operation. And he had a life expectancy far shorter than that—very likely just two or three years. The potential benefits of the procedures were dwarfed by their risks.

Related, especially about balancing patient expectations and the placebo effect with measurable positive impacts: Wired: An Alternative-Medicine Believer's Journey Back To Science.