Unnecessary medical treatments are being deleted: ‘Surgeons see that removing an appendix sometimes has no added value’

Every doctor experiences it, says ENT-doctor Raphael Hemler. You see a patient in the outpatient clinic and think: why actually? Why is this patient coming? What does this treatment add? What does the patient have about it? The doctor keeps the thought of or talks about it with colleagues later. But with the next patient he or she does it again. Until now, he hopes.

Thursday presented eleven scientific doctors’ associations A list of thirteen everyday medical procedures and interventions Who, when the doctors sat down well, probably add so little that they can be deleted. There are interventions that have been taken for granted by doctors and patients for years. Such as the removal of an inflamed blind intestine – in a mild inflammation, in healthy people, an antibiotic cure should now suffice. There are also checks that took time but did not add much, the doctor says, because patients with complaints already reported.

It is, says Hemler, who was involved in the bracket operation on behalf of the Federation of Medical Specialists, a “paradigmashift.” If there was little scientific evidence when writing medical guidelines that something worked, it was nevertheless recorded. “We did not want to do patients short, or it seemed safer to us. Now we say: if there is no evidence that you should do it, you may not have to do it.”

Are the interventions deleted to save costs, or to help patients?

“The latter in particular. The cost saving is not too bad. Behind every patient we will not see anymore, there is someone we can see for something else. And the patient who is treated less benefits from that. From our practical experiences we have looked at the guidelines. They are often quite careful, while in practice they sometimes did few.”

But what is the profit? Financially the scrapping of the guidelines is estimated to be around 70 million euros, at 113 billion euros in healthcare costs last year.

“Well, for parents it makes a lot of difference if a baby with poo in amniotic fluid can go home four hours earlier. Or that someone with a light cerebral infarction is no longer absorbed as standard for observation. And surgeons see that sometimes there is no added value to remove the blindfarm. It is nice for patients if they don’t have to under the knife.”

Does this make it easier to run more production in healthcare? Every appointment that falls away can be filled with another patient.

“You can no longer run production, you remove a piece of the pressure on healthcare. Of course, if one patient needs less, then that creates time and space for someone else. But every minute and euro you can only spend once. We strive for appropriate care, that is something other than that this is a disguised production profit. That is not a misconception that I hear more often.”

Is it known what the damage can be of scrapping certain interventions and guidelines?

“No. That is exactly the paradigmashift. Sometimes you don’t know things exactly. You can say: we sit on the very safe side and do everything and keep an eye on everything. That is how we did it first. Then a doctor happened to see a pancreat cyst on a scan and we went to persecute, while we didn’t see it, but we don’t have any changes, but we don’t have any changes, but we don’t have any changes, but we don’t have any changes, but we don’t have any changes, but we don’t have any changes, but we don’t have any changes. Instructions that something adds little, so in principle we no longer do it. “

Such a change is not easy, Hemler expects. “Stopping something seems easy, but it is not.” In the work of Medici there are ‘tips’ that they have learned, for example, on their education, but that they can miss. And patients have expectations – for example, that that inflamed blind intestine has to be removed.

We want, says Hemler, “to initiate a movement to look critically at the care.” The thirteen deleted care acts are therefore only the beginning. He hopes for a subsidy, so that the scientific doctors’ associations can review more guidelines in search of over -cautious formulations. “We can now finally develop a method to detect and stop such actions.”

To share





Mail the editors