Survey Finds Communication Gaps Between Older Americans, Physicians

A lack of communication among older Americans and their physicians increases unnecessary healthcare spending on unneeded scans, screenings, medications, and procedures for the patient, according to a survey from the National Poll on Healthy Aging.

“The new findings suggest patients and providers need to work together more to prevent overuse of healthcare services that provide the least value to patients,” Jeffrey Kullgren, MD, MS, MPH, said in a statement. Kullgren, of the University of Michigan, designed the poll and analyzed its results.

The study included 2,007 Americans between the ages of 50 and 80. The study was conducted by the University of Michigan Institute for Healthcare Policy and Innovation, and sponsored by the American Association of Retired Persons and Michigan Medicine.

The poll found that while 1 in 6 older patients reported they were offered health services they believed to be unnecessary in the last year, almost half gave in to receiving the test or prescription recommended by their doctor. In addition, a quarter of respondents said that their health providers ordered tests or prescribed drugs in the past without consulting with the patient first.

On the other hand, 1 in 10 respondents said their doctor advised them not to take a test or medication that they wished to receive. Although most reported an explanation was given by the physician as to why they shouldn’t receive the service, roughly 40% did not understand the given reasoning.

In the poll, 50% of patients who were not sure if they needed a test took it anyway, and 41% filled a prescription even though they believed they might not need it.

If the provider had recommended those tests or medicines based on evidence that they held high value and were necessary, then it is a concern if some patients did not follow the recommendations. But the researchers said other studies have shown some providers order low-value tests and screenings, or may even do so to avoid patient dissatisfaction or legal liability.

Overall, 54% of patients polled believe that physicians recommend tests, screenings, and prescriptions that are unnecessary.

To fix the communication issue, Kullgren recommended the website Choosing Wisely as a tool to evaluate which tests and treatments are of low value for certain patients. If communication is achieved, services that are of high value to patients will be used more frequently.

“Patients should speak up when they aren’t sure if a test or medication recommended to them is needed,” Kullgren added. “And providers need to communicate about how a particular service will — or will not – affect the patient’s health, both when they’re recommending it and when a patient has requested it.”