An estimated 1 million unnecessary tests and treatments are performed annually
Multiple measures have been suggested to combat the continuing rise in Canada’s healthcare expenditure. Some say people need to be educated about generic or lower-cost drug options, and others have called for preventive measures, such as public policies against obesity. And one medical practitioner has pointed out another problem: unnecessary procedures.
“A national effort to curb unnecessary testing and treatment not only makes medical sense, but is also economically prudent in the context of ballooning health care utilization,” said Adam Kassam, a resident physician at Western University’s department of physical medicine and rehabilitation, said in an opinion piece published by the Toronto Star.
Citing figures from the Canadian Institute of Health Information (CIHI), Kassam said that Canada’s healthcare expenditure reached $228 billion in 2016. The institute has also reported that around 1 million unnecessary tests and treatments, amounting to 30% of health care, are performed every year.
To mitigate the waste associated with such medical procedures, a team from the University of Toronto, Canadian Medical Association and St. Michael’s Hospital started Choosing Wisely Canada in 2014. Part of a global movement, the initiative publishes practice recommendations for physicians based on international peer-reviewed research.
However, Kassam noted that the campaign still has its shortcomings. “Many of the studies used to guide these recommendations did not collect data or outcomes on minority populations,” he said. “In studies that did, most of the patients analyzed were Caucasian.”
The current medical understanding of how disease affects women is limited because most information from research came from middle-aged male subjects. Minority populations have been similarly underrepresented, despite studies showing that “a patient’s race plays a significant role in disease screening, diagnosis and management.”
According to Kassam, challenges inherent in medical research make it difficult to break away from the current tilt. Even after researchers develop experimental protocols, secure funding, and pass institutional reviews, they still face the daunting task of subject recruitment.
“Ideal patients are those who have the luxury of time and who are able to travel to downtown research hospitals for repeated evaluation,” he said. “It is easy to see how this is unlikely to include a minority single mother working multiple jobs in Scarborough.”
Noting efforts by Canadian Minister of Science Kirsty Duncan to promote equal representation in research, Kassam said that society will slowly shift away from one-size-fits-all treatment, and toward more personalized approaches.
“Future iterations of [Choosing Wisely’s] recommendations, along with any practice guidelines created, should endeavour to more comprehensively apply to and represent the great diversity of Canada,” he said.
Related stories:
Despite high health spending, Canada near bottom on doctors and wait times
Saskatchewan saddled with hundreds of millions in unnecessary healthcare
“A national effort to curb unnecessary testing and treatment not only makes medical sense, but is also economically prudent in the context of ballooning health care utilization,” said Adam Kassam, a resident physician at Western University’s department of physical medicine and rehabilitation, said in an opinion piece published by the Toronto Star.
Citing figures from the Canadian Institute of Health Information (CIHI), Kassam said that Canada’s healthcare expenditure reached $228 billion in 2016. The institute has also reported that around 1 million unnecessary tests and treatments, amounting to 30% of health care, are performed every year.
To mitigate the waste associated with such medical procedures, a team from the University of Toronto, Canadian Medical Association and St. Michael’s Hospital started Choosing Wisely Canada in 2014. Part of a global movement, the initiative publishes practice recommendations for physicians based on international peer-reviewed research.
However, Kassam noted that the campaign still has its shortcomings. “Many of the studies used to guide these recommendations did not collect data or outcomes on minority populations,” he said. “In studies that did, most of the patients analyzed were Caucasian.”
The current medical understanding of how disease affects women is limited because most information from research came from middle-aged male subjects. Minority populations have been similarly underrepresented, despite studies showing that “a patient’s race plays a significant role in disease screening, diagnosis and management.”
According to Kassam, challenges inherent in medical research make it difficult to break away from the current tilt. Even after researchers develop experimental protocols, secure funding, and pass institutional reviews, they still face the daunting task of subject recruitment.
“Ideal patients are those who have the luxury of time and who are able to travel to downtown research hospitals for repeated evaluation,” he said. “It is easy to see how this is unlikely to include a minority single mother working multiple jobs in Scarborough.”
Noting efforts by Canadian Minister of Science Kirsty Duncan to promote equal representation in research, Kassam said that society will slowly shift away from one-size-fits-all treatment, and toward more personalized approaches.
“Future iterations of [Choosing Wisely’s] recommendations, along with any practice guidelines created, should endeavour to more comprehensively apply to and represent the great diversity of Canada,” he said.
Related stories:
Despite high health spending, Canada near bottom on doctors and wait times
Saskatchewan saddled with hundreds of millions in unnecessary healthcare
