Most people assume that more medical care is better medical care. It makes sense, doesn’t it? Routine screenings. Diagnostic testing. Additional treatments. Ongoing monitoring and follow-up. But what if some of the care routinely provided to older adults is unnecessary—or even harmful?
Researchers are increasingly challenging long-held assumptions about common medical interventions, including colonoscopies, treatment of precancerous skin lesions, and thyroid medications prescribed to older patients. The emerging evidence raises an uncomfortable question for healthcare providers, patients, and policymakers alike: when does continuing treatment stop being good medicine?
When Routine Care Deserves a Second Look
Those questions are especially relevant here in Washington, where research from the University of Washington School of Medicine has helped shape national conversations about aging, patient outcomes, and how treatment decisions affect quality of life and individual patient goals. Those same considerations are at the center of a recent KFF Health News report, which examines whether some common interventions continue to benefit older adults as they age. Researchers are questioning repeat colonoscopies after age 75, treatment of actinic keratoses, and long-term use of levothyroxine in certain older adults. In each case, the concern is the same: whether the risks outweigh the benefits.
The issue is not that these treatments never help. Rather, it is whether the risks, costs, and burdens outweigh the benefits as patients age.
The Risks of Overtreatment
For patients and families, the consequences of overtreatment can be significant. A screening test may lead to complications. A medication may create side effects without improving quality of life. An abnormal finding may trigger a cascade of additional procedures that ultimately provide little benefit. These outcomes are not necessarily malpractice, but they do underscore the importance of informed consent and thoughtful physician-patient communication.
Generally, healthcare providers should strive to practice evidence-based care by matching treatment to a patient’s individual needs rather than relying on a one-size-fits-all approach. When providers lose sight of that balance, patients may undergo unnecessary procedures or experience avoidable complications. Medical negligence cases often focus on care that providers delayed or failed to provide, but the opposite problem also deserves attention—treatment that continues simply because it has become routine.
As new evidence emerges, providers should do more than explain the risks of treatment; they should also discuss whether a test, procedure, or medication is necessary in the first place. The difficulty from our perspective, though, is that it would be hard to develop a medical negligence case where the patient did the long-recommended procedure/test and suffered only minor harm from it. This study reflects, instead, a response to the larger effort to paint patient populations with broad brushes, to step away from individualized treatment recommendations, we see with the corporatization of health care.
