25/03/2025
*Blind Spot: The Global Rise of Unnecessary Health Care and What We Can We Do About it.*
*Dr Marty Makary*, who practices surgical oncology and gastrointestinal laparoscopic surgery at the Johns Hopkins Hospital, has caused an earthquake in the American medical world by putting in black and white certain facts which are normally kept away from public gaze. No wonder his book, Blind Spot: The Global Rise of Unnecessary Health Care and What We Can Do About It, is selling like the proverbial hot cakes!
He reveals that:
1. *Over 50% of Surgeries Are Unnecessary*: Studies suggest that more than half of all surgeries performed in the U.S. may not be medically necessary.
2. *Medical Errors Are the Third Leading Cause of Death*: Medical errors, including unnecessary treatments and surgeries, are the third leading cause of death in the United States, after heart disease and cancer.
3. *$1 Trillion in Waste*: The U.S. healthcare system wastes an estimated $1 trillion each year due to unnecessary treatments, tests, and administrative inefficiencies.
4. *Doctors Perform Procedures They Would Avoid for Themselves*: Many doctors admit that they would not undergo certain surgeries or treatments that they routinely recommend to their patients.
5. *Hospital Rankings Are Misleading*: Many hospital ranking systems are based on the number of procedures performed rather than the quality of outcomes, incentivising hospitals to do more, not better.
6. *40% of Knee Replacements Are Unnecessary*: A significant portion of knee replacement surgeries is unnecessary and could be avoided with less invasive treatment options.
7. *C-Sections Are Overperformed*: In the U.S., about one in three babies is delivered via cesarean section, often without a medical necessity, increasing risks for both mother and child.
8. *Overuse of Antibiotics*: Antibiotics are frequently prescribed for viral infections, which they do not treat, contributing to antibiotic resistance and harming patients’ microbiomes.
9. *Lack of Transparency in Healthcare Pricing*: Most patients have no idea what a procedure will cost until after it is performed, contributing to skyrocketing healthcare expenses.
10. *End-of-Life Overtreatment*: A significant portion of healthcare spending is on aggressive treatments in the last year of life, even when these treatments offer little or no benefit to the patient.
11. *Misleading Screening Tests*: Many routine cancer screening tests, like PSA for prostate cancer or mammograms, can lead to overdiagnosis, resulting in unnecessary treatments and anxiety.
12. *90% of Patients Don’t Get a Second Opinion*: Despite the importance of second opinions in avoiding unnecessary treatments, the vast majority of patients don’t seek them.
13. *Financial Incentives for Overtreatment*: The fee-for-service payment model encourages doctors to perform more procedures, as they are paid per treatment rather than for outcomes.
14. *Routine Care for Low-Risk Pregnancies*: Many low-risk pregnancies are treated as high-risk, leading to unnecessary interventions, tests, and procedures.
15. *Doctors Are Paid More for Surgery Than Non-Surgical Care*: Doctors are financially incentivised to perform surgeries because they are reimbursed more for surgical interventions than for preventive or conservative treatments.
16. *Overuse of Imaging*: Diagnostic imaging tests like MRIs and CT scans are overused, leading to incidental findings that often result in unnecessary surgeries and treatments.
17. *Up to 30% of Healthcare Is Unnecessary*: Research suggests that up to 30% of all healthcare provided in the U.S. is unnecessary or even harmful.
18. *Overdiagnosis of Thyroid Cancer*: The rise in thyroid cancer diagnoses is largely due to overdiagnosis of small, non-threatening tumours, leading to unnecessary surgeries and treatments.
19. *Defensive Medicine*: Physicians frequently order unnecessary tests or treatments not because they are needed, but because they are afraid of being sued for malpractice.
20. *Lack of Accountability for Overtreatment*: There is little accountability in the healthcare system for doctors who perform unnecessary treatments or surgeries.
21. *Medical Schools Teach Too Little About Costs*: Medical schools rarely teach doctors about the cost of healthcare services, leaving them unaware of the financial burden their recommendations place on patients.
22. *Prostate Cancer Overdiagnosis*: The PSA test for prostate cancer often leads to overdiagnosis and unnecessary treatments, such as surgery or radiation, which may cause more harm than good.
23. *Patients Are Rarely Informed of All Options*: Many doctors do not inform patients of all treatment options, including less invasive or conservative alternatives.
24. *Surgical Complication Rates Are Underreported*: Many hospitals underreport their surgical complication rates, hiding the true risks of certain procedures from the public.
25. *Burnout in Healthcare Professionals*: The pressure to perform more procedures, combined with the administrative burden, contributes to high rates of burnout among healthcare providers.
These facts from Blind Spot expose the widespread problem of unnecessary healthcare in the United States and other developed nations, emphasizing the need for systemic changes to prioritise patient safety, informed decision-making, and value-based care.
