221:, 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."
798:
36:
405:, 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.
851:
5315:
837:
631:(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
649:
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
537:
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.
294:
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
435:
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
270:
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
240:
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
635:(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.
525:
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
299:
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,
388:
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
252:
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
244:
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
721:
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.
3708:
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".
571:
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
285:
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
232:
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
159:
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
366:
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.
253:
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."
504:. 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.
568:. 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.
308:
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.
763:
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
658:
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.
696:. 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.
277:
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.
3149:
1009:
312:
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
3444:
3196:
736:
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
256:
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.
526:
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.
3845:
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?".
2086:
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".
424:
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.
952:
3612:
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".
4199:
2496:
1073:
389:
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
444:
Dartmouth Medical School professor Gilbert Welch argued 2016 that certain predispositions by physicians and the general public may lead to unnecessary health care, including:
4759:
3221:
4391:
1257:, Gottlieb DJ, Lucas FL, Pinder EL (February 2003). "The implications of regional variations in Medicare spending. Part 2: health outcomes and satisfaction with care".
480:
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 "
46:
4314:
4244:
4027:
3598:
2777:
2385:
2029:
1944:
1576:
1300:
676:
tools can help decrease unnecessary laboratory testing. The PLUGS initiative (Patient-Centered Laboratory Utilization Guidance Services) aims to formalize laboratory
3563:
3300:
3146:
642:, 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."
2270:
1001:
332:
When care is overused, patients are put at risk of complications unnecessarily, with documented harm to patients from overuse of surgeries and other treatments.
5274:
4711:
4363:
3441:
3193:
2547:
3881:
420:
To protect themselves from legal prosecution U.S. physicians have an incentive to order clinically unnecessary tests or tests of little potential value. While
262:, 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.
1136:
3774:
2699:
583:
124:, 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.
2734:
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".
3406:
Roland KB, Soman A, Bernard VB, et al. (2011). "Human papillomavirus and Papanicolaou tests screening interval recommendations in the United States".
2638:
2451:
685:
663:
4121:
1832:
639:
296:
173:
500:(WHO)—have developed "appropriateness criteria". The Canadian Association of Radiologists estimated in 2009 that 30% of imaging was unnecessary in the
2309:
3073:
1119:
4820:
117:
241:
higher-spending regions receive more care than those in lower-spending regions, but do not have better health outcomes or satisfaction with care."
4764:
402:
4914:
2964:
666:(CLSI) issued a 2017 guideline, "Developing and Managing a Medical Laboratory (Test) Utilization Program (GP49)", to help laboratories establish
2853:
4624:
4485:
983:
5199:
5140:
4854:
4384:
4057:
1848:
1801:
1726:
2510:
1392:
Ralston Shawn L., Schroeder Alan R. (2015). "Doing More vs Doing Good: Aligning Our Ethical Principles From the Personal to the Societal".
729:
issued 2021 guidelines for the minimum time that should elapse before a given laboratory test is repeated in a specific clinical scenario.
1899:(February 2003). "The implications of regional variations in Medicare spending. Part 1: the content, quality, and accessibility of care".
1510:
4320:
3489:
Maratt, Jennifer K.; Kerr, Eve A.; Klamerus, Mandi L.; Lohman, Shannon E.; Froehlich, Whit; Bhatia, R. Sacha; Saini, Sameer D. (2019).
3173:
2049:(April 2011). "Personal reflections on the high cost of American medical care: Many causes but few politically sustainable solutions".
5102:
2797:
2421:
3936:
1984:(February 2003). "The implications of regional variations in Medicare spending. Part 2: health outcomes and satisfaction with care".
3970:
2164:
290:
in 2010 gave two estimates of "unnecessary services," using different methodologies: 0.2% or 1% to 5% of health spending, which was
80:
2879:
680:
practices. The TRUU-Lab (Test Renaming for Understanding and Utilization in the Laboratory) initiative is a cooperative effort of
646:, a health economist at Princeton, said "the minute you attack overutilization, you will be called a Nazi before the day is out".
5339:
5281:
4377:
1559:
693:
3218:
2580:
2399:
5301:
5269:
3049:
1154:
484:, patient wishes, inappropriate financially motivated factors, health system factors, industry, media, lack of awareness" and
5010:
4414:
2189:
432:
466:
Treating patients with terminal illness to maximize life span over quality of life, without probing a patient's preferences
5247:
5232:
4970:
4754:
4469:
2517:
2051:
726:
493:
489:
1488:
5222:
3290:
463:
Preferring newer over older treatments without considering the cost of new treatments or the effectiveness of older ones
190:, in the strict sense, may refer to unnecessary medical interventions, including treatment of a self-limited condition (
58:
5252:
5097:
4790:
4785:
4495:
3647:
3004:
2262:
1986:
1901:
62:
4327:
Gawande, Atul A.; Colla, Carrie H.; Halpern, Scott D.; Landon, Bruce E. (April 3, 2014). "Avoiding Low-Value Care".
3992:
Zapata Josué A., Lai Andrew R., Moriates Christopher (2017). "Is Excessive Resource Utilization an Adverse Event?".
2557:
1601:
McWilliams, J. Michael; Chernew, Michael E.; Elshaug, Adam G.; Landon, Bruce E.; Schwartz, Aaron L. (July 1, 2014).
4617:
4547:
3798:"The Genetic Testing Stewardship Program:: A Bridge to Precision Diagnostics for the Non-genetics Medical Provider"
1862:
1133:
2793:"Do doctors under-provide, over-provide or do both? Exploring the quality of medical treatment in the Philippines"
5344:
5296:
5242:
5025:
4965:
4847:
4087:
Hendee WR, Becker GJ, Borgstede JP, et al. (October 2010). "Addressing overutilization in medical imaging".
889:
673:
497:
318:
169:
3472:
1432:"Strategies to Reduce Low-Value Cardiovascular Care: A Scientific Statement From the American Heart Association"
5291:
5155:
4894:
4737:
2884:
904:
703:
394:
305:
3673:
Lewandrowski K (June 2019). "Integrating Decision Support into a Laboratory Utilization Management Program".
775:
Patient safety committees, which are charged with reviewing the quality of care, can view overutilization as
5190:
3068:
2849:
2295:
520:
481:
3064:"Heart Treatment Overused – Study Finds Doctors Often Too Quick to Try Costly Procedures to Clear Arteries"
3063:
5227:
4732:
1206:
1109:
879:
733:
628:
594:
550:
Surgeries in Medicare patients in their last year of life; regions with high levels had higher death rates
344:
of unnecessary care, though the potential incentives and penalties they face can influence their choices.
4264:
4182:
4178:
3745:
3561:(September 2005). "A simple, focused, computerized query to detect overutilization of laboratory tests".
2962:(January 2011). "Overuse of antibiotics in children for upper respiratory infections (URIs): a dilemma".
1828:
Building a Better Delivery System: A New Engineering/Health Care Partnership – Bridging the Quality Chasm
507:
Overuse of imaging can lead to a diagnosis of a condition that would have otherwise remained irrelevant (
5216:
5117:
4780:
4748:
4610:
4510:
4459:
4439:
4308:
4260:
4238:
4174:
4021:
3592:
3249:
2959:
2771:
2490:
2379:
2023:
1973:
1938:
1888:
1294:
714:, form a committee to audit blood utilization, identify areas for improvement, and monitor compliance.
558:
501:
287:
217:
4158:
3914:
1969:
1965:
1880:
4186:
3546:
1981:
1896:
5318:
5286:
5210:
4904:
4889:
4840:
4454:
4256:
4252:
4190:
4068:
3550:
3323:
2842:
2697:(March 2004). "Turf wars in radiology: the overutilization of imaging resulting from self-referral".
2127:
1884:
1254:
769:
699:
590:
248:
In April 2012, Berwick, from the Institute for Healthcare Improvement, and Andrew Hackbarth from the
2995:
2690:
1658:
McWilliams, J. Michael; Zaslavsky, Alan M.; Jena, Anupam B.; Schwartz, Aaron L. (December 3, 2018).
1211:
451:
Attempting to fix an underlying problem, instead of using a less-risky monitoring or coping strategy
5194:
4650:
4552:
4500:
4277:
4166:
4162:
4119:(October 1998). "Whither the almshouse? Overutilization and the role of the emergency department".
3491:"Measures Used to Assess the Impact of Interventions to Reduce Low-Value Care: a Systematic Review"
3295:
2955:
2216:
2211:
2046:
415:
180:
as a condition for payment. However, the threshold between necessity and lack thereof can often be
128:
4116:
2991:
2694:
2117:
5180:
4955:
4919:
4706:
4576:
4449:
4434:
4170:
4146:
3554:
2937:
2759:
2611:
2552:
2011:
1926:
1807:
1751:
1554:
1469:
1430:
American Heart Association Council on Quality of Care and Outcomes Research (February 22, 2022).
1339:
1282:
1232:
1114:
1031:
944:
894:
710:. To become accredited, participating hospitals may distribute guidelines for appropriateness of
632:
530:
485:
421:
273:
225:
200:
165:
136:
2521:
448:
Attempting to mitigate a risk without considering how small or unlikely the potential benefit is
3453:
2908:"The intensity and variation of surgical care at the end of life: a retrospective cohort study"
2442:
5127:
5112:
5107:
5014:
4884:
4879:
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2417:
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2233:
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2003:
1961:
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1844:
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1732:
1722:
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1622:
1461:
1409:
1374:
1331:
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177:
144:
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2629:
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2357:
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2225:
2091:
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1999:
1995:
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1910:
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1401:
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341:
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132:
1710:
The Healthcare Imperative: Lowering Costs and Improving Outcomes: Workshop Series Summary
1786:
Proceedings 14th International Parallel and Distributed Processing Symposium. IPDPS 2000
17:
5150:
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5006:
4816:
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4221:
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1431:
1197:
864:
576:
554:
374:
314:
3337:
2925:
2907:
2229:
850:
797:
547:
Hospitalizations for those with chronic conditions who could be treated as outpatients
5333:
4924:
4909:
4899:
4675:
4655:
4537:
4521:
4424:
4419:
4047:
2747:
1473:
1405:
1343:
899:
776:
753:
643:
534:
508:
381:. In 2006, the town of McAllen was the second-most expensive Medicare market, behind
212:
192:
113:
4150:
2941:
2615:
1930:
1675:
1618:
1236:
1173:
5237:
5170:
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5001:
4800:
4727:
4696:
4645:
4515:
3558:
2763:
2599:
2258:
2064:
2015:
1811:
1782:"Replicating the contents of a WWW multimedia repository to minimize download time"
1286:
869:
788:
737:
370:
181:
2181:
1155:""Too much medicine": Insights and explanations from economic theory and research"
196:) or to extensive treatment for a condition that requires only limited treatment.
3576:
1447:
4863:
4680:
4569:
2906:
Kwok AC, Semel ME, Lipsitz SR, Bader AM, Barnato AE, Gawande AA, Jha AK (2011).
2214:(October 2009). "US reimbursement systems encourage fraud and overutilisation".
1977:
1892:
1781:
1314:
Snyder L (2012). "American College of Physicians Ethics Manual: sixth edition".
757:
741:
677:
667:
390:
326:
109:
3506:
3419:
2712:
5081:
5041:
4134:
3813:
3686:
3245:"When things go wrong: how health care organizations deal with major failures"
3229:
2912:
2353:
2095:
1793:
1357:
Berwick DM, Hackbarth AD (April 2012). "Eliminating waste in US health care".
832:
3722:
3514:
3263:
3244:
2334:, Amitabh Chandra, Atul A. Gawande & David M. Studdert (September 2010).
1626:
971:
358:
When public or private insurance cover expenses and doctors are paid under a
300:
unnecessary repetition, poor communication, and inefficiency. In 2003 Fisher
5076:
4960:
4291:
4272:
4100:
3458:
2810:
2300:
612:
565:
363:
322:
161:
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4108:
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4005:
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3035:
2977:
2933:
2828:
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2720:
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2482:
2371:
2237:
2152:
The Treatment Trap: How the Overuse of Medical Care is Wrecking Your Health
2103:
2072:
2007:
1922:
1858:
1736:
1708:
1693:
1644:
1465:
1413:
1378:
1335:
1278:
1228:
1181:
1094:
1086:
1002:"We spend $ 750 billion on unnecessary health care. Two charts explain why"
979:
152:
4369:
4142:
3625:
3114:
1370:
1051:
4996:
4950:
4940:
4340:
616:
148:
2651:
2581:"First do no harm – The impact of financial incentives on dental X-rays"
2464:
1826:
5160:
5056:
4945:
4364:"Disease Creep: How we're fooled into using more medicine than we need"
2263:"The Cost Conundrum – What a Texas town can teach us about health care"
1522:
718:
156:
3858:
3473:"Doing Better by Doing Less: Approaches to Tackle Overuse of Services"
3017:
4991:
27:
Health care provided with a higher volume or cost than is appropriate
1660:"Analysis of Physician Variation in Provision of Low-Value Services"
454:
Acting too quickly, when waiting for more information might be wiser
1840:
1718:
582:
Stents performed by the formal chair of cardiology, Mark Midei, at
4273:"National trends in CT use in the emergency department: 1995–2007"
1038:(2008). "Health Care Overutilization in the United States—Reply".
382:
281:
Researchers in 2014 analyzed many services listed as low value by
112:
provided with a higher volume or cost than is appropriate. In the
4049:
Overtreated: Why too much medicine is making us sicker and poorer
401:
As America struggles to extend healthcare coverage while curbing
1153:
Hensher, Martin; Tisdell, John; Zimitat, Craig (March 1, 2017).
707:
385:. Costs per beneficiary were almost twice the national average.
304:. found that there was "no apparent regional health benefit for
4836:
4606:
4602:
4373:
2791:
James CD, Hanson K, Solon O, Whitty CJ, Peabody J (June 2011).
1511:"Spending, Use of Services, Prices, and Health in 13 Countries"
579:(used in $ 20,000 procedures) with nonacute indications (U.S.)
4832:
3147:
Progress, but not enough, against needless hospital procedures
3050:
Blood transfusion regulations needed to rein in overuse: Panel
2305:
2122:
1195:
Reilly BM, Evans AT (2009). "Much ado about (doing) nothing".
792:
689:
681:
598:
121:
29:
45:
deal primarily with the United States and do not represent a
3906:
3654:. Clinical and Laboratory Standards Institute. July 31, 2017
4195:"Non-evidence-based ICD implantations in the United States"
3796:
Thomas M, Amlie-Wolf L, Baker L, Gripp KW (December 2021).
2965:
Journal of the College of Physicians and Surgeons--Pakistan
3882:"National minimum retesting intervals in pathology (G147)"
2402:
American College of Physicians, n.d., retrieved 9 May 2018
3967:"2013 Lown Conference: From Avoidable Care to Right Care"
3324:"Can Funders Quell a 'Perfect Storm of Overutilization'?"
2447:"Imaging overutilisation: Is enough being done globally?"
604:
Screening patients with advanced cancer for other cancers
553:
Antibiotic use for viral or self-limiting infections (an
3471:
Berenson, Robert A.; Docteur, Elizabeth (January 2013).
2843:"Effective Care – A Dartmouth Atlas Project Topic Brief"
457:
Acting without considering the benefits of doing nothing
3937:"Avoiding Avoidable Care Conference- Featured Speakers"
3746:"Standardizing Lab Test Names: the TRUU-Lab Initiative"
3097:"Appropriateness of Percutaneous Coronary Intervention"
3000:"Over-, under- and misuse of pain treatment in Germany"
1071:(December 2009). "Eliminating 'waste' in health care".
809:
650:
overutilizing laboratory tests." In November 2011, the
54:
3357:"Cancer screening among patients with advanced cancer"
4200:
JAMA: The Journal of the American Medical Association
1074:
JAMA: The Journal of the American Medical Association
5263:
5179:
5126:
5090:
5034:
4979:
4933:
4809:
4773:
4720:
4689:
4638:
4561:
4530:
4478:
4407:
3291:"At California Hospital, Red Flags and an FBI Raid"
2880:"Medicare Patients Get Costly Surgery Before Death"
2634:"Overuse, overdose, overdiagnosis... overreaction?"
2546:Walt Bogdanich; Jo Craven McGinty (June 17, 2011).
2296:"Spend More, Get Less? The Health Care 'Conundrum'"
760:. A second meeting was planned for December 2013.
4760:Political abuse of psychiatry in the United States
3775:"Creating a Universal Standard for Lab Test Names"
3052:CBS News/Associated Press. Accessed June 28, 2011.
2118:"Medicare Options In Biden Budget Talks Get Boost"
1788:. The National Academies Press. pp. 101–102.
4366:by medical investigative journalist Jeanne Lenzer
2495:: CS1 maint: DOI inactive as of September 2024 (
1550:"Law May Do Little to Help Curb Unnecessary Care"
1143:– Managed Healthcare Executive, February 01, 2003
3777:. Children's Hospital Association. March 1, 2024
2798:International Journal for Quality in Health Care
2336:"National costs of the medical liability system"
1436:Circulation: Cardiovascular Quality and Outcomes
3880:Lang, Dr. Tim; Croal, Dr. Bernie (March 2021).
3614:The Journal of the American Medical Association
3564:Archives of Pathology & Laboratory Medicine
1040:The Journal of the American Medical Association
960:The Journal of the American Medical Association
939:
937:
935:
933:
931:
929:
927:
925:
410:Medical malpractice laws and defensive medicine
399:
2548:"Medicare Claims Show Overuse for CT Scanning"
2041:
2039:
1543:
1541:
1539:
652:American Board of Internal Medicine Foundation
529:As of a 2018 review evidence of overtreatment
4848:
4712:Prescription drug prices in the United States
4618:
4385:
3408:American Journal of Obstetrics and Gynecology
3219:Maryland Revokes Mark Midei’s Medical License
2579:Chalkley, M.; Listl, S. (December 30, 2017).
584:St. Joseph Medical Center of Towson, Maryland
43:The examples and perspective in this article
8:
4313:: CS1 maint: multiple names: authors list (
4243:: CS1 maint: multiple names: authors list (
4026:: CS1 maint: multiple names: authors list (
3597:: CS1 maint: multiple names: authors list (
3062:Ron Winslow; John Carreyrou (July 6, 2011).
2776:: CS1 maint: multiple names: authors list (
2700:Journal of the American College of Radiology
2400:Assumptions That Drive Too Much Medical Care
2384:: CS1 maint: multiple names: authors list (
2290:
2288:
2253:
2251:
2249:
2247:
2028:: CS1 maint: multiple names: authors list (
1943:: CS1 maint: multiple names: authors list (
1299:: CS1 maint: multiple names: authors list (
373:investigated Medicare FFS reimbursements in
3442:Annual Pap tests often ordered but unneeded
2639:Biomedical Imaging and Intervention Journal
2452:Biomedical Imaging and Intervention Journal
2437:
2435:
2433:
664:Clinical and Laboratory Standards Institute
460:Discounting downsides of diagnostic testing
4855:
4841:
4833:
4625:
4611:
4603:
4392:
4378:
4370:
4122:Journal of Health Politics, Policy and Law
1775:
1773:
732:In April 2012, the Lown Institute and the
640:Patient Protection and Affordable Care Act
611:in women with medical histories of normal
297:United States National Academy of Sciences
174:Centers for Medicare and Medicaid Services
127:Factors that drive overuse include paying
4290:
4220:
3821:
3522:
3382:
3262:
3122:
3025:
2818:
2659:
2472:
2361:
1683:
1634:
1455:
1210:
81:Learn how and when to remove this message
4069:"America's Epidemic of Unnecessary Care"
3351:Camelia S. Sima; Katherine S. Panageas;
1956:
1954:
1509:Squires, David; Anderson, Chloe (2015).
168:or overuse. This drives payers, such as
4765:Political abuse of psychiatry in Russia
3194:St. Joseph Medical Center's CEO resigns
2685:
2683:
2681:
2679:
2000:10.7326/0003-4819-138-4-200302180-00007
1915:10.7326/0003-4819-138-4-200302180-00006
1328:10.7326/0003-4819-156-1-201201031-00001
1271:10.7326/0003-4819-138-4-200302180-00007
1221:10.7326/0003-4819-150-4-200902170-00008
1063:
1061:
921:
564:Opiate prescriptions carry the risk of
4486:Caesarean delivery on maternal request
4306:
4236:
4019:
3590:
3303:from the original on November 10, 2012
2769:
2488:
2377:
2192:from the original on February 16, 2010
2021:
1936:
1759:
1749:
1603:"Measuring Low-Value Care in Medicare"
1577:"Table 1 National Health Expenditures"
1571:
1569:
1292:
1122:from the original on November 5, 2011.
1012:from the original on December 30, 2015
953:"The perfect storm of overutilization"
638:The 2010 U.S. health care reform, the
488:. Respected organizations—such as the
348:Third-party payers and fee-for-service
295:each other and the $ 210 billion. The
5200:Artificial intelligence in healthcare
3973:from the original on November 4, 2013
7:
3917:from the original on January 3, 2015
3495:Journal of General Internal Medicine
3440:Kathleen Doheny (August 20, 2011). "
2859:from the original on October 2, 2011
2518:Canadian Association of Radiologists
4562:Works about unnecessary health care
3943:. April 25–26, 2012. Archived from
3322:Rosemary Gibson (August 25, 2010).
2312:from the original on March 28, 2014
1780:Loukopoulos, T.; Ahmad, I. (2000).
1562:from the original on July 16, 2017.
5275:reform debate in the United States
3181:Maryland State Board of Physicians
3076:from the original on July 17, 2015
2273:from the original on June 10, 2011
1865:from the original on July 9, 2008.
1108:Alix Spiegel (November 10, 2009).
1000:Kliff, Sarah (September 7, 2012).
211:A forerunner of the term was what
25:
5302:(Category Health care by country)
3338:10.1377/forefront.20100825.006700
2155:. Chicago: Ivan R. Dee. pp.
1487:Kliff, Sarah (October 16, 2017).
717:In the UK, 2011, online platform
118:health care costs are the highest
5314:
5313:
3005:GMS Health Technology Assessment
2748:10.1001/jamapediatrics.2017.5752
2182:"Texas town's healthcare puzzle"
2149:Gibson; Singh, Rosemary (2010).
1406:10.1001/jamapediatrics.2015.2702
849:
835:
796:
34:
4690:Economic and financial concerns
4329:New England Journal of Medicine
3887:. Royal College of Pathologists
3648:"New Test Utilization Document"
3192:Meredith Cohn (July 29, 2011).
2878:Carrie Gann (October 6, 2011).
2467:(inactive September 18, 2024).
1676:10.1001/jamainternmed.2018.5086
1619:10.1001/jamainternmed.2014.1541
1174:10.1016/j.socscimed.2017.01.020
199:It is economically linked with
5011:Academic health science centre
4415:Direct-to-consumer advertising
4067:Gawande, Atul (May 11, 2015).
3243:Walshe K, Shortell SM (2004).
3217:Larry Husten (July 13, 2011).
2600:10.1016/j.jhealeco.2017.12.005
2065:10.1001/archinternmed.2011.149
1707:Institute of Medicine (2010).
1548:Gina Colata (March 29, 2010).
433:Direct-to-consumer advertising
428:Direct-to-consumer advertising
340:Physicians' decisions are the
1:
5248:Health information management
5233:health information technology
4971:Health information management
4755:Political abuse of psychiatry
4470:Political abuse of psychiatry
3145:Jay Hancock (July 18, 2011).
2926:10.1016/S0140-6736(11)61268-3
2230:10.1016/S1470-2045(09)70297-9
2052:Archives of Internal Medicine
1162:Social Science & Medicine
727:Royal College of Pathologists
494:Royal College of Radiologists
490:American College of Radiology
5223:Translational bioinformatics
3577:10.5858/2005-129-1141-ASFCQT
3461:). Accessed August 22, 2011.
3048:Ryan Jaslow (June 28, 2011)
1833:National Academy of Sciences
1448:10.1161/HCQ.0000000000000105
377:, for a 2009 article in the
362:(FFS) model, neither has an
5253:Consumer health informatics
4791:Hospital-acquired infection
4786:Hospital-acquired pneumonia
4496:Benzodiazepine use disorder
3199:September 29, 2012, at the
3176:September 30, 2011, at the
3152:September 20, 2011, at the
2588:Journal of Health Economics
1987:Annals of Internal Medicine
1902:Annals of Internal Medicine
1489:"The problem is the prices"
502:Canadian health care system
271:levels in other countries.
57:, discuss the issue on the
5361:
4548:Medication discontinuation
4046:Brownlee, Shannon (2007).
3507:10.1007/s11606-019-05069-5
3420:10.1016/j.ajog.2011.06.001
3095:Chan; et al. (2011).
2713:10.1016/j.jacr.2003.12.009
2414:Less Medicine, More Health
2180:Katty Kay (July 7, 2009).
1442:(3): HCQ0000000000000105.
1139:December 18, 2007, at the
1134:Clamping down on variation
786:
575:An estimated one in eight
518:
413:
397:, market. Gawande advised:
351:
5309:
5243:Public health informatics
5156:Electronic health records
5026:Supervised injection site
4966:Allied health professions
4870:
4135:10.1215/03616878-23-5-795
3907:"Avoiding Avoidable Care"
3814:10.32481/djph.2021.12.007
3687:10.1016/j.cll.2019.01.004
2354:10.1377/hlthaff.2009.0807
2096:10.5858/arpa.2023-0486-OA
1794:10.1109/ipdps.2000.846027
890:Clinical decision support
674:Clinical decision support
609:cervical cancer screening
498:World Health Organization
440:Physician predispositions
319:prostate-specific antigen
170:national health insurance
4738:Compulsory sterilization
3723:10.1373/jalm.2017.023606
3264:10.1377/hlthaff.23.3.103
3233:Accessed August 4, 2011.
3208:Accessed August 4, 2011.
3183:Accessed August 4, 2011.
3171:Final Decision and Order
3161:Accessed August 4, 2011.
2511:"Do you need that scan?"
1825:Lawrence, David (2005).
1253:Fisher ES, Wennberg DE,
972:10.1001/jama.299.23.2789
905:Patient blood management
704:patient blood management
702:offers accreditation in
395:Grand Junction, Colorado
224:In 2008, US bioethicist
18:Unnecessary medical care
5340:Unnecessary health care
5191:Medical image computing
5141:Artificial intelligence
4666:Unnecessary health care
4401:Unnecessary health care
4292:10.1148/radiol.10100640
4101:10.1148/radiol.10100063
3941:Avoiding Avoidable Care
3447:March 20, 2012, at the
3069:The Wall Street Journal
2850:Dartmouth Atlas Project
1419:(subscription required)
1242:(subscription required)
521:Physician self-referral
515:Physician self-referral
147:in instances where the
94:Unnecessary health care
5228:Translational medicine
4733:Sluggish schizophrenia
4213:10.1001/jama.2010.1915
4052:. London: Bloomsbury.
4006:10.1001/jama.2017.0698
3375:10.1001/jama.2010.1449
3224:July 16, 2011, at the
2520:. 2009. Archived from
2412:Gilbert Welch (2016).
1664:JAMA Internal Medicine
1607:JAMA Internal Medicine
1087:10.1001/jama.2009.1821
880:Antibiotic stewardship
768:in medical school and
734:New America Foundation
629:Utilization management
595:Redding Medical Center
591:Heart bypass surgeries
407:
143:, and insulation from
5217:Computational biology
5118:Universal precautions
4810:Records and histories
4781:Adverse drug reaction
4749:The Protest Psychosis
4511:Proton-pump inhibitor
4460:Quaternary prevention
4440:Unwarranted variation
3626:10.1001/jama.2012.476
3250:Health Aff (Millwood)
3115:10.1001/jama.2011.916
2811:10.1093/intqhc/mzr029
2560:on September 20, 2020
1371:10.1001/jama.2012.362
1052:10.1001/jama.2008.605
989:on September 2, 2009.
783:Consumer cost sharing
597:which resulted in an
559:antibiotic resistance
436:more harm than good.
288:Institute of Medicine
260:Low-value health care
228:and health economist
218:unwarranted variation
5211:Behavior informatics
4531:Tools and situations
4479:Overused health care
4455:Prescription cascade
4341:10.1056/NEJMp1401245
3802:Dela J Public Health
2852:. January 15, 2007.
2128:The Associated Press
1515:commonwealthfund.org
706:in conjunction with
700:The Joint Commission
172:systems or the U.S.
129:health professionals
63:create a new article
55:improve this article
5195:imaging informatics
5103:Cultural competence
4651:Medical malpractice
4553:Withdrawal syndrome
4501:Opioid use disorder
4265:Shelia R. Salisbury
4183:Adrian F. Hernandez
4179:Paul A. Heidenreich
3296:The Washington Post
2920:(9800): 1408–1413.
2652:10.2349/biij.6.3.e8
2594:(March 2018): 1–9.
2465:10.2349/biij.7.1.e6
2217:The Lancet Oncology
2088:Arch Pathol Lab Med
2047:Steven A. Schroeder
1006:The Washington Post
633:perverse incentives
416:Medical malpractice
139:to protect against
120:as a percentage of
5181:Health informatics
4956:Healthcare science
4707:Financial toxicity
4577:The Treatment Trap
4450:Overmedicalization
4435:Defensive medicine
4261:Beverly M. Schnell
4175:Gillian D. Sanders
3969:. Lown Institute.
3947:on August 14, 2013
3478:. Urban Institute.
2960:Rukhsana W. Zuberi
2553:The New York Times
1974:Daniel J. Gottlieb
1889:Daniel J. Gottlieb
1831:. Washington, DC:
1555:The New York Times
1523:10.26099/77tf-5060
1322:(1 Pt 2): 73–104.
1115:This American Life
1032:Ezekiel J. Emanuel
945:Ezekiel J. Emanuel
895:Overmedicalization
808:. You can help by
531:overmedicalization
486:defensive medicine
422:defensive medicine
274:The New York Times
226:Ezekiel J. Emanuel
201:overmedicalization
166:health care prices
137:defensive medicine
5327:
5326:
5091:Skills / training
5015:Teaching hospital
4830:
4829:
4796:Iatrogenic anemia
4743:Physician gag law
4600:
4599:
4591:Overdosed America
4506:Psychoactive drug
4491:Antibiotic misuse
4465:Disease mongering
4173:, Eric Peterson,
4159:Sana M. Al-Khatib
4059:978-1-58234-580-2
3911:avoidablecare.org
3859:10.1111/trf.16929
3620:(17): 1801–1802.
3369:(14): 1584–1591.
3289:(July 25, 2005).
3205:The Baltimore Sun
3158:The Baltimore Sun
3018:10.3205/hta000094
2527:on March 22, 2011
2308:. June 17, 2009.
1970:Therese A. Stukel
1966:David E. Wennberg
1962:Elliott S. Fisher
1885:Thérèse A. Stukel
1881:David E. Wennberg
1877:Elliott S. Fisher
1850:978-0-309-65406-7
1803:978-0-309-26073-2
1728:978-0-309-14433-9
1132:Michael T. McCue
1081:(22): 2481–2482.
875:Antibiotic misuse
826:
825:
766:hidden curriculum
712:blood transfusion
624:Reduction efforts
557:that can promote
403:health care costs
178:medical necessity
145:price sensitivity
131:more to do more (
91:
90:
83:
65:, as appropriate.
16:(Redirected from
5352:
5345:Health economics
5317:
5316:
5205:Neuroinformatics
5146:Connected health
4857:
4850:
4843:
4834:
4774:Related concerns
4627:
4620:
4613:
4604:
4584:Selling Sickness
4394:
4387:
4380:
4371:
4352:
4318:
4312:
4304:
4294:
4271:(January 2011).
4269:Howard P. Forman
4248:
4242:
4234:
4224:
4193:(January 2011).
4187:Lesley H. Curtis
4154:
4112:
4083:
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4032:
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3877:
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3853:(8): 1483–1494.
3842:
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3764:
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3571:(9): 1141–1143.
3547:Jamie A. Weydert
3543:
3537:
3536:
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3501:(9): 1857–1864.
3486:
3480:
3479:
3477:
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3432:
3431:
3403:
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3396:
3386:
3355:(October 2010).
3348:
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2543:
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2500:
2494:
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2476:
2445:(January 2011).
2439:
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2416:. Beacon Press.
2409:
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2383:
2375:
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2348:(9): 1569–1577.
2328:
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2261:(June 1, 2009).
2255:
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2076:
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1982:Etoile L. Pinder
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1873:
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1613:(7): 1067–1076.
1598:
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1259:Ann. Intern. Med
1250:
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1065:
1056:
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1021:
1019:
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982:. Archived from
957:
941:
859:
854:
853:
845:
840:
839:
838:
821:
818:
800:
793:
746:Christine Cassel
325:25-hydroxy, and
293:
250:RAND Corporation
86:
79:
75:
72:
66:
38:
37:
30:
21:
5360:
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5330:
5329:
5328:
5323:
5305:
5259:
5258:
5257:
5175:
5122:
5086:
5062:Overutilization
5030:
5021:Pharmacy school
4987:Assisted living
4975:
4929:
4866:
4861:
4831:
4826:
4805:
4769:
4721:Political abuse
4716:
4702:Balance billing
4685:
4634:
4631:
4601:
4596:
4557:
4543:Choosing Wisely
4526:
4474:
4430:Fee-for-service
4403:
4398:
4360:
4355:
4326:
4305:
4257:Lara W. Johnson
4253:David B. Larson
4251:
4235:
4191:Stephen Hammill
4157:
4115:
4086:
4077:
4075:
4066:
4060:
4045:
4041:
4036:
4035:
4018:
3991:
3990:
3986:
3976:
3974:
3965:
3964:
3960:
3950:
3948:
3935:
3934:
3930:
3920:
3918:
3905:
3904:
3900:
3890:
3888:
3884:
3879:
3878:
3874:
3844:
3843:
3839:
3795:
3794:
3790:
3780:
3778:
3773:
3772:
3768:
3758:
3756:
3748:
3743:
3742:
3738:
3707:
3706:
3702:
3672:
3671:
3667:
3657:
3655:
3646:
3645:
3641:
3611:
3610:
3606:
3589:
3551:Newell D. Nobbs
3545:
3544:
3540:
3488:
3487:
3483:
3475:
3470:
3469:
3465:
3449:Wayback Machine
3439:
3435:
3414:(5): 447.e1–8.
3405:
3404:
3400:
3350:
3349:
3345:
3321:
3320:
3316:
3306:
3304:
3287:Gilbert M. Gaul
3285:
3284:
3280:
3242:
3241:
3237:
3226:Wayback Machine
3216:
3212:
3201:Wayback Machine
3191:
3187:
3178:Wayback Machine
3169:
3165:
3154:Wayback Machine
3144:
3140:
3094:
3093:
3089:
3079:
3077:
3061:
3060:
3056:
3047:
3043:
2990:
2989:
2985:
2954:
2953:
2949:
2905:
2904:
2900:
2890:
2888:
2877:
2876:
2872:
2862:
2860:
2856:
2845:
2841:
2840:
2836:
2790:
2789:
2785:
2768:
2736:JAMA Pediatrics
2733:
2732:
2728:
2689:
2688:
2677:
2628:
2627:
2623:
2583:
2578:
2577:
2573:
2563:
2561:
2545:
2544:
2540:
2530:
2528:
2524:
2513:
2509:
2508:
2504:
2487:
2441:
2440:
2431:
2424:
2411:
2410:
2406:
2397:
2393:
2376:
2330:
2329:
2325:
2315:
2313:
2294:
2293:
2286:
2276:
2274:
2257:
2256:
2245:
2224:(10): 937–938.
2210:
2209:
2205:
2195:
2193:
2179:
2178:
2174:
2167:
2148:
2147:
2143:
2133:
2131:
2130:. June 15, 2011
2116:
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2080:
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1875:
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1537:
1527:
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1508:
1507:
1503:
1493:
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1486:
1485:
1481:
1429:
1428:
1424:
1418:
1394:JAMA Pediatrics
1391:
1390:
1386:
1356:
1355:
1351:
1313:
1312:
1308:
1291:
1252:
1251:
1247:
1241:
1212:10.1.1.688.1277
1194:
1193:
1189:
1157:
1152:
1151:
1147:
1141:Wayback Machine
1131:
1127:
1107:
1106:
1102:
1069:Victor R. Fuchs
1067:
1066:
1059:
1036:Victor R. Fuchs
1030:
1029:
1025:
1015:
1013:
999:
998:
994:
986:
966:(23): 2789–91.
955:
949:Victor R. Fuchs
943:
942:
923:
918:
913:
885:Choosing Wisely
857:Politics portal
855:
848:
843:Medicine portal
841:
836:
834:
831:
822:
816:
813:
806:needs expansion
791:
785:
750:Amitabh Chandra
656:Choosing Wisely
626:
577:coronary stents
544:
523:
517:
478:
473:
442:
430:
418:
412:
360:fee-for-service
356:
354:Fee-for-service
350:
342:proximate cause
338:
291:
283:Choosing Wisely
268:
235:overconsumption
230:Victor R. Fuchs
209:
133:fee-for-service
98:overutilization
87:
76:
70:
67:
52:
39:
35:
28:
23:
22:
15:
12:
11:
5:
5358:
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5322:
5321:
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5282:United Kingdom
5279:
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5267:
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5260:
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5240:
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5187:
5186:
5185:
5183:
5177:
5176:
5174:
5173:
5168:
5163:
5158:
5153:
5151:Digital health
5148:
5143:
5138:
5136:3D bioprinting
5132:
5130:
5124:
5123:
5121:
5120:
5115:
5110:
5105:
5100:
5098:Bedside manner
5094:
5092:
5088:
5087:
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5084:
5079:
5074:
5069:
5064:
5059:
5054:
5049:
5044:
5038:
5036:
5032:
5031:
5029:
5028:
5023:
5018:
5007:Medical school
5004:
4999:
4994:
4989:
4983:
4981:
4977:
4976:
4974:
4973:
4968:
4963:
4958:
4953:
4948:
4943:
4937:
4935:
4931:
4930:
4928:
4927:
4922:
4917:
4912:
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4902:
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4892:
4887:
4882:
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4868:
4867:
4862:
4860:
4859:
4852:
4845:
4837:
4828:
4827:
4825:
4824:
4817:Drug pollution
4813:
4811:
4807:
4806:
4804:
4803:
4798:
4793:
4788:
4783:
4777:
4775:
4771:
4770:
4768:
4767:
4762:
4757:
4752:
4745:
4740:
4735:
4730:
4724:
4722:
4718:
4717:
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4714:
4709:
4704:
4699:
4693:
4691:
4687:
4686:
4684:
4683:
4678:
4673:
4671:Adverse effect
4668:
4663:
4661:Patient safety
4658:
4653:
4648:
4642:
4640:
4636:
4635:
4632:
4630:
4629:
4622:
4615:
4607:
4598:
4597:
4595:
4594:
4587:
4580:
4573:
4565:
4563:
4559:
4558:
4556:
4555:
4550:
4545:
4540:
4534:
4532:
4528:
4527:
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4518:
4513:
4508:
4503:
4498:
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4488:
4482:
4480:
4476:
4475:
4473:
4472:
4467:
4462:
4457:
4452:
4447:
4445:Overmedication
4442:
4437:
4432:
4427:
4422:
4417:
4411:
4409:
4405:
4404:
4399:
4397:
4396:
4389:
4382:
4374:
4368:
4367:
4359:
4358:External links
4356:
4354:
4353:
4324:
4285:(1): 164–173.
4249:
4155:
4129:(5): 795–832.
4113:
4084:
4064:
4058:
4042:
4040:
4037:
4034:
4033:
4000:(8): 849–850.
3984:
3958:
3928:
3898:
3872:
3837:
3788:
3766:
3736:
3717:(2): 259–268.
3711:J Appl Lab Med
3700:
3681:(2): 245–257.
3665:
3639:
3604:
3538:
3481:
3463:
3433:
3398:
3353:Deborah Schrag
3343:
3329:Health Affairs
3314:
3278:
3235:
3210:
3185:
3163:
3138:
3087:
3054:
3041:
2996:Dieter Korczak
2983:
2947:
2898:
2870:
2834:
2783:
2742:(5): 482–486.
2726:
2707:(3): 169–172.
2691:David C. Levin
2675:
2621:
2571:
2538:
2502:
2429:
2423:978-0807077580
2422:
2404:
2398:Gilbert Welch
2391:
2341:Health Affairs
2332:Michelle Mello
2323:
2284:
2267:The New Yorker
2243:
2203:
2172:
2165:
2141:
2109:
2078:
2059:(8): 722–727.
2035:
1994:(4): 288–298.
1950:
1909:(4): 273–287.
1868:
1849:
1841:10.17226/11378
1835:. p. 99.
1817:
1802:
1769:
1760:|website=
1727:
1719:10.17226/12750
1699:
1650:
1593:
1565:
1535:
1501:
1479:
1422:
1400:(12): 1085–6.
1384:
1365:(14): 1513–6.
1349:
1316:Ann Intern Med
1306:
1245:
1198:Ann Intern Med
1187:
1145:
1125:
1110:"More is Less"
1100:
1057:
1023:
992:
920:
919:
917:
914:
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892:
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872:
867:
865:Medicare fraud
861:
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803:
801:
787:Main article:
784:
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625:
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569:
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555:overmedication
551:
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519:Main article:
516:
513:
496:(RCR) and the
477:
474:
472:
469:
468:
467:
464:
461:
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455:
452:
449:
441:
438:
429:
426:
411:
408:
375:McAllen, Texas
349:
346:
337:
334:
315:Hemoglobin A1c
267:
264:
208:
205:
176:, to focus on
89:
88:
49:of the subject
47:worldwide view
42:
40:
33:
26:
24:
14:
13:
10:
9:
6:
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2:
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5285:
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5276:
5273:
5272:
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5270:United States
5268:
5266:
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5251:
5249:
5246:
5244:
5241:
5239:
5236:
5234:
5231:
5229:
5226:
5224:
5221:
5219:in healthcare
5218:
5215:
5213:in healthcare
5212:
5209:
5207:in healthcare
5206:
5203:
5201:
5198:
5196:
5192:
5189:
5188:
5184:
5182:
5178:
5172:
5169:
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5164:
5162:
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4679:
4677:
4676:Patient abuse
4674:
4672:
4669:
4667:
4664:
4662:
4659:
4657:
4656:Medical error
4654:
4652:
4649:
4647:
4644:
4643:
4641:
4637:
4628:
4623:
4621:
4616:
4614:
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4605:
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4567:
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4551:
4549:
4546:
4544:
4541:
4539:
4538:Deprescribing
4536:
4535:
4533:
4529:
4523:
4522:incidentaloma
4520:treatment of
4519:
4517:
4514:
4512:
4509:
4507:
4504:
4502:
4499:
4497:
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4451:
4448:
4446:
4443:
4441:
4438:
4436:
4433:
4431:
4428:
4426:
4425:Overdiagnosis
4423:
4421:
4420:Overscreening
4418:
4416:
4413:
4412:
4410:
4406:
4402:
4395:
4390:
4388:
4383:
4381:
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4375:
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4365:
4362:
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4325:
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4316:
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4274:
4270:
4266:
4262:
4258:
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4246:
4240:
4232:
4228:
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4218:
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4210:
4206:
4202:
4201:
4196:
4192:
4188:
4184:
4180:
4176:
4172:
4168:
4167:Jeptha Curtis
4164:
4163:Anne Hellkamp
4160:
4156:
4152:
4148:
4144:
4140:
4136:
4132:
4128:
4124:
4123:
4118:
4114:
4110:
4106:
4102:
4098:
4094:
4090:
4085:
4074:
4073:newyorker.com
4070:
4065:
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4055:
4051:
4050:
4044:
4043:
4038:
4029:
4023:
4015:
4011:
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3988:
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3968:
3962:
3959:
3946:
3942:
3938:
3932:
3929:
3916:
3912:
3908:
3902:
3899:
3891:September 19,
3883:
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3841:
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3811:
3807:
3803:
3799:
3792:
3789:
3781:September 18,
3776:
3770:
3767:
3759:September 18,
3754:
3747:
3740:
3737:
3732:
3728:
3724:
3720:
3716:
3712:
3704:
3701:
3696:
3692:
3688:
3684:
3680:
3676:
3669:
3666:
3658:September 18,
3653:
3649:
3643:
3640:
3635:
3631:
3627:
3623:
3619:
3615:
3608:
3605:
3600:
3594:
3586:
3582:
3578:
3574:
3570:
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3565:
3560:
3556:
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3548:
3542:
3539:
3534:
3530:
3525:
3520:
3516:
3512:
3508:
3504:
3500:
3496:
3492:
3485:
3482:
3474:
3467:
3464:
3460:
3456:
3455:
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3446:
3443:
3437:
3434:
3429:
3425:
3421:
3417:
3413:
3409:
3402:
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3390:
3385:
3380:
3376:
3372:
3368:
3364:
3363:
3358:
3354:
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3335:
3331:
3330:
3325:
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3302:
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3297:
3292:
3288:
3282:
3279:
3274:
3270:
3265:
3260:
3257:(3): 103–11.
3256:
3252:
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3236:
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3231:
3227:
3223:
3220:
3214:
3211:
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2997:
2993:
2987:
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2979:
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2961:
2957:
2956:Malika Taufiq
2951:
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2821:
2816:
2812:
2808:
2805:(4): 445–55.
2804:
2800:
2799:
2794:
2787:
2784:
2779:
2773:
2765:
2761:
2757:
2753:
2749:
2745:
2741:
2737:
2730:
2727:
2722:
2718:
2714:
2710:
2706:
2702:
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2696:
2692:
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2684:
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2680:
2676:
2671:
2667:
2662:
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2653:
2649:
2645:
2641:
2640:
2635:
2632:(July 2010).
2631:
2625:
2622:
2617:
2613:
2609:
2605:
2601:
2597:
2593:
2589:
2582:
2575:
2572:
2559:
2555:
2554:
2549:
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2539:
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2519:
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2506:
2503:
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2480:
2475:
2470:
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2462:
2458:
2454:
2453:
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2438:
2436:
2434:
2430:
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2408:
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2395:
2392:
2387:
2381:
2373:
2369:
2364:
2359:
2355:
2351:
2347:
2343:
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2337:
2333:
2327:
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2303:
2302:
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2289:
2285:
2272:
2268:
2264:
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2252:
2250:
2248:
2244:
2239:
2235:
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2227:
2223:
2219:
2218:
2213:
2212:Bryant Furlow
2207:
2204:
2191:
2187:
2183:
2176:
2173:
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2166:9781566638425
2162:
2158:
2154:
2153:
2145:
2142:
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2125:
2124:
2119:
2113:
2110:
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2089:
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2079:
2074:
2070:
2066:
2062:
2058:
2054:
2053:
2048:
2042:
2040:
2036:
2031:
2025:
2017:
2013:
2009:
2005:
2001:
1997:
1993:
1989:
1988:
1983:
1979:
1975:
1971:
1967:
1963:
1957:
1955:
1951:
1946:
1940:
1932:
1928:
1924:
1920:
1916:
1912:
1908:
1904:
1903:
1898:
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1890:
1886:
1882:
1878:
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1813:
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1691:
1686:
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1620:
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1578:
1572:
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1566:
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1458:
1453:
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1376:
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1307:
1302:
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1288:
1284:
1280:
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1272:
1268:
1265:(4): 288–98.
1264:
1260:
1256:
1249:
1246:
1238:
1234:
1230:
1226:
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1200:
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1126:
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1104:
1101:
1096:
1092:
1088:
1084:
1080:
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1064:
1062:
1058:
1053:
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1037:
1033:
1027:
1024:
1011:
1007:
1003:
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993:
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981:
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973:
969:
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950:
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938:
936:
934:
932:
930:
928:
926:
922:
915:
910:
906:
903:
901:
900:Overdiagnosis
898:
896:
893:
891:
888:
886:
883:
881:
878:
876:
873:
871:
868:
866:
863:
862:
858:
852:
847:
844:
833:
828:
820:
811:
807:
804:This section
802:
799:
795:
794:
790:
782:
780:
778:
777:adverse event
773:
771:
767:
761:
759:
755:
754:JudyAnn Bigby
751:
747:
743:
739:
735:
730:
728:
723:
720:
715:
713:
709:
705:
701:
697:
695:
691:
687:
683:
679:
675:
671:
669:
665:
660:
657:
653:
647:
645:
644:Uwe Reinhardt
641:
636:
634:
630:
623:
618:
614:
610:
606:
603:
600:
596:
592:
589:
585:
581:
580:
578:
574:
572:complications
570:
567:
563:
560:
556:
552:
549:
546:
545:
541:
539:
536:
535:overdiagnosis
532:
527:
522:
514:
512:
510:
509:overdiagnosis
505:
503:
499:
495:
491:
487:
483:
482:self-referral
475:
470:
465:
462:
459:
456:
453:
450:
447:
446:
445:
439:
437:
434:
427:
425:
423:
417:
409:
406:
404:
398:
396:
392:
386:
384:
380:
376:
372:
368:
365:
361:
355:
347:
345:
343:
335:
333:
330:
328:
324:
320:
316:
310:
307:
303:
298:
289:
284:
279:
276:
275:
265:
263:
261:
257:
254:
251:
246:
242:
238:
236:
231:
227:
222:
220:
219:
214:
213:Jack Wennberg
206:
204:
202:
197:
195:
194:
193:overdiagnosis
189:
188:Overtreatment
185:
183:
179:
175:
171:
167:
163:
158:
154:
150:
146:
142:
141:litigiousness
138:
134:
130:
125:
123:
119:
115:
114:United States
111:
107:
106:overtreatment
103:
99:
95:
85:
82:
74:
64:
60:
56:
50:
48:
41:
32:
31:
19:
5238:Telemedicine
5171:Telemedicine
5166:Nanomedicine
5002:Nursing home
4801:Hand washing
4747:
4728:Drapetomania
4697:Medical debt
4665:
4646:Iatrogenesis
4633:Medical harm
4589:
4582:
4575:
4568:
4516:Polypharmacy
4400:
4332:
4328:
4323:on the study
4309:cite journal
4282:
4276:
4239:cite journal
4207:(1): 43–49.
4204:
4198:
4126:
4120:
4117:R. E. Malone
4095:(1): 240–5.
4092:
4088:
4076:. Retrieved
4072:
4048:
4022:cite journal
3997:
3993:
3987:
3975:. Retrieved
3961:
3949:. Retrieved
3945:the original
3940:
3931:
3919:. Retrieved
3910:
3901:
3889:. Retrieved
3875:
3850:
3846:
3840:
3808:(5): 20–23.
3805:
3801:
3791:
3779:. Retrieved
3769:
3757:. Retrieved
3752:
3744:Singh, Ila.
3739:
3714:
3710:
3703:
3678:
3675:Clin Lab Med
3674:
3668:
3656:. Retrieved
3651:
3642:
3617:
3613:
3607:
3593:cite journal
3568:
3562:
3559:John D. Kemp
3541:
3498:
3494:
3484:
3466:
3452:
3436:
3411:
3407:
3401:
3366:
3360:
3346:
3327:
3317:
3305:. Retrieved
3294:
3281:
3254:
3248:
3238:
3228:
3213:
3203:
3188:
3180:
3166:
3156:
3141:
3109:(1): 53–61.
3106:
3100:
3090:
3078:. Retrieved
3067:
3057:
3044:
3009:
3003:
2992:Markus Dietl
2986:
2969:
2963:
2950:
2917:
2911:
2901:
2889:. Retrieved
2883:
2873:
2861:. Retrieved
2837:
2802:
2796:
2786:
2772:cite journal
2739:
2735:
2729:
2704:
2698:
2695:Vijay M. Rao
2643:
2637:
2624:
2591:
2587:
2574:
2562:. Retrieved
2558:the original
2551:
2541:
2529:. Retrieved
2522:the original
2505:
2491:cite journal
2456:
2450:
2413:
2407:
2394:
2380:cite journal
2345:
2339:
2326:
2314:. Retrieved
2299:
2275:. Retrieved
2266:
2259:Atul Gawande
2221:
2215:
2206:
2194:. Retrieved
2185:
2175:
2151:
2144:
2132:. Retrieved
2121:
2112:
2087:
2081:
2056:
2050:
2024:cite journal
1991:
1985:
1939:cite journal
1906:
1900:
1871:
1827:
1820:
1785:
1740:. Retrieved
1709:
1702:
1670:(1): 16–25.
1667:
1663:
1653:
1610:
1606:
1596:
1584:. Retrieved
1580:
1553:
1526:. Retrieved
1514:
1504:
1492:. Retrieved
1482:
1439:
1435:
1425:
1397:
1393:
1387:
1362:
1358:
1352:
1319:
1315:
1309:
1295:cite journal
1262:
1258:
1248:
1205:(4): 270–1.
1202:
1196:
1190:
1165:
1161:
1148:
1128:
1113:
1103:
1078:
1072:
1046:(19): 2251.
1043:
1039:
1026:
1014:. Retrieved
1005:
995:
984:the original
963:
959:
870:Moral hazard
817:October 2011
814:
810:adding to it
805:
789:Cost sharing
774:
762:
738:Bernard Lown
731:
724:
716:
698:
672:
661:
648:
637:
627:
528:
524:
506:
479:
443:
431:
419:
400:
387:
378:
371:Atul Gawande
369:
357:
339:
331:
327:lipid panels
311:
301:
280:
272:
269:
259:
258:
255:
247:
243:
239:
223:
216:
210:
198:
191:
187:
186:
164:to restrain
126:
105:
101:
97:
93:
92:
77:
68:
44:
5297:New Zealand
5052:End-of-life
4934:Professions
4864:Health care
4681:Never event
4570:Overtreated
4335:(14): e21.
4171:Daniel Mark
3921:January 19,
3847:Transfusion
3555:Ronald Feld
1978:F. L. Lucas
1893:F. L. Lucas
1742:December 7,
1586:December 5,
1528:December 7,
1494:December 7,
758:Julio Frenk
742:Don Berwick
678:stewardship
668:stewardship
393:and in the
391:Mayo Clinic
151:is not the
110:health care
5334:Categories
5264:By country
5128:Technology
5067:Palliative
4895:Philosophy
4885:Guidelines
3977:August 21,
3951:August 21,
2913:The Lancet
2891:October 6,
911:References
670:programs.
654:began the
414:See also:
379:New Yorker
352:See also:
245:patient."
207:Definition
182:subjective
5292:Australia
5113:Education
5108:Diagnosis
4961:Dentistry
4905:Providers
4880:Equipment
4875:Economics
4278:Radiology
4089:Radiology
3515:0884-8734
3459:USA Today
3454:HealthDay
3012:: Doc03.
2972:(1): 60.
2646:(3): e8.
2459:(1): e6.
2443:B. Rehani
2301:Fresh Air
1762:ignored (
1752:cite book
1627:2168-6106
1474:247023707
1344:207536403
1255:Stukel TA
1207:CiteSeerX
1168:: 77–84.
1016:March 31,
916:Citations
770:residency
613:pap smear
566:addiction
364:incentive
323:vitamin D
162:incentive
59:talk page
5319:Category
4997:Hospital
4980:Settings
4951:Pharmacy
4941:Medicine
4890:Industry
4639:Concepts
4349:24693918
4301:21115875
4231:21205965
4151:10081763
4109:20736333
4014:28245327
3971:Archived
3915:Archived
3867:35616174
3832:35619979
3731:32630981
3695:31036278
3652:clsi.gov
3634:22492759
3585:16119987
3533:31250366
3445:Archived
3428:21840492
3393:20940384
3301:Archived
3273:15160808
3222:Archived
3197:Archived
3174:Archived
3150:Archived
3133:21730241
3074:Archived
3036:21522485
2998:(2011).
2978:21276393
2942:31805773
2934:21982520
2885:ABC News
2863:June 29,
2854:Archived
2829:21672923
2756:29582079
2721:17411553
2670:21611049
2616:46797965
2608:29408150
2564:June 22,
2531:June 27,
2483:21655115
2372:20820010
2316:June 29,
2310:Archived
2277:June 29,
2271:Archived
2238:19810157
2196:June 19,
2190:Archived
2186:BBC News
2134:June 26,
2104:38839058
2073:21518938
2008:12585826
1931:27581938
1923:12585825
1863:Archived
1859:20669457
1737:21595114
1694:30508010
1645:24819824
1560:Archived
1466:35189687
1414:26502277
1379:22419800
1336:22213573
1279:12585826
1237:12934288
1229:19221379
1182:28131024
1137:Archived
1120:Archived
1095:19996406
1010:Archived
980:18560006
951:(2008).
829:See also
617:HPV test
471:Examples
306:Medicare
149:consumer
116:, where
71:May 2018
53:You may
5161:mHealth
5072:Primary
5057:Hospice
5047:Chronic
4946:Nursing
4915:Ranking
4222:3432303
4143:9803363
4039:Sources
3823:9124555
3753:cdc.gov
3524:6712188
3384:3728828
3307:July 5,
3124:3293218
3080:July 6,
3027:3080661
2820:3136200
2764:4369253
2661:3097773
2474:3107688
2363:3048809
2016:8031637
1812:9998202
1685:6583417
1636:4241845
1581:cms.gov
1457:9909614
1287:8031637
719:AskMyGP
619:results
607:Annual
492:(ACR),
476:Imaging
292:US$ 2.6
215:called
157:patient
102:overuse
5287:Canada
4992:Clinic
4925:System
4920:Reform
4910:Public
4900:Policy
4408:Causes
4347:
4299:
4267:&
4229:
4219:
4189:&
4149:
4141:
4107:
4078:May 4,
4056:
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3830:
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3729:
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3632:
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3557:&
3531:
3521:
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3271:
3230:Forbes
3131:
3121:
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3024:
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2976:
2958:&
2940:
2932:
2827:
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2754:
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2630:Elm Ho
2614:
2606:
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2360:
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2006:
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1800:
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1093:
1034:&
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756:, and
692:, and
542:Others
533:, and
336:Causes
5082:Total
5042:Acute
4321:story
4147:S2CID
3885:(PDF)
3755:. CDC
3749:(PDF)
3476:(PDF)
2938:S2CID
2857:(PDF)
2846:(PDF)
2760:S2CID
2612:S2CID
2584:(PDF)
2525:(PDF)
2514:(PDF)
2157:63–83
2012:S2CID
1927:S2CID
1808:S2CID
1470:S2CID
1340:S2CID
1283:S2CID
1233:S2CID
1158:(PDF)
987:(PDF)
956:(PDF)
383:Miami
302:et al
155:—the
153:payer
108:) is
104:, or
61:, or
5193:and
5077:Self
5035:Care
4821:List
4345:PMID
4319:– a
4315:link
4297:PMID
4245:link
4227:PMID
4139:PMID
4105:PMID
4080:2015
4054:ISBN
4028:link
4010:PMID
3994:JAMA
3979:2013
3953:2013
3923:2015
3893:2024
3863:PMID
3828:PMID
3783:2024
3761:2024
3727:PMID
3691:PMID
3660:2024
3630:PMID
3599:link
3581:PMID
3529:PMID
3511:ISSN
3424:PMID
3389:PMID
3362:JAMA
3309:2011
3269:PMID
3129:PMID
3102:JAMA
3082:2011
3032:PMID
2974:PMID
2930:PMID
2893:2011
2865:2011
2825:PMID
2778:link
2752:PMID
2717:PMID
2666:PMID
2604:PMID
2566:2011
2533:2011
2497:link
2479:PMID
2418:ISBN
2386:link
2368:PMID
2318:2011
2279:2011
2234:PMID
2198:2011
2161:ISBN
2136:2011
2100:PMID
2069:PMID
2030:link
2004:PMID
1945:link
1919:PMID
1855:PMID
1845:ISBN
1798:ISBN
1764:help
1744:2018
1733:PMID
1723:ISBN
1690:PMID
1641:PMID
1623:ISSN
1588:2018
1530:2018
1496:2018
1462:PMID
1410:PMID
1375:PMID
1359:JAMA
1332:PMID
1301:link
1275:PMID
1225:PMID
1178:PMID
1091:PMID
1018:2016
976:PMID
725:The
708:AABB
662:The
615:and
601:raid
266:Cost
4337:doi
4333:370
4287:doi
4283:258
4217:PMC
4209:doi
4205:305
4131:doi
4097:doi
4093:257
4002:doi
3998:317
3855:doi
3818:PMC
3810:doi
3719:doi
3683:doi
3622:doi
3618:307
3573:doi
3569:129
3519:PMC
3503:doi
3416:doi
3412:205
3379:PMC
3371:doi
3367:304
3334:doi
3259:doi
3119:PMC
3111:doi
3107:306
3022:PMC
3014:doi
2922:doi
2918:378
2815:PMC
2807:doi
2744:doi
2740:172
2709:doi
2656:PMC
2648:doi
2596:doi
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