Can a doctor-patient relationship lead to unnecessary care?

Can a doctor-patient relationship lead to unnecessary care?

Care by a single primary care doctor is associated with many health benefits for patients, including that they adhere better to treatment plans and are less likely to be admitted to the hospital. But can there be unintended consequences with this close relationship?

A University of Florida study explored whether this connection can lead patients to follow recommendations for low-value or even harmful care. The study, published in Frontiers in Medicine, found men with a primary care doctor were more likely than those who saw a specialist  to receive a prostate cancer screening test during a period when the test was not recommended by the U.S. Preventive Services Task Force.

Using results from a nationwide system of health-related telephone surveys, the UF team analyzed data from 2016, four years after the task force recommended against the prostate specific antigen, or PSA, test. The task force concluded the potential harms, including false positives and over treatment, outweighed the benefits.

Among more than 200,000 men who responded to the survey, nearly 40% reported receiving a PSA test during the period when it was not recommended. Those who reported having a single primary doctor said they discussed the advantages and disadvantages of PSA tests with their doctor, and were significantly more likely to get a recommendation to have the test.

The researchers emphasized the results should not suggest that having a regular doctor is a problem. To the contrary, the findings reinforce the power of these relationships. Trust in one’s doctor is critical in providing care, but the responsibility falls to physicians to ensure they are providing evidence-based care.

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