A few years ago Atul Gwande wrote about the medical cost conundrum in the U.S. He follows up on that article with Overkill. This article is an in-depth look at the harm caused by unnecessary medical care.

I’ve become cautiously skeptical of most medical advice and this article reinforces much of my skepticism.

Here are a couple of interesting quotes from the article:

Doctors generally know more about the value of a given medical treatment than patients, who have little ability to determine the quality of the advice they are getting. Doctors, therefore, are in a powerful position. We can recommend care of little or no value because it enhances our incomes, because it’s our habit, or because we genuinely but incorrectly believe in it, and patients will tend to follow our recommendations.

The forces that have led to a global epidemic of overtesting, overdiagnosis, and overtreatment are easy to grasp. Doctors get paid for doing more, not less. We’re more afraid of doing too little than of doing too much. And patients often feel the same way. They’re likely to be grateful for the extra test done in the name of “being thorough”—and then for the procedure to address what’s found.