Many Procedures Give No More Benefit Than Doing Nothing


 
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By Kevin Rawlinson

Doctors should think carefully about whether some procedures, including x-rays and casts, are needed.

A number of common treatments and procedures routinely undertaken by doctors are largely pointless, leading physicians have said.

Many treatments for conditions from minor grazes to terminal cancers often give no more benefit to the patient than simply doing nothing.

Some broken bones, for example, would not always require a plaster cast and that an x-ray was not always necessary for patients with back pain. Doctors going forward should try to think carefully about whether certain procedures were required, given their possible side-effects.

“We all have a duty to look after resources in healthcare, especially when the NHS is under so much pressure, but that’s not the main motivation for this initiative,” said professor Dame Sue Bailey.

“What’s much more important is that both doctors and patients really question whether the particular treatment is really necessary. Medicine or surgical interventions don’t need to be the only solution offered by a doctor and more certainly doesn’t always mean better.”

Dozens of conditions for which common treatments were not necessarily beneficial, when considering the side-effects they can produce.

“Studies have shown that drinking-quality tap water is just as effective for cleaning and washing cuts and grazes as sterile saline solution,” it said. It also said that broken bones in the feet “do not usually need to be put into a plaster cast as they will heal just as quickly in a removable boot”, nor does a child’s wrist when it suffers a certain type of fracture.

And the college said routine cholesterol level checks were not needed for people taking statins who did not have “pre-existing conditions, such as a heart attack, a stroke or a family tendency towards problems with high lipids”.

Other conditions it identified included terminal cancers – particularly those that that have not responded well to previous courses of chemotherapy. The treatment is “by its very nature toxic”, the college said. “Therefore, the combination of failing to achieve a response and causing toxicity can ‘do more harm than good’.”


 
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