'Illusion' can raise costs

In an effort to improve the use of medical treatments, a University of Pennsylvania Medical School professor is calling for more research to help doctors recognize and manage what some call a “therapeutic illusion.”

“Physicians' belief that their actions or tools are more effective than they actually are can perpetuate unnecessary and costly care,” Professor David J. Casarett, M.D., MA, stated in his March 31 “Perspective” piece in the New England Journal of Medicine. Casarett also serves as director of Hospice and Palliative Care at Penn Medicine.

Casarett argues that numerous studies have “proven” that some doctors have “an unjustified belief in treatment,” or “therapeutic illusion,” with many even acknowledging they overestimate the benefits of inappropriate tests.

Despite continued rising healthcare expenditures, Casarett echoed a 2015 Kaiser Health System study that showed many countries outperform the U.S. in life expectancy at birth, costs preventing access to health care, and disease burden.

The author acknowledges that “overtreatment” is sometimes fueled by reimbursement pressures, quality measures, fear of litigation and family expectations. He advocates physicians try “more rational decision-making” and exploring possible evidence of ineffective treatments.