210:, different rates of treatments based upon where people lived, not clinical rationale. He had discovered that in studies that began in 1967 and were published in the 1970s and the 1980s: "The basic premise – that medicine was driven by science and by physicians capable of making clinical decisions based on well-established fact and theory – was simply incompatible with the data we saw. It was immediately apparent that suppliers were more important in driving demand than had been previously realized."
25:
787:
840:
5304:
394:, we face a decision that is more important than whether we have a public-insurance option, more important than whether we will have a single-payer system in the long run or a mixture of public and private insurance, as we do now. The decision is whether we are going to reward the leaders who are trying to build a new generation of Mayos and Grand Junctions. If we don't, McAllen won't be an outlier. It will be our future.
826:
620:(utilization review) has evolved over decades among both public and private payers in an attempt to reduce overuse. In this effort, insurers employ physicians to review the actions of other physicians and detect overuse. Utilization review has a poor reputation among most clinicians as a corrupted system in which utilization reviewers have their own
638:
Professional societies and other groups have begun to push for policy changes that would encourage clinicians to avoid providing unnecessary care. Most physicians accept that laboratory tests are overused, but "it remains difficult to persuade them to consider the possibility that they, too, might be
526:
in
Pediatrics have been use of commercial rehydration solution, antidepressants, and parenteral nutrition; overmedicalization with planned early deliveries, immobilization of ankle injuries, use of hydrolyzed infant formula; and overdiagnosis of hypoxemia among children recovering from bronchiolitis.
283:
trillion. The
Institute of Medicine quoted that 2010 report in a 2012 report to support an estimate of 8% ($ 210 billion) in unnecessary services, without explaining the discrepancy. This IOM 2012 report also said there were $ 555 billion in other wasted spending, which have an "unknown overlap" with
424:
can encourage patients to ask for drugs, devices, diagnostics, or procedures. Sometimes service providers will simply give these treatments or services rather than attempting the potentially more unpleasant task of convincing the patient what they have requested is not needed, or is likely to cause
259:
In the US, the country which spends the most on health care per person globally, patients have fewer doctor visits and fewer days in hospitals than people in other countries do, but prices are high, there is more use of some procedures and new drugs than elsewhere, and doctor salaries are double the
229:
In 2009 two US physicians wrote in an editorial, that unnecessary care was "defined as services which show no demonstrable benefit to patients" and might represent 30% of U.S. medical care. They referred to a 2003 study on regional variations in
Medicare spending, which found, "Medicare enrollees in
624:(i.e., find ways to deny coverage no matter what) and in some cases are not practicing physicians, lacking real-world clinical insight or wisdom. Results of a recent systematic review found that many studies focused more on reductions in utilization than in improving clinically meaningful measures.
514:
One type of overuse can be physician self-referral. Multiple studies have replicated the finding that when non-radiologists have an ownership interest in the fees generated by radiology equipment—and can self-refer—their use of imaging is unnecessarily higher. The majority of U.S. growth in imaging
288:
estimated in 2005, without giving its methods or sources, that "between $ .30 and $ .40 of every dollar spent on health care is spent on the costs of poor quality," amounting to" slightly more than a half-trillion dollars a year... wasted on overuse, underuse, misuse, duplication, system failures,
377:
In 1992, however, McAllen had been almost exactly in line with the
Medicare spending average. After looking at other potential explanations such as relatively poorer health or medical malpractice, Gawande concluded the town was a chief example of the overuse of medical services. Gawande concluded
241:
defined overtreatment as "subjecting patients to care that, according to sound science and the patients' own preferences, cannot possibly help them—care rooted in outmoded habits, supply-driven behaviors, and ignoring science." They wrote that trying to do something (treatment or testing) for all
233:
In
January 2012, the American College of Physicians Ethics, Professionalism, and Human Rights Committee suggested that overtreatment can also be understood in contrast to 'parsimonious care', defined as "care that utilizes the most efficient means to effectively diagnose a condition and treat a
710:
was launched to decrease the amount of unnecessary medical appointments. In the app patients are given a questionnaire about their symptoms, which then assesses the patient's need for medical care. The program was a success, and as of
January 2018 has managed over 29,000 patient episodes.
3697:
Dickerson JA, Fletcher AH, Procop G, Keren DF, Singh IR, Garcia JJ, Carpenter RB, Miles J, Jackson B, Astion ML (September 2017). "Transforming
Laboratory Utilization Review into Laboratory Stewardship: Guidelines by the PLUGS National Committee for Laboratory Stewardship".
560:
Many blood transfusions in the U.S. are given without checking to see if they are needed after a previous transfusion, or are given in cases where monitoring, recovering the patient's own blood, or iron therapy would be effective and reduce the risk of
274:
and other sources. They looked at spending in 2008–2009 and found that these services represented 0.6% or 2.7% of
Medicare costs and there was no significant pattern of particular types of physicians ordering these low value services. The
2953:
221:
defined unnecessary health care as "overutilization", health care provided with a higher volume or cost than is appropriate. Recently, economists have sought to understand unnecessary health care in terms of misconsumption rather than
148:
receives goods and services but insurance pays for them (whether public insurance, private, or both). Such factors leave many actors in the system (doctors, patients, pharmaceutical companies, device manufacturers) with inadequate
355:
to consider the cost of treatment, a combination that contributes to waste. Fee-for-service is a large incentive for overuse because health care providers (such as doctors and hospitals) receive revenue from the overtreatment.
242:
patients who might need it inevitably entails doing that same thing for some patients who might not need it." In uncertain situations, "some non-beneficial care was the necessary byproduct of optimal clinical decision making."
493:. 2008 Medicare claims showed overuse with chest CT's. Financial incentives have also been shown to have a significant impact on dental X-ray use with dentists who are paid a separate fee for each X-ray providing more X-rays.
2786:
557:. In some cases, the number of pills prescribed might exceed what is actually needed for pain relief from a given condition, or a different pain management technique or medication would be effective but less risky.
297:
recipients from doing more, whether 'more' is expressed as hospitalizations, surgical procedures, or consultations within the hospital." Up to 30% of
Medicare spending could be cut in 2003 without harming patients.
752:
Since the meeting, the Lown
Institute has focused its work on deepening the understanding of overuse and generating public discussion of the ethical and cultural drivers of overuse, especially on the role of the
4146:
647:
campaign, which aims to raise awareness of overtreatment and change physician behavior by publicizing lists of tests and treatments that are often overused, and which doctors and patients should try to avoid.
685:. The project aims to standardize the names of laboratory tests to limit errant test ordering. Genetic testing stewardship programs have been established to streamline molecular diagnostic ordering patterns.
266:
reported "no one knows for sure" how much unnecessary care exists in the United States. Overuse of medical care is no longer a large fraction of total health care spending, which was $ 3.3 trillion in 2016.
3138:
998:
301:
A study of low-value care in laboratory testing suggested that Medicare may have overspent at least US$ 1.95 billion on laboratory tests in the year 2019. The study found excessively frequent ordering of
3433:
3185:
725:
Health Policy Program convened the 'Avoiding Avoidable Care' conference. It was the first major medical conference to focus entirely on overuse, and it included presentations from speakers including
245:
In October 2015, two pediatricians said that considering "overtreatment as an ethical violation" could help see the conflicting incentives of health care workers for treatment or nontreatment.
515:
use (the fastest-growing physician service) comes from self-referring nonradiologists. In 2004, this overuse was estimated to contribute to $ 16 billion of annual U.S. health care costs.
2506:
3834:
Gammon RR, Blanton K, Gilstad C, Hong H, Nichols T, Putnam H, Marinaro L, Segura T, Tay S, Bocquet C (August 2022). "How do we obtain and maintain patient blood management certification?".
2075:
Smart D, Schreier J, Singh IR (June 2024). "Inappropriate Laboratory Testing: Significant Waste Quantified by a Large-Scale Year-Long Study of Medicare and Commercial Payer Reimbursement".
413:
is a favored explanation for high medical costs by physicians, Gawande estimated in 2010 it only contributed to 2.4% of the total $ 2.3 trillion of U.S. health care spending in 2008.
941:
2993:
3601:
Cassel, Christine. K. (of Choosing Wisely); Guest, James A. (of Consumer Reports) (2012). "Choosing Wisely - Helping Physicians and Patients Make Smart Decisions About Their Care".
378:
that a business culture (physicians viewing their practices as a revenue stream) had established itself there, in contrast to a culture of low-cost high-quality medicine at the
433:
Dartmouth Medical School professor Gilbert Welch argued 2016 that certain predispositions by physicians and the general public may lead to unnecessary health care, including:
3210:
1246:, Gottlieb DJ, Lucas FL, Pinder EL (February 2003). "The implications of regional variations in Medicare spending. Part 2: health outcomes and satisfaction with care".
469:
Overuse of diagnostic imaging, such as X-rays and CT scans, is defined as any application unlikely to improve patient care. Factors that contribute to overuse include "
1565:
665:
tools can help decrease unnecessary laboratory testing. The PLUGS initiative (Patient-Centered Laboratory Utilization Guidance Services) aims to formalize laboratory
3289:
3135:
631:, did not contain serious strategies to reduce overuse; "the public has made it clear that it does not want to be told what medical care it can and cannot have."
2259:
990:
321:
When care is overused, patients are put at risk of complications unnecessarily, with documented harm to patients from overuse of surgeries and other treatments.
4352:
3430:
3182:
2536:
3870:
409:
To protect themselves from legal prosecution U.S. physicians have an incentive to order clinically unnecessary tests or tests of little potential value. While
251:, for the most part, is administration of tests or treatment, which though useful initially, offer little value if given repeatedly as a part of routine care.
1125:
4253:
4188:
4171:
4167:
3763:
2485:
1062:
113:, overuse was the predominant factor in its expense, accounting for about a third of its health care spending ($ 750 billion out of $ 2.6 trillion) in 2012.
2723:
Coon Eric R., Young Paul C., Quinonez Ricardo A., Morgan Daniel J., Dhruva Sanket S., Schroeder Alan R. (2018). "2017 Update on Pediatric Medical Overuse".
4249:
4163:
3395:
Roland KB, Soman A, Bernard VB, et al. (2011). "Human papillomavirus and Papanicolaou tests screening interval recommendations in the United States".
2948:
1962:
1877:
4147:
1958:
1954:
1869:
4748:
4175:
3535:
1970:
1885:
489:(WHO)—have developed "appropriateness criteria". The Canadian Association of Radiologists estimated in 2009 that 30% of imaging was unnecessary in the
2298:
4380:
4245:
4241:
4179:
3539:
3062:
1108:
4303:
4233:
4016:
3587:
2984:
2766:
2679:
2374:
2018:
1933:
1289:
230:
higher-spending regions receive more care than those in lower-spending regions, but do not have better health outcomes or satisfaction with care."
4155:
4151:
2944:
2200:
655:(CLSI) issued a 2017 guideline, "Developing and Managing a Medical Laboratory (Test) Utilization Program (GP49)", to help laboratories establish
2842:
4105:
3552:
2980:
2683:
1949:
1864:
35:
972:
5263:
4700:
4159:
3543:
2688:
2499:
1381:
Ralston Shawn L., Schroeder Alan R. (2015). "Doing More vs Doing Good: Aligning Our Ethical Principles From the Personal to the Societal".
718:
issued 2021 guidelines for the minimum time that should elapse before a given laboratory test is repeated in a specific clinical scenario.
572:
1888:(February 2003). "The implications of regional variations in Medicare spending. Part 1: the content, quality, and accessibility of care".
3442:
2627:
2440:
2431:
674:
652:
1499:
4309:
4110:
3478:
Maratt, Jennifer K.; Kerr, Eve A.; Klamerus, Mandi L.; Lohman, Shannon E.; Froehlich, Whit; Bhatia, R. Sacha; Saini, Sameer D. (2019).
3162:
2722:
2038:(April 2011). "Personal reflections on the high cost of American medical care: Many causes but few politically sustainable solutions".
1821:
628:
285:
162:
3925:
1973:(February 2003). "The implications of regional variations in Medicare spending. Part 2: health outcomes and satisfaction with care".
3959:
279:
in 2010 gave two estimates of "unnecessary services," using different methodologies: 0.2% or 1% to 5% of health spending, which was
4809:
2868:
2618:
106:
669:
practices. The TRUU-Lab (Test Renaming for Understanding and Utilization in the Laboratory) initiative is a cooperative effort of
635:, a health economist at Princeton, said "the minute you attack overutilization, you will be called a Nazi before the day is out".
4903:
4753:
1548:
391:
4240:
3207:
2569:
2388:
4613:
4474:
3038:
1143:
473:, patient wishes, inappropriate financially motivated factors, health system factors, industry, media, lack of awareness" and
5188:
5129:
4843:
4373:
4046:
2178:
1837:
1790:
1715:
455:
Treating patients with terminal illness to maximize life span over quality of life, without probing a patient's preferences
1477:
5086:
3279:
452:
Preferring newer over older treatments without considering the cost of new treatments or the effectiveness of older ones
179:, in the strict sense, may refer to unnecessary medical interventions, including treatment of a self-limited condition (
5091:
2410:
3636:
2251:
2153:
69:
4316:
Gawande, Atul A.; Colla, Carrie H.; Halpern, Scott D.; Landon, Bruce E. (April 3, 2014). "Avoiding Low-Value Care".
3981:
Zapata Josué A., Lai Andrew R., Moriates Christopher (2017). "Is Excessive Resource Utilization an Adverse Event?".
2546:
1590:
McWilliams, J. Michael; Chernew, Michael E.; Elshaug, Adam G.; Landon, Bruce E.; Schwartz, Aaron L. (July 1, 2014).
5328:
5270:
4366:
3787:"The Genetic Testing Stewardship Program:: A Bridge to Precision Diagnostics for the Non-genetics Medical Provider"
1851:
1122:
682:
2782:"Do doctors under-provide, over-provide or do both? Exploring the quality of medical treatment in the Philippines"
5290:
5258:
4076:
Hendee WR, Becker GJ, Borgstede JP, et al. (October 2010). "Addressing overutilization in medical imaging".
3461:
1421:"Strategies to Reduce Low-Value Cardiovascular Care: A Scientific Statement From the American Heart Association"
4999:
4403:
421:
798:
5236:
5221:
4959:
4743:
4458:
3662:
Lewandrowski K (June 2019). "Integrating Decision Support into a Laboratory Utilization Management Program".
2040:
764:
Patient safety committees, which are charged with reviewing the quality of care, can view overutilization as
715:
482:
478:
2284:
5211:
3053:"Heart Treatment Overused – Study Finds Doctors Often Too Quick to Try Costly Procedures to Clear Arteries"
3052:
1418:
47:
1098:
539:
Surgeries in Medicare patients in their last year of life; regions with high levels had higher death rates
333:
of unnecessary care, though the potential incentives and penalties they face can influence their choices.
5241:
4779:
4774:
4484:
3734:
3550:(September 2005). "A simple, focused, computerized query to detect overutilization of laboratory tests".
2951:(January 2011). "Overuse of antibiotics in children for upper respiratory infections (URIs): a dilemma".
1975:
1890:
1817:
Building a Better Delivery System: A New Engineering/Health Care Partnership – Bridging the Quality Chasm
496:
Overuse of imaging can lead to a diagnosis of a condition that would have otherwise remained irrelevant (
2319:
703:, form a committee to audit blood utilization, identify areas for improvement, and monitor compliance.
4606:
4536:
3903:
5333:
5285:
5231:
5014:
4954:
4836:
4057:
3312:
2831:
2686:(March 2004). "Turf wars in radiology: the overutilization of imaging resulting from self-referral".
878:
662:
486:
307:
237:
In April 2012, Berwick, from the Institute for Healthcare Improvement, and Andrew Hackbarth from the
158:
1752:
1647:
McWilliams, J. Michael; Zaslavsky, Alan M.; Jena, Anupam B.; Schwartz, Aaron L. (December 3, 2018).
1200:
440:
Attempting to fix an underlying problem, instead of using a less-risky monitoring or coping strategy
5280:
5144:
4883:
4726:
4108:(October 1998). "Whither the almshouse? Overutilization and the role of the emergency department".
3480:"Measures Used to Assess the Impact of Interventions to Reduce Low-Value Care: a Systematic Review"
2873:
1241:
893:
692:
383:
294:
169:
as a condition for payment. However, the threshold between necessity and lack thereof can often be
51:
2106:
5179:
3534:
3057:
2838:
1419:
American Heart Association Council on Quality of Care and Outcomes Research (February 22, 2022).
699:. To become accredited, participating hospitals may distribute guidelines for appropriateness of
509:
470:
43:
2510:
437:
Attempting to mitigate a risk without considering how small or unlikely the potential benefit is
5216:
4721:
2897:"The intensity and variation of surgical care at the end of life: a retrospective cohort study"
1195:
868:
722:
617:
583:
5205:
5106:
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4599:
4499:
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4428:
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4227:
4010:
3955:
3581:
3238:
2760:
2479:
2368:
2145:
2139:
2012:
1927:
1283:
547:
490:
276:
206:
3159:
1988:
1903:
1316:
1259:
1209:
5307:
5275:
5199:
4893:
4878:
4829:
4443:
2116:
758:
688:
597:
579:
129:
3933:
8:
5183:
4639:
4541:
4489:
4266:
3284:
2205:
2035:
1873:
1699:
The Healthcare Imperative: Lowering Costs and Improving Outcomes: Workshop Series Summary
1243:
404:
117:
4315:
1775:
Proceedings 14th International Parallel and Distributed Processing Symposium. IPDPS 2000
5169:
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3112:
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2748:
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2462:
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1020:
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621:
519:
474:
410:
262:
214:
189:
154:
125:
3326:
2914:
2896:
2218:
536:
Hospitalizations for those with chronic conditions who could be treated as outpatients
5116:
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5003:
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4731:
4579:
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4479:
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3998:
3851:
3816:
3715:
3679:
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3517:
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3412:
3377:
3257:
3193:
3146:
3117:
3020:
2962:
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2813:
2740:
2736:
2705:
2654:
2592:
2467:
2406:
2356:
2222:
2149:
2088:
2057:
1992:
1950:
1907:
1865:
1843:
1833:
1786:
1721:
1711:
1678:
1629:
1611:
1462:
1450:
1398:
1394:
1363:
1332:
1320:
1263:
1213:
1166:
1079:
964:
863:
754:
700:
370:. In 2006, the town of McAllen was the second-most expensive Medicare market, behind
166:
133:
4139:
3980:
2930:
2604:
1919:
1664:
1607:
1225:
1162:
5193:
5134:
5040:
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4572:
4325:
4275:
4257:
4205:
4197:
4119:
4085:
3990:
3843:
3806:
3798:
3707:
3671:
3610:
3561:
3507:
3491:
3404:
3367:
3359:
3322:
3247:
3107:
3099:
3010:
3002:
2910:
2803:
2795:
2752:
2732:
2697:
2644:
2636:
2588:
2584:
2457:
2449:
2346:
2338:
2214:
2080:
2053:
2049:
2004:
1984:
1899:
1825:
1800:
1778:
1771:"Replicating the contents of a WWW multimedia repository to minimize download time"
1703:
1668:
1660:
1619:
1603:
1507:
1440:
1432:
1390:
1355:
1312:
1275:
1255:
1205:
1158:
1071:
1036:
956:
734:
238:
3339:
2170:
1144:""Too much medicine": Insights and explanations from economic theory and research"
185:) or to extensive treatment for a condition that requires only limited treatment.
5055:
5050:
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4975:
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4531:
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845:
831:
738:
644:
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348:
342:
330:
271:
223:
218:
121:
2895:
Kwok AC, Semel ME, Lipsitz SR, Bader AM, Barnato AE, Gawande AA, Jha AK (2011).
2203:(October 2009). "US reimbursement systems encourage fraud and overutilisation".
1770:
1303:
Snyder L (2012). "American College of Physicians Ethics Manual: sixth edition".
5139:
5124:
4995:
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3350:
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2701:
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1186:
853:
565:
543:
363:
303:
4123:
3802:
3675:
3234:"When things go wrong: how health care organizations deal with major failures"
2342:
2084:
1782:
1346:
Berwick DM, Hackbarth AD (April 2012). "Eliminating waste in US health care".
5322:
4913:
4898:
4888:
4664:
4644:
4526:
4510:
4413:
4408:
3711:
3503:
3252:
3233:
2323:, Amitabh Chandra, Atul A. Gawande & David M. Studdert (September 2010).
1615:
960:
888:
765:
742:
632:
523:
497:
347:
When public or private insurance cover expenses and doctors are paid under a
289:
unnecessary repetition, poor communication, and inefficiency. In 2003 Fisher
201:
181:
102:
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4261:
4089:
2799:
5226:
5159:
5154:
5060:
5035:
4990:
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4002:
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3719:
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3622:
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3521:
3416:
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2922:
2817:
2744:
2709:
2658:
2596:
2471:
2360:
2247:
2226:
2141:
The Treatment Trap: How the Overuse of Medical Care is Wrecking Your Health
2092:
2061:
1996:
1911:
1847:
1725:
1697:
1682:
1633:
1454:
1402:
1367:
1324:
1267:
1217:
1170:
1083:
1075:
991:"We spend $ 750 billion on unnecessary health care. Two charts explain why"
968:
858:
777:
726:
359:
170:
141:
4358:
4131:
3614:
3103:
1359:
1040:
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4558:
4329:
1966:
1881:
746:
730:
666:
656:
379:
315:
98:
2640:
2570:"First do no harm – The impact of financial incentives on dental X-rays"
2453:
1815:
1019:
839:
786:
5070:
5030:
4353:"Disease Creep: How we're fooled into using more medicine than we need"
3218:
2901:
2252:"The Cost Conundrum – What a Texas town can teach us about health care"
1511:
3847:
3462:"Doing Better by Doing Less: Approaches to Tackle Overuse of Services"
3006:
2943:
5065:
4949:
3447:
2289:
601:
554:
352:
311:
150:
16:
Health care provided with a higher volume or cost than is appropriate
1649:"Analysis of Physician Variation in Provision of Low-Value Services"
443:
Acting too quickly, when waiting for more information might be wiser
4985:
4939:
4929:
1829:
1707:
1380:
932:
605:
571:
Stents performed by the formal chair of cardiology, Mark Midei, at
137:
4262:"National trends in CT use in the emergency department: 1995–2007"
1027:(2008). "Health Care Overutilization in the United States—Reply".
398:
270:
Researchers in 2014 analyzed many services listed as low value by
101:
provided with a higher volume or cost than is appropriate. In the
5149:
5045:
4934:
4038:
Overtreated: Why too much medicine is making us sicker and poorer
2979:
2678:
707:
390:
As America struggles to extend healthcare coverage while curbing
145:
1142:
Hensher, Martin; Tisdell, John; Zimitat, Craig (March 1, 2017).
374:. Costs per beneficiary were almost twice the national average.
293:. found that there was "no apparent regional health benefit for
4980:
4591:
2780:
James CD, Hanson K, Solon O, Whitty CJ, Peabody J (June 2011).
2534:
1646:
1500:"Spending, Use of Services, Prices, and Health in 13 Countries"
568:(used in $ 20,000 procedures) with nonacute indications (U.S.)
4821:
3136:
Progress, but not enough, against needless hospital procedures
3039:
Blood transfusion regulations needed to rein in overuse: Panel
1589:
1184:
Reilly BM, Evans AT (2009). "Much ado about (doing) nothing".
371:
34:
deal primarily with the United States and do not represent a
3895:
3696:
3643:. Clinical and Laboratory Standards Institute. July 31, 2017
4184:"Non-evidence-based ICD implantations in the United States"
3785:
Thomas M, Amlie-Wolf L, Baker L, Gripp KW (December 2021).
2954:
Journal of the College of Physicians and Surgeons--Pakistan
696:
3871:"National minimum retesting intervals in pathology (G147)"
3784:
2391:
American College of Physicians, n.d., retrieved 9 May 2018
3956:"2013 Lown Conference: From Avoidable Care to Right Care"
3313:"Can Funders Quell a 'Perfect Storm of Overutilization'?"
3050:
2436:"Imaging overutilisation: Is enough being done globally?"
2294:
2111:
678:
670:
593:
Screening patients with advanced cancer for other cancers
587:
542:
Antibiotic use for viral or self-limiting infections (an
336:
110:
3833:
3477:
3460:
Berenson, Robert A.; Docteur, Elizabeth (January 2013).
2832:"Effective Care – A Dartmouth Atlas Project Topic Brief"
1345:
446:
Acting without considering the benefits of doing nothing
3926:"Avoiding Avoidable Care Conference- Featured Speakers"
3735:"Standardizing Lab Test Names: the TRUU-Lab Initiative"
3086:"Appropriateness of Percutaneous Coronary Intervention"
2989:"Over-, under- and misuse of pain treatment in Germany"
1060:(December 2009). "Eliminating 'waste' in health care".
639:
overutilizing laboratory tests." In November 2011, the
3346:"Cancer screening among patients with advanced cancer"
2779:
4189:
JAMA: The Journal of the American Medical Association
4075:
2894:
1695:
1141:
1063:
JAMA: The Journal of the American Medical Association
821:
3280:"At California Hospital, Red Flags and an FBI Raid"
2869:"Medicare Patients Get Costly Surgery Before Death"
2623:"Overuse, overdose, overdiagnosis... overreaction?"
2535:Walt Bogdanich; Jo Craven McGinty (June 17, 2011).
2285:"Spend More, Get Less? The Health Care 'Conundrum'"
2034:
749:. A second meeting was planned for December 2013.
4749:Political abuse of psychiatry in the United States
3764:"Creating a Universal Standard for Lab Test Names"
3394:
3041:CBS News/Associated Press. Accessed June 28, 2011.
2107:"Medicare Options In Biden Budget Talks Get Boost"
2074:
1777:. The National Academies Press. pp. 101–102.
4355:by medical investigative journalist Jeanne Lenzer
2484:: CS1 maint: DOI inactive as of September 2024 (
1539:"Law May Do Little to Help Curb Unnecessary Care"
1132:– Managed Healthcare Executive, February 01, 2003
416:
5320:
3766:. Children's Hospital Association. March 1, 2024
2787:International Journal for Quality in Health Care
2325:"National costs of the medical liability system"
1768:
1425:Circulation: Cardiovascular Quality and Outcomes
3869:Lang, Dr. Tim; Croal, Dr. Bernie (March 2021).
3603:The Journal of the American Medical Association
3553:Archives of Pathology & Laboratory Medicine
3459:
3310:
3274:
1497:
1056:
1029:The Journal of the American Medical Association
949:The Journal of the American Medical Association
928:
926:
924:
922:
920:
918:
916:
914:
399:Medical malpractice laws and defensive medicine
3231:
2537:"Medicare Claims Show Overuse for CT Scanning"
2030:
2028:
1640:
1532:
1530:
1528:
641:American Board of Internal Medicine Foundation
518:As of a 2018 review evidence of overtreatment
4837:
4701:Prescription drug prices in the United States
4607:
4374:
3397:American Journal of Obstetrics and Gynecology
3208:Maryland Revokes Mark Midei’s Medical License
2568:Chalkley, M.; Listl, S. (December 30, 2017).
2567:
2400:
2199:
573:St. Joseph Medical Center of Towson, Maryland
32:The examples and perspective in this article
4302:: CS1 maint: multiple names: authors list (
4232:: CS1 maint: multiple names: authors list (
4104:
4015:: CS1 maint: multiple names: authors list (
3661:
3586:: CS1 maint: multiple names: authors list (
3051:Ron Winslow; John Carreyrou (July 6, 2011).
2765:: CS1 maint: multiple names: authors list (
2689:Journal of the American College of Radiology
2389:Assumptions That Drive Too Much Medical Care
2373:: CS1 maint: multiple names: authors list (
2279:
2277:
2246:
2242:
2240:
2238:
2236:
2017:: CS1 maint: multiple names: authors list (
1932:: CS1 maint: multiple names: authors list (
1288:: CS1 maint: multiple names: authors list (
1096:
911:
428:
362:investigated Medicare FFS reimbursements in
4388:
3600:
3594:
3431:Annual Pap tests often ordered but unneeded
2866:
2628:Biomedical Imaging and Intervention Journal
2441:Biomedical Imaging and Intervention Journal
2426:
2424:
2422:
2137:
2025:
1536:
1525:
1183:
653:Clinical and Laboratory Standards Institute
449:Discounting downsides of diagnostic testing
4844:
4830:
4614:
4600:
4381:
4367:
4111:Journal of Health Politics, Policy and Law
1764:
1762:
1583:
721:In April 2012, the Lown Institute and the
629:Patient Protection and Affordable Care Act
600:in women with medical histories of normal
503:
286:United States National Academy of Sciences
163:Centers for Medicare and Medicaid Services
116:Factors that drive overuse include paying
4279:
4209:
3868:
3810:
3511:
3371:
3251:
3111:
3014:
2807:
2648:
2461:
2430:
2350:
2274:
2233:
2168:
1672:
1623:
1444:
1412:
1199:
1090:
70:Learn how and when to remove this message
4058:"America's Epidemic of Unnecessary Care"
4034:
3340:Camelia S. Sima; Katherine S. Panageas;
2419:
1945:
1943:
1813:
1498:Squires, David; Anderson, Chloe (2015).
1302:
771:
157:or overuse. This drives payers, such as
4754:Political abuse of psychiatry in Russia
4055:
3225:
3183:St. Joseph Medical Center's CEO resigns
2674:
2672:
2670:
2668:
1989:10.7326/0003-4819-138-4-200302180-00007
1904:10.7326/0003-4819-138-4-200302180-00006
1759:
1689:
1317:10.7326/0003-4819-156-1-201201031-00001
1260:10.7326/0003-4819-138-4-200302180-00007
1210:10.7326/0003-4819-150-4-200902170-00008
1052:
1050:
553:Opiate prescriptions carry the risk of
5321:
4475:Caesarean delivery on maternal request
3292:from the original on November 10, 2012
2617:
2181:from the original on February 16, 2010
1592:"Measuring Low-Value Care in Medicare"
1566:"Table 1 National Health Expenditures"
1560:
1558:
1177:
1111:from the original on November 5, 2011.
1001:from the original on December 30, 2015
942:"The perfect storm of overutilization"
627:The 2010 U.S. health care reform, the
477:. Respected organizations—such as the
337:Third-party payers and fee-for-service
284:each other and the $ 210 billion. The
5189:Artificial intelligence in healthcare
4825:
4595:
4362:
3962:from the original on November 4, 2013
2099:
1940:
1858:
1491:
1475:
988:
3906:from the original on January 3, 2015
3484:Journal of General Internal Medicine
3429:Kathleen Doheny (August 20, 2011). "
3083:
2848:from the original on October 2, 2011
2665:
2507:Canadian Association of Radiologists
1047:
781:
612:
18:
4551:Works about unnecessary health care
3932:. April 25–26, 2012. Archived from
3311:Rosemary Gibson (August 25, 2010).
2301:from the original on March 28, 2014
1769:Loukopoulos, T.; Ahmad, I. (2000).
1555:
1551:from the original on July 16, 2017.
1469:
13:
5264:reform debate in the United States
3170:Maryland State Board of Physicians
3065:from the original on July 17, 2015
2262:from the original on June 10, 2011
1854:from the original on July 9, 2008.
1097:Alix Spiegel (November 10, 2009).
989:Kliff, Sarah (September 7, 2012).
200:A forerunner of the term was what
14:
5345:
5291:(Category Health care by country)
4346:
3732:
3327:10.1377/forefront.20100825.006700
2144:. Chicago: Ivan R. Dee. pp.
1476:Kliff, Sarah (October 16, 2017).
706:In the UK, 2011, online platform
107:health care costs are the highest
5303:
5302:
4621:
2994:GMS Health Technology Assessment
2737:10.1001/jamapediatrics.2017.5752
2171:"Texas town's healthcare puzzle"
2138:Gibson; Singh, Rosemary (2010).
1395:10.1001/jamapediatrics.2015.2702
838:
824:
785:
23:
4851:
4679:Economic and financial concerns
4318:New England Journal of Medicine
3974:
3948:
3918:
3888:
3876:. Royal College of Pathologists
3862:
3827:
3778:
3756:
3726:
3690:
3655:
3637:"New Test Utilization Document"
3629:
3528:
3471:
3453:
3423:
3388:
3333:
3304:
3268:
3200:
3181:Meredith Cohn (July 29, 2011).
3175:
3153:
3128:
3077:
3044:
3031:
2973:
2937:
2888:
2867:Carrie Gann (October 6, 2011).
2860:
2824:
2773:
2716:
2611:
2561:
2528:
2492:
2456:(inactive September 18, 2024).
2394:
2381:
2313:
2193:
2162:
2131:
2068:
1807:
1665:10.1001/jamainternmed.2018.5086
1608:10.1001/jamainternmed.2014.1541
1374:
1339:
1296:
1163:10.1016/j.socscimed.2017.01.020
188:It is economically linked with
5000:Academic health science centre
4404:Direct-to-consumer advertising
4056:Gawande, Atul (May 11, 2015).
3232:Walshe K, Shortell SM (2004).
3206:Larry Husten (July 13, 2011).
2589:10.1016/j.jhealeco.2017.12.005
2054:10.1001/archinternmed.2011.149
1696:Institute of Medicine (2010).
1537:Gina Colata (March 29, 2010).
1235:
1135:
1115:
1013:
982:
422:Direct-to-consumer advertising
417:Direct-to-consumer advertising
329:Physicians' decisions are the
1:
5237:Health information management
5222:health information technology
4960:Health information management
4744:Political abuse of psychiatry
4459:Political abuse of psychiatry
3134:Jay Hancock (July 18, 2011).
2915:10.1016/S0140-6736(11)61268-3
2219:10.1016/S1470-2045(09)70297-9
2041:Archives of Internal Medicine
1151:Social Science & Medicine
899:
716:Royal College of Pathologists
483:Royal College of Radiologists
479:American College of Radiology
195:
5212:Translational bioinformatics
3566:10.5858/2005-129-1141-ASFCQT
3450:). Accessed August 22, 2011.
3037:Ryan Jaslow (June 28, 2011)
1822:National Academy of Sciences
1437:10.1161/HCQ.0000000000000105
904:
366:, for a 2009 article in the
351:(FFS) model, neither has an
7:
5242:Consumer health informatics
4780:Hospital-acquired infection
4775:Hospital-acquired pneumonia
4485:Benzodiazepine use disorder
3188:September 29, 2012, at the
3165:September 30, 2011, at the
3141:September 20, 2011, at the
2577:Journal of Health Economics
1976:Annals of Internal Medicine
1891:Annals of Internal Medicine
1478:"The problem is the prices"
817:
491:Canadian health care system
459:
260:levels in other countries.
46:, discuss the issue on the
10:
5350:
4537:Medication discontinuation
4035:Brownlee, Shannon (2007).
4027:
3496:10.1007/s11606-019-05069-5
3409:10.1016/j.ajog.2011.06.001
3084:Chan; et al. (2011).
2702:10.1016/j.jacr.2003.12.009
2403:Less Medicine, More Health
2169:Katty Kay (July 7, 2009).
1431:(3): HCQ0000000000000105.
1128:December 18, 2007, at the
1123:Clamping down on variation
775:
564:An estimated one in eight
507:
464:
402:
386:, market. Gawande advised:
340:
5298:
5252:
5232:Public health informatics
5168:
5145:Electronic health records
5115:
5079:
5023:
5015:Supervised injection site
4968:
4955:Allied health professions
4922:
4859:
4798:
4762:
4709:
4678:
4627:
4550:
4519:
4467:
4396:
4124:10.1215/03616878-23-5-795
3896:"Avoiding Avoidable Care"
3803:10.32481/djph.2021.12.007
3676:10.1016/j.cll.2019.01.004
2343:10.1377/hlthaff.2009.0807
2085:10.5858/arpa.2023-0486-OA
1783:10.1109/ipdps.2000.846027
879:Clinical decision support
663:Clinical decision support
598:cervical cancer screening
530:
487:World Health Organization
429:Physician predispositions
324:
308:prostate-specific antigen
159:national health insurance
4727:Compulsory sterilization
3712:10.1373/jalm.2017.023606
3253:10.1377/hlthaff.23.3.103
3222:Accessed August 4, 2011.
3197:Accessed August 4, 2011.
3172:Accessed August 4, 2011.
3160:Final Decision and Order
3150:Accessed August 4, 2011.
2500:"Do you need that scan?"
1814:Lawrence, David (2005).
1242:Fisher ES, Wennberg DE,
961:10.1001/jama.299.23.2789
894:Patient blood management
693:patient blood management
691:offers accreditation in
384:Grand Junction, Colorado
213:In 2008, US bioethicist
5329:Unnecessary health care
5180:Medical image computing
5130:Artificial intelligence
4655:Unnecessary health care
4390:Unnecessary health care
4281:10.1148/radiol.10100640
4090:10.1148/radiol.10100063
3930:Avoiding Avoidable Care
3436:March 20, 2012, at the
3058:The Wall Street Journal
2839:Dartmouth Atlas Project
1408:(subscription required)
1231:(subscription required)
510:Physician self-referral
504:Physician self-referral
254:
136:in instances where the
83:Unnecessary health care
5217:Translational medicine
4722:Sluggish schizophrenia
4202:10.1001/jama.2010.1915
4041:. London: Bloomsbury.
3995:10.1001/jama.2017.0698
3364:10.1001/jama.2010.1449
3213:July 16, 2011, at the
2509:. 2009. Archived from
2401:Gilbert Welch (2016).
1653:JAMA Internal Medicine
1596:JAMA Internal Medicine
1076:10.1001/jama.2009.1821
869:Antibiotic stewardship
757:in medical school and
723:New America Foundation
618:Utilization management
584:Redding Medical Center
580:Heart bypass surgeries
396:
132:, and insulation from
5206:Computational biology
5107:Universal precautions
4799:Records and histories
4770:Adverse drug reaction
4738:The Protest Psychosis
4500:Proton-pump inhibitor
4449:Quaternary prevention
4429:Unwarranted variation
3615:10.1001/jama.2012.476
3239:Health Aff (Millwood)
3104:10.1001/jama.2011.916
2800:10.1093/intqhc/mzr029
2549:on September 20, 2020
1360:10.1001/jama.2012.362
1041:10.1001/jama.2008.605
978:on September 2, 2009.
772:Consumer cost sharing
586:which resulted in an
548:antibiotic resistance
425:more harm than good.
388:
277:Institute of Medicine
249:Low-value health care
217:and health economist
207:unwarranted variation
5200:Behavior informatics
4520:Tools and situations
4468:Overused health care
4444:Prescription cascade
4330:10.1056/NEJMp1401245
3791:Dela J Public Health
2841:. January 15, 2007.
2117:The Associated Press
1504:commonwealthfund.org
695:in conjunction with
689:The Joint Commission
161:systems or the U.S.
118:health professionals
52:create a new article
44:improve this article
5184:imaging informatics
5092:Cultural competence
4640:Medical malpractice
4542:Withdrawal syndrome
4490:Opioid use disorder
4254:Shelia R. Salisbury
4172:Adrian F. Hernandez
4168:Paul A. Heidenreich
3285:The Washington Post
2909:(9800): 1408–1413.
2641:10.2349/biij.6.3.e8
2583:(March 2018): 1–9.
2454:10.2349/biij.7.1.e6
2206:The Lancet Oncology
2077:Arch Pathol Lab Med
2036:Steven A. Schroeder
995:The Washington Post
622:perverse incentives
405:Medical malpractice
128:to protect against
109:as a percentage of
5170:Health informatics
4945:Healthcare science
4696:Financial toxicity
4566:The Treatment Trap
4439:Overmedicalization
4424:Defensive medicine
4250:Beverly M. Schnell
4164:Gillian D. Sanders
3958:. Lown Institute.
3936:on August 14, 2013
3467:. Urban Institute.
2949:Rukhsana W. Zuberi
2542:The New York Times
1963:Daniel J. Gottlieb
1878:Daniel J. Gottlieb
1820:. Washington, DC:
1544:The New York Times
1512:10.26099/77tf-5060
1311:(1 Pt 2): 73–104.
1104:This American Life
1021:Ezekiel J. Emanuel
934:Ezekiel J. Emanuel
884:Overmedicalization
797:. You can help by
520:overmedicalization
475:defensive medicine
411:defensive medicine
263:The New York Times
215:Ezekiel J. Emanuel
190:overmedicalization
155:health care prices
126:defensive medicine
5316:
5315:
5080:Skills / training
5004:Teaching hospital
4819:
4818:
4785:Iatrogenic anemia
4732:Physician gag law
4589:
4588:
4580:Overdosed America
4495:Psychoactive drug
4480:Antibiotic misuse
4454:Disease mongering
4162:, Eric Peterson,
4148:Sana M. Al-Khatib
4048:978-1-58234-580-2
3900:avoidablecare.org
3848:10.1111/trf.16929
3609:(17): 1801–1802.
3358:(14): 1584–1591.
3278:(July 25, 2005).
3194:The Baltimore Sun
3147:The Baltimore Sun
3007:10.3205/hta000094
2516:on March 22, 2011
2297:. June 17, 2009.
1959:Therese A. Stukel
1955:David E. Wennberg
1951:Elliott S. Fisher
1874:Thérèse A. Stukel
1870:David E. Wennberg
1866:Elliott S. Fisher
1839:978-0-309-65406-7
1792:978-0-309-26073-2
1717:978-0-309-14433-9
1121:Michael T. McCue
1070:(22): 2481–2482.
864:Antibiotic misuse
815:
814:
755:hidden curriculum
701:blood transfusion
613:Reduction efforts
546:that can promote
392:health care costs
167:medical necessity
134:price sensitivity
120:more to do more (
80:
79:
72:
54:, as appropriate.
5341:
5334:Health economics
5306:
5305:
5194:Neuroinformatics
5135:Connected health
4846:
4839:
4832:
4823:
4822:
4763:Related concerns
4616:
4609:
4602:
4593:
4592:
4573:Selling Sickness
4383:
4376:
4369:
4360:
4359:
4341:
4307:
4301:
4293:
4283:
4260:(January 2011).
4258:Howard P. Forman
4237:
4231:
4223:
4213:
4182:(January 2011).
4176:Lesley H. Curtis
4143:
4101:
4072:
4070:
4068:
4052:
4021:
4020:
4014:
4006:
3978:
3972:
3971:
3969:
3967:
3952:
3946:
3945:
3943:
3941:
3922:
3916:
3915:
3913:
3911:
3892:
3886:
3885:
3883:
3881:
3875:
3866:
3860:
3859:
3842:(8): 1483–1494.
3831:
3825:
3824:
3814:
3782:
3776:
3775:
3773:
3771:
3760:
3754:
3753:
3751:
3749:
3739:
3730:
3724:
3723:
3694:
3688:
3687:
3659:
3653:
3652:
3650:
3648:
3633:
3627:
3626:
3598:
3592:
3591:
3585:
3577:
3560:(9): 1141–1143.
3536:Jamie A. Weydert
3532:
3526:
3525:
3515:
3490:(9): 1857–1864.
3475:
3469:
3468:
3466:
3457:
3451:
3427:
3421:
3420:
3392:
3386:
3385:
3375:
3344:(October 2010).
3337:
3331:
3330:
3308:
3302:
3301:
3299:
3297:
3272:
3266:
3265:
3255:
3229:
3223:
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3198:
3179:
3173:
3157:
3151:
3132:
3126:
3125:
3115:
3081:
3075:
3074:
3072:
3070:
3048:
3042:
3035:
3029:
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2977:
2971:
2970:
2941:
2935:
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2892:
2886:
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2883:
2881:
2864:
2858:
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2853:
2847:
2836:
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2821:
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2777:
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2770:
2764:
2756:
2720:
2714:
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2663:
2662:
2652:
2615:
2609:
2608:
2574:
2565:
2559:
2558:
2556:
2554:
2545:. Archived from
2532:
2526:
2525:
2523:
2521:
2515:
2504:
2496:
2490:
2489:
2483:
2475:
2465:
2434:(January 2011).
2428:
2417:
2416:
2405:. Beacon Press.
2398:
2392:
2385:
2379:
2378:
2372:
2364:
2354:
2337:(9): 1569–1577.
2317:
2311:
2310:
2308:
2306:
2281:
2272:
2271:
2269:
2267:
2250:(June 1, 2009).
2244:
2231:
2230:
2197:
2191:
2190:
2188:
2186:
2166:
2160:
2159:
2135:
2129:
2128:
2126:
2124:
2103:
2097:
2096:
2072:
2066:
2065:
2032:
2023:
2022:
2016:
2008:
1971:Etoile L. Pinder
1947:
1938:
1937:
1931:
1923:
1886:Etoile L. Pinder
1862:
1856:
1855:
1811:
1805:
1804:
1766:
1757:
1756:
1750:
1746:
1744:
1736:
1734:
1732:
1693:
1687:
1686:
1676:
1644:
1638:
1637:
1627:
1602:(7): 1067–1076.
1587:
1581:
1580:
1578:
1576:
1562:
1553:
1552:
1534:
1523:
1522:
1520:
1518:
1495:
1489:
1488:
1486:
1484:
1473:
1467:
1466:
1448:
1416:
1410:
1409:
1406:
1378:
1372:
1371:
1343:
1337:
1336:
1300:
1294:
1293:
1287:
1279:
1248:Ann. Intern. Med
1239:
1233:
1232:
1229:
1203:
1181:
1175:
1174:
1148:
1139:
1133:
1119:
1113:
1112:
1094:
1088:
1087:
1054:
1045:
1044:
1017:
1011:
1010:
1008:
1006:
986:
980:
979:
977:
971:. Archived from
946:
930:
848:
843:
842:
834:
829:
828:
827:
810:
807:
789:
782:
735:Christine Cassel
314:25-hydroxy, and
282:
239:RAND Corporation
75:
68:
64:
61:
55:
27:
26:
19:
5349:
5348:
5344:
5343:
5342:
5340:
5339:
5338:
5319:
5318:
5317:
5312:
5294:
5248:
5247:
5246:
5164:
5111:
5075:
5051:Overutilization
5019:
5010:Pharmacy school
4976:Assisted living
4964:
4918:
4855:
4850:
4820:
4815:
4794:
4758:
4710:Political abuse
4705:
4691:Balance billing
4674:
4623:
4620:
4590:
4585:
4546:
4532:Choosing Wisely
4515:
4463:
4419:Fee-for-service
4392:
4387:
4349:
4344:
4295:
4294:
4246:Lara W. Johnson
4242:David B. Larson
4225:
4224:
4180:Stephen Hammill
4066:
4064:
4049:
4030:
4025:
4024:
4008:
4007:
3979:
3975:
3965:
3963:
3954:
3953:
3949:
3939:
3937:
3924:
3923:
3919:
3909:
3907:
3894:
3893:
3889:
3879:
3877:
3873:
3867:
3863:
3832:
3828:
3783:
3779:
3769:
3767:
3762:
3761:
3757:
3747:
3745:
3737:
3731:
3727:
3695:
3691:
3660:
3656:
3646:
3644:
3635:
3634:
3630:
3599:
3595:
3579:
3578:
3540:Newell D. Nobbs
3533:
3529:
3476:
3472:
3464:
3458:
3454:
3438:Wayback Machine
3428:
3424:
3403:(5): 447.e1–8.
3393:
3389:
3338:
3334:
3309:
3305:
3295:
3293:
3276:Gilbert M. Gaul
3273:
3269:
3230:
3226:
3215:Wayback Machine
3205:
3201:
3190:Wayback Machine
3180:
3176:
3167:Wayback Machine
3158:
3154:
3143:Wayback Machine
3133:
3129:
3082:
3078:
3068:
3066:
3049:
3045:
3036:
3032:
2978:
2974:
2942:
2938:
2893:
2889:
2879:
2877:
2865:
2861:
2851:
2849:
2845:
2834:
2830:
2829:
2825:
2778:
2774:
2758:
2757:
2725:JAMA Pediatrics
2721:
2717:
2677:
2666:
2616:
2612:
2572:
2566:
2562:
2552:
2550:
2533:
2529:
2519:
2517:
2513:
2502:
2498:
2497:
2493:
2477:
2476:
2429:
2420:
2413:
2399:
2395:
2386:
2382:
2366:
2365:
2318:
2314:
2304:
2302:
2283:
2282:
2275:
2265:
2263:
2245:
2234:
2213:(10): 937–938.
2198:
2194:
2184:
2182:
2167:
2163:
2156:
2136:
2132:
2122:
2120:
2119:. June 15, 2011
2105:
2104:
2100:
2073:
2069:
2033:
2026:
2010:
2009:
1948:
1941:
1925:
1924:
1863:
1859:
1840:
1812:
1808:
1793:
1767:
1760:
1748:
1747:
1738:
1737:
1730:
1728:
1718:
1694:
1690:
1645:
1641:
1588:
1584:
1574:
1572:
1564:
1563:
1556:
1535:
1526:
1516:
1514:
1496:
1492:
1482:
1480:
1474:
1470:
1417:
1413:
1407:
1383:JAMA Pediatrics
1379:
1375:
1344:
1340:
1301:
1297:
1281:
1280:
1240:
1236:
1230:
1201:10.1.1.688.1277
1182:
1178:
1146:
1140:
1136:
1130:Wayback Machine
1120:
1116:
1095:
1091:
1058:Victor R. Fuchs
1055:
1048:
1025:Victor R. Fuchs
1018:
1014:
1004:
1002:
987:
983:
975:
955:(23): 2789–91.
944:
938:Victor R. Fuchs
931:
912:
907:
902:
874:Choosing Wisely
846:Politics portal
844:
837:
832:Medicine portal
830:
825:
823:
820:
811:
805:
802:
795:needs expansion
780:
774:
739:Amitabh Chandra
645:Choosing Wisely
615:
566:coronary stents
533:
512:
506:
467:
462:
431:
419:
407:
401:
349:fee-for-service
345:
343:Fee-for-service
339:
331:proximate cause
327:
280:
272:Choosing Wisely
257:
224:overconsumption
219:Victor R. Fuchs
198:
122:fee-for-service
87:overutilization
76:
65:
59:
56:
41:
28:
24:
17:
12:
11:
5:
5347:
5337:
5336:
5331:
5314:
5313:
5311:
5310:
5299:
5296:
5295:
5293:
5288:
5283:
5278:
5273:
5271:United Kingdom
5268:
5267:
5266:
5256:
5254:
5250:
5249:
5245:
5244:
5239:
5234:
5229:
5224:
5219:
5214:
5209:
5203:
5197:
5191:
5186:
5176:
5175:
5174:
5172:
5166:
5165:
5163:
5162:
5157:
5152:
5147:
5142:
5140:Digital health
5137:
5132:
5127:
5125:3D bioprinting
5121:
5119:
5113:
5112:
5110:
5109:
5104:
5099:
5094:
5089:
5087:Bedside manner
5083:
5081:
5077:
5076:
5074:
5073:
5068:
5063:
5058:
5053:
5048:
5043:
5038:
5033:
5027:
5025:
5021:
5020:
5018:
5017:
5012:
5007:
4996:Medical school
4993:
4988:
4983:
4978:
4972:
4970:
4966:
4965:
4963:
4962:
4957:
4952:
4947:
4942:
4937:
4932:
4926:
4924:
4920:
4919:
4917:
4916:
4911:
4906:
4901:
4896:
4891:
4886:
4881:
4876:
4871:
4866:
4860:
4857:
4856:
4849:
4848:
4841:
4834:
4826:
4817:
4816:
4814:
4813:
4806:Drug pollution
4802:
4800:
4796:
4795:
4793:
4792:
4787:
4782:
4777:
4772:
4766:
4764:
4760:
4759:
4757:
4756:
4751:
4746:
4741:
4734:
4729:
4724:
4719:
4713:
4711:
4707:
4706:
4704:
4703:
4698:
4693:
4688:
4682:
4680:
4676:
4675:
4673:
4672:
4667:
4662:
4660:Adverse effect
4657:
4652:
4650:Patient safety
4647:
4642:
4637:
4631:
4629:
4625:
4624:
4619:
4618:
4611:
4604:
4596:
4587:
4586:
4584:
4583:
4576:
4569:
4562:
4554:
4552:
4548:
4547:
4545:
4544:
4539:
4534:
4529:
4523:
4521:
4517:
4516:
4514:
4513:
4507:
4502:
4497:
4492:
4487:
4482:
4477:
4471:
4469:
4465:
4464:
4462:
4461:
4456:
4451:
4446:
4441:
4436:
4434:Overmedication
4431:
4426:
4421:
4416:
4411:
4406:
4400:
4398:
4394:
4393:
4386:
4385:
4378:
4371:
4363:
4357:
4356:
4348:
4347:External links
4345:
4343:
4342:
4313:
4274:(1): 164–173.
4238:
4144:
4118:(5): 795–832.
4102:
4073:
4053:
4047:
4031:
4029:
4026:
4023:
4022:
3989:(8): 849–850.
3973:
3947:
3917:
3887:
3861:
3826:
3777:
3755:
3725:
3706:(2): 259–268.
3700:J Appl Lab Med
3689:
3670:(2): 245–257.
3654:
3628:
3593:
3527:
3470:
3452:
3422:
3387:
3342:Deborah Schrag
3332:
3318:Health Affairs
3303:
3267:
3224:
3199:
3174:
3152:
3127:
3076:
3043:
3030:
2985:Dieter Korczak
2972:
2936:
2887:
2859:
2823:
2772:
2731:(5): 482–486.
2715:
2696:(3): 169–172.
2680:David C. Levin
2664:
2610:
2560:
2527:
2491:
2418:
2412:978-0807077580
2411:
2393:
2387:Gilbert Welch
2380:
2330:Health Affairs
2321:Michelle Mello
2312:
2273:
2256:The New Yorker
2232:
2192:
2161:
2154:
2130:
2098:
2067:
2048:(8): 722–727.
2024:
1983:(4): 288–298.
1939:
1898:(4): 273–287.
1857:
1838:
1830:10.17226/11378
1824:. p. 99.
1806:
1791:
1758:
1749:|website=
1716:
1708:10.17226/12750
1688:
1639:
1582:
1554:
1524:
1490:
1468:
1411:
1389:(12): 1085–6.
1373:
1354:(14): 1513–6.
1338:
1305:Ann Intern Med
1295:
1234:
1187:Ann Intern Med
1176:
1134:
1114:
1099:"More is Less"
1089:
1046:
1012:
981:
909:
908:
906:
903:
901:
898:
897:
896:
891:
886:
881:
876:
871:
866:
861:
856:
854:Medicare fraud
850:
849:
835:
819:
816:
813:
812:
792:
790:
776:Main article:
773:
770:
614:
611:
610:
609:
594:
591:
577:
576:
575:
562:
558:
551:
544:overmedication
540:
537:
532:
529:
508:Main article:
505:
502:
485:(RCR) and the
466:
463:
461:
458:
457:
456:
453:
450:
447:
444:
441:
438:
430:
427:
418:
415:
400:
397:
364:McAllen, Texas
338:
335:
326:
323:
304:Hemoglobin A1c
256:
253:
197:
194:
165:, to focus on
78:
77:
38:of the subject
36:worldwide view
31:
29:
22:
15:
9:
6:
4:
3:
2:
5346:
5335:
5332:
5330:
5327:
5326:
5324:
5309:
5301:
5300:
5297:
5292:
5289:
5287:
5284:
5282:
5279:
5277:
5274:
5272:
5269:
5265:
5262:
5261:
5260:
5259:United States
5257:
5255:
5251:
5243:
5240:
5238:
5235:
5233:
5230:
5228:
5225:
5223:
5220:
5218:
5215:
5213:
5210:
5208:in healthcare
5207:
5204:
5202:in healthcare
5201:
5198:
5196:in healthcare
5195:
5192:
5190:
5187:
5185:
5181:
5178:
5177:
5173:
5171:
5167:
5161:
5158:
5156:
5153:
5151:
5148:
5146:
5143:
5141:
5138:
5136:
5133:
5131:
5128:
5126:
5123:
5122:
5120:
5118:
5114:
5108:
5105:
5103:
5100:
5098:
5095:
5093:
5090:
5088:
5085:
5084:
5082:
5078:
5072:
5069:
5067:
5064:
5062:
5059:
5057:
5054:
5052:
5049:
5047:
5044:
5042:
5039:
5037:
5034:
5032:
5029:
5028:
5026:
5022:
5016:
5013:
5011:
5008:
5005:
5001:
4997:
4994:
4992:
4989:
4987:
4984:
4982:
4979:
4977:
4974:
4973:
4971:
4967:
4961:
4958:
4956:
4953:
4951:
4948:
4946:
4943:
4941:
4938:
4936:
4933:
4931:
4928:
4927:
4925:
4921:
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4912:
4910:
4907:
4905:
4902:
4900:
4897:
4895:
4892:
4890:
4887:
4885:
4882:
4880:
4877:
4875:
4872:
4870:
4867:
4865:
4862:
4861:
4858:
4854:
4847:
4842:
4840:
4835:
4833:
4828:
4827:
4824:
4811:
4807:
4804:
4803:
4801:
4797:
4791:
4788:
4786:
4783:
4781:
4778:
4776:
4773:
4771:
4768:
4767:
4765:
4761:
4755:
4752:
4750:
4747:
4745:
4742:
4740:
4739:
4735:
4733:
4730:
4728:
4725:
4723:
4720:
4718:
4715:
4714:
4712:
4708:
4702:
4699:
4697:
4694:
4692:
4689:
4687:
4684:
4683:
4681:
4677:
4671:
4668:
4666:
4665:Patient abuse
4663:
4661:
4658:
4656:
4653:
4651:
4648:
4646:
4645:Medical error
4643:
4641:
4638:
4636:
4633:
4632:
4630:
4626:
4617:
4612:
4610:
4605:
4603:
4598:
4597:
4594:
4582:
4581:
4577:
4575:
4574:
4570:
4568:
4567:
4563:
4561:
4560:
4556:
4555:
4553:
4549:
4543:
4540:
4538:
4535:
4533:
4530:
4528:
4527:Deprescribing
4525:
4524:
4522:
4518:
4512:
4511:incidentaloma
4509:treatment of
4508:
4506:
4503:
4501:
4498:
4496:
4493:
4491:
4488:
4486:
4483:
4481:
4478:
4476:
4473:
4472:
4470:
4466:
4460:
4457:
4455:
4452:
4450:
4447:
4445:
4442:
4440:
4437:
4435:
4432:
4430:
4427:
4425:
4422:
4420:
4417:
4415:
4414:Overdiagnosis
4412:
4410:
4409:Overscreening
4407:
4405:
4402:
4401:
4399:
4395:
4391:
4384:
4379:
4377:
4372:
4370:
4365:
4364:
4361:
4354:
4351:
4350:
4339:
4335:
4331:
4327:
4323:
4319:
4314:
4311:
4305:
4299:
4291:
4287:
4282:
4277:
4273:
4269:
4268:
4263:
4259:
4255:
4251:
4247:
4243:
4239:
4235:
4229:
4221:
4217:
4212:
4207:
4203:
4199:
4195:
4191:
4190:
4185:
4181:
4177:
4173:
4169:
4165:
4161:
4157:
4156:Jeptha Curtis
4153:
4152:Anne Hellkamp
4149:
4145:
4141:
4137:
4133:
4129:
4125:
4121:
4117:
4113:
4112:
4107:
4103:
4099:
4095:
4091:
4087:
4083:
4079:
4074:
4063:
4062:newyorker.com
4059:
4054:
4050:
4044:
4040:
4039:
4033:
4032:
4018:
4012:
4004:
4000:
3996:
3992:
3988:
3984:
3977:
3961:
3957:
3951:
3935:
3931:
3927:
3921:
3905:
3901:
3897:
3891:
3880:September 19,
3872:
3865:
3857:
3853:
3849:
3845:
3841:
3837:
3830:
3822:
3818:
3813:
3808:
3804:
3800:
3796:
3792:
3788:
3781:
3770:September 18,
3765:
3759:
3748:September 18,
3743:
3736:
3729:
3721:
3717:
3713:
3709:
3705:
3701:
3693:
3685:
3681:
3677:
3673:
3669:
3665:
3658:
3647:September 18,
3642:
3638:
3632:
3624:
3620:
3616:
3612:
3608:
3604:
3597:
3589:
3583:
3575:
3571:
3567:
3563:
3559:
3555:
3554:
3549:
3545:
3541:
3537:
3531:
3523:
3519:
3514:
3509:
3505:
3501:
3497:
3493:
3489:
3485:
3481:
3474:
3463:
3456:
3449:
3445:
3444:
3439:
3435:
3432:
3426:
3418:
3414:
3410:
3406:
3402:
3398:
3391:
3383:
3379:
3374:
3369:
3365:
3361:
3357:
3353:
3352:
3347:
3343:
3336:
3328:
3324:
3320:
3319:
3314:
3307:
3291:
3287:
3286:
3281:
3277:
3271:
3263:
3259:
3254:
3249:
3246:(3): 103–11.
3245:
3241:
3240:
3235:
3228:
3221:
3220:
3216:
3212:
3209:
3203:
3196:
3195:
3191:
3187:
3184:
3178:
3171:
3168:
3164:
3161:
3156:
3149:
3148:
3144:
3140:
3137:
3131:
3123:
3119:
3114:
3109:
3105:
3101:
3097:
3093:
3092:
3087:
3080:
3064:
3060:
3059:
3054:
3047:
3040:
3034:
3026:
3022:
3017:
3012:
3008:
3004:
3000:
2996:
2995:
2990:
2986:
2982:
2976:
2968:
2964:
2960:
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2950:
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2945:Malika Taufiq
2940:
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2819:
2815:
2810:
2805:
2801:
2797:
2794:(4): 445–55.
2793:
2789:
2788:
2783:
2776:
2768:
2762:
2754:
2750:
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2621:(July 2010).
2620:
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1990:
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1956:
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1254:(4): 288–98.
1253:
1249:
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890:
889:Overdiagnosis
887:
885:
882:
880:
877:
875:
872:
870:
867:
865:
862:
860:
857:
855:
852:
851:
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841:
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833:
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809:
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796:
793:This section
791:
788:
784:
783:
779:
769:
767:
766:adverse event
762:
760:
756:
750:
748:
744:
743:JudyAnn Bigby
740:
736:
732:
728:
724:
719:
717:
712:
709:
704:
702:
698:
694:
690:
686:
684:
680:
676:
672:
668:
664:
660:
658:
654:
649:
646:
642:
636:
634:
633:Uwe Reinhardt
630:
625:
623:
619:
607:
603:
599:
595:
592:
589:
585:
581:
578:
574:
570:
569:
567:
563:
561:complications
559:
556:
552:
549:
545:
541:
538:
535:
534:
528:
525:
524:overdiagnosis
521:
516:
511:
501:
499:
498:overdiagnosis
494:
492:
488:
484:
480:
476:
472:
471:self-referral
454:
451:
448:
445:
442:
439:
436:
435:
434:
426:
423:
414:
412:
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395:
393:
387:
385:
381:
375:
373:
369:
365:
361:
357:
354:
350:
344:
334:
332:
322:
319:
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313:
309:
305:
299:
296:
292:
287:
278:
273:
268:
265:
264:
252:
250:
246:
243:
240:
235:
231:
227:
225:
220:
216:
211:
209:
208:
203:
202:Jack Wennberg
193:
191:
186:
184:
183:
182:overdiagnosis
178:
177:Overtreatment
174:
172:
168:
164:
160:
156:
152:
147:
143:
139:
135:
131:
130:litigiousness
127:
123:
119:
114:
112:
108:
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103:United States
100:
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95:overtreatment
92:
88:
84:
74:
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30:
21:
20:
5227:Telemedicine
5160:Telemedicine
5155:Nanomedicine
4991:Nursing home
4790:Hand washing
4736:
4717:Drapetomania
4686:Medical debt
4654:
4635:Iatrogenesis
4622:Medical harm
4578:
4571:
4564:
4557:
4505:Polypharmacy
4389:
4321:
4317:
4312:on the study
4298:cite journal
4271:
4265:
4228:cite journal
4196:(1): 43–49.
4193:
4187:
4115:
4109:
4106:R. E. Malone
4084:(1): 240–5.
4081:
4077:
4065:. Retrieved
4061:
4037:
4011:cite journal
3986:
3982:
3976:
3964:. Retrieved
3950:
3938:. Retrieved
3934:the original
3929:
3920:
3908:. Retrieved
3899:
3890:
3878:. Retrieved
3864:
3839:
3835:
3829:
3797:(5): 20–23.
3794:
3790:
3780:
3768:. Retrieved
3758:
3746:. Retrieved
3741:
3733:Singh, Ila.
3728:
3703:
3699:
3692:
3667:
3664:Clin Lab Med
3663:
3657:
3645:. Retrieved
3640:
3631:
3606:
3602:
3596:
3582:cite journal
3557:
3551:
3548:John D. Kemp
3530:
3487:
3483:
3473:
3455:
3441:
3425:
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3396:
3390:
3355:
3349:
3335:
3316:
3306:
3294:. Retrieved
3283:
3270:
3243:
3237:
3227:
3217:
3202:
3192:
3177:
3169:
3155:
3145:
3130:
3098:(1): 53–61.
3095:
3089:
3079:
3067:. Retrieved
3056:
3046:
3033:
2998:
2992:
2981:Markus Dietl
2975:
2958:
2952:
2939:
2906:
2900:
2890:
2878:. Retrieved
2872:
2862:
2850:. Retrieved
2826:
2791:
2785:
2775:
2761:cite journal
2728:
2724:
2718:
2693:
2687:
2684:Vijay M. Rao
2632:
2626:
2613:
2580:
2576:
2563:
2551:. Retrieved
2547:the original
2540:
2530:
2518:. Retrieved
2511:the original
2494:
2480:cite journal
2445:
2439:
2402:
2396:
2383:
2369:cite journal
2334:
2328:
2315:
2303:. Retrieved
2288:
2264:. Retrieved
2255:
2248:Atul Gawande
2210:
2204:
2195:
2183:. Retrieved
2174:
2164:
2140:
2133:
2121:. Retrieved
2110:
2101:
2076:
2070:
2045:
2039:
2013:cite journal
1980:
1974:
1928:cite journal
1895:
1889:
1860:
1816:
1809:
1774:
1729:. Retrieved
1698:
1691:
1659:(1): 16–25.
1656:
1652:
1642:
1599:
1595:
1585:
1573:. Retrieved
1569:
1542:
1515:. Retrieved
1503:
1493:
1481:. Retrieved
1471:
1428:
1424:
1414:
1386:
1382:
1376:
1351:
1347:
1341:
1308:
1304:
1298:
1284:cite journal
1251:
1247:
1237:
1194:(4): 270–1.
1191:
1185:
1179:
1154:
1150:
1137:
1117:
1102:
1092:
1067:
1061:
1035:(19): 2251.
1032:
1028:
1015:
1003:. Retrieved
994:
984:
973:the original
952:
948:
859:Moral hazard
806:October 2011
803:
799:adding to it
794:
778:Cost sharing
763:
751:
727:Bernard Lown
720:
713:
705:
687:
661:
650:
637:
626:
616:
517:
513:
495:
468:
432:
420:
408:
389:
376:
367:
360:Atul Gawande
358:
346:
328:
320:
316:lipid panels
300:
290:
269:
261:
258:
248:
247:
244:
236:
232:
228:
212:
205:
199:
187:
180:
176:
175:
153:to restrain
115:
94:
90:
86:
82:
81:
66:
57:
33:
5286:New Zealand
5041:End-of-life
4923:Professions
4853:Health care
4670:Never event
4559:Overtreated
4324:(14): e21.
4160:Daniel Mark
3910:January 19,
3836:Transfusion
3544:Ronald Feld
1967:F. L. Lucas
1882:F. L. Lucas
1731:December 7,
1575:December 5,
1517:December 7,
1483:December 7,
747:Julio Frenk
731:Don Berwick
667:stewardship
657:stewardship
382:and in the
380:Mayo Clinic
140:is not the
99:health care
5323:Categories
5253:By country
5117:Technology
5056:Palliative
4884:Philosophy
4874:Guidelines
3966:August 21,
3940:August 21,
2902:The Lancet
2880:October 6,
900:References
659:programs.
643:began the
403:See also:
368:New Yorker
341:See also:
234:patient."
196:Definition
171:subjective
5281:Australia
5102:Education
5097:Diagnosis
4950:Dentistry
4894:Providers
4869:Equipment
4864:Economics
4267:Radiology
4078:Radiology
3504:0884-8734
3448:USA Today
3443:HealthDay
3001:: Doc03.
2961:(1): 60.
2635:(3): e8.
2448:(1): e6.
2432:B. Rehani
2290:Fresh Air
1751:ignored (
1741:cite book
1616:2168-6106
1463:247023707
1333:207536403
1244:Stukel TA
1196:CiteSeerX
1157:: 77–84.
1005:March 31,
905:Citations
759:residency
602:pap smear
555:addiction
353:incentive
312:vitamin D
151:incentive
48:talk page
5308:Category
4986:Hospital
4969:Settings
4940:Pharmacy
4930:Medicine
4879:Industry
4628:Concepts
4338:24693918
4290:21115875
4220:21205965
4140:10081763
4098:20736333
4003:28245327
3960:Archived
3904:Archived
3856:35616174
3821:35619979
3720:32630981
3684:31036278
3641:clsi.gov
3623:22492759
3574:16119987
3522:31250366
3434:Archived
3417:21840492
3382:20940384
3290:Archived
3262:15160808
3211:Archived
3186:Archived
3163:Archived
3139:Archived
3122:21730241
3063:Archived
3025:21522485
2987:(2011).
2967:21276393
2931:31805773
2923:21982520
2874:ABC News
2852:June 29,
2843:Archived
2818:21672923
2745:29582079
2710:17411553
2659:21611049
2605:46797965
2597:29408150
2553:June 22,
2520:June 27,
2472:21655115
2361:20820010
2305:June 29,
2299:Archived
2266:June 29,
2260:Archived
2227:19810157
2185:June 19,
2179:Archived
2175:BBC News
2123:June 26,
2093:38839058
2062:21518938
1997:12585826
1920:27581938
1912:12585825
1852:Archived
1848:20669457
1726:21595114
1683:30508010
1634:24819824
1549:Archived
1455:35189687
1403:26502277
1368:22419800
1325:22213573
1268:12585826
1226:12934288
1218:19221379
1171:28131024
1126:Archived
1109:Archived
1084:19996406
999:Archived
969:18560006
940:(2008).
818:See also
606:HPV test
460:Examples
295:Medicare
138:consumer
105:, where
60:May 2018
42:You may
5150:mHealth
5061:Primary
5046:Hospice
5036:Chronic
4935:Nursing
4904:Ranking
4211:3432303
4132:9803363
4028:Sources
3812:9124555
3742:cdc.gov
3513:6712188
3373:3728828
3296:July 5,
3113:3293218
3069:July 6,
3016:3080661
2809:3136200
2753:4369253
2650:3097773
2463:3107688
2352:3048809
2005:8031637
1801:9998202
1674:6583417
1625:4241845
1570:cms.gov
1446:9909614
1276:8031637
708:AskMyGP
608:results
596:Annual
481:(ACR),
465:Imaging
281:US$ 2.6
204:called
146:patient
91:overuse
5276:Canada
4981:Clinic
4914:System
4909:Reform
4899:Public
4889:Policy
4397:Causes
4336:
4288:
4256:&
4218:
4208:
4178:&
4138:
4130:
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4067:May 4,
4045:
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967:
745:, and
681:, and
531:Others
522:, and
325:Causes
5071:Total
5031:Acute
4310:story
4136:S2CID
3874:(PDF)
3744:. CDC
3738:(PDF)
3465:(PDF)
2927:S2CID
2846:(PDF)
2835:(PDF)
2749:S2CID
2601:S2CID
2573:(PDF)
2514:(PDF)
2503:(PDF)
2146:63–83
2001:S2CID
1916:S2CID
1797:S2CID
1459:S2CID
1329:S2CID
1272:S2CID
1222:S2CID
1147:(PDF)
976:(PDF)
945:(PDF)
372:Miami
291:et al
144:—the
142:payer
97:) is
93:, or
50:, or
5182:and
5066:Self
5024:Care
4810:List
4334:PMID
4308:– a
4304:link
4286:PMID
4234:link
4216:PMID
4128:PMID
4094:PMID
4069:2015
4043:ISBN
4017:link
3999:PMID
3983:JAMA
3968:2013
3942:2013
3912:2015
3882:2024
3852:PMID
3817:PMID
3772:2024
3750:2024
3716:PMID
3680:PMID
3649:2024
3619:PMID
3588:link
3570:PMID
3518:PMID
3500:ISSN
3413:PMID
3378:PMID
3351:JAMA
3298:2011
3258:PMID
3118:PMID
3091:JAMA
3071:2011
3021:PMID
2963:PMID
2919:PMID
2882:2011
2854:2011
2814:PMID
2767:link
2741:PMID
2706:PMID
2655:PMID
2593:PMID
2555:2011
2522:2011
2486:link
2468:PMID
2407:ISBN
2375:link
2357:PMID
2307:2011
2268:2011
2223:PMID
2187:2011
2150:ISBN
2125:2011
2089:PMID
2058:PMID
2019:link
1993:PMID
1934:link
1908:PMID
1844:PMID
1834:ISBN
1787:ISBN
1753:help
1733:2018
1722:PMID
1712:ISBN
1679:PMID
1630:PMID
1612:ISSN
1577:2018
1519:2018
1485:2018
1451:PMID
1399:PMID
1364:PMID
1348:JAMA
1321:PMID
1290:link
1264:PMID
1214:PMID
1167:PMID
1080:PMID
1007:2016
965:PMID
714:The
697:AABB
651:The
604:and
590:raid
255:Cost
4326:doi
4322:370
4276:doi
4272:258
4206:PMC
4198:doi
4194:305
4120:doi
4086:doi
4082:257
3991:doi
3987:317
3844:doi
3807:PMC
3799:doi
3708:doi
3672:doi
3611:doi
3607:307
3562:doi
3558:129
3508:PMC
3492:doi
3405:doi
3401:205
3368:PMC
3360:doi
3356:304
3323:doi
3248:doi
3108:PMC
3100:doi
3096:306
3011:PMC
3003:doi
2911:doi
2907:378
2804:PMC
2796:doi
2733:doi
2729:172
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2645:PMC
2637:doi
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2458:PMC
2450:doi
2347:PMC
2339:doi
2295:NPR
2215:doi
2112:NPR
2081:doi
2050:doi
2046:171
1985:doi
1981:138
1900:doi
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