Saskatchewan taxpayers could save hundreds of millions of dollars a year by eliminating unnecessary tests, medication and surgeries, say researchers.
The savings could chop off a large chunk of the provincial government's projected $1.2-billion deficit. It would also improve the quality of care.
Some of that care isn't just frivolous – it's harmful.
"There's a significant portion of health care that isn't supported by science," said Tai Huynh, co-founder of the health education website Choosing Wisely Canada.
"Some of the intervention exposes the patient to significant risk. We should try to avoid those things."
'Cultural revolution' required
Tackling this enormous problem will require time and a "cultural revolution" among patients, doctors and other health workers, said Saskatoon health policy consultant Steven Lewis.
"The real issue is not identifying where the overuse is, but getting rid of it," Lewis said.
"Every unnecessary procedure puts money in someone's pocket, be it a doctor, a nurse on the ward, the lab technician, the manufacturer, the pharmaceutical company."
Recent studies have estimated up to 30 per cent of all health care is unnecessary or harmful, said Lewis and Huynh.
Even if Saskatchewan did a better job than other provinces and had a rate of just 15 per cent, that's up to $800 million per year that could be saved, Lewis said.
'Default position is that more is better': Lewis
The Choosing Wisely Canada website features lists of unnecessary tests and treatments.
The most common interventions are over-prescription of antibiotics for children and over-medicating the elderly. Excessive use of high-radiation test scans or surgeries are a problem, too.
A host of maladies and injuries are accompanied by a list of questions every patient and health care provider should be asking.
Huynh said the proliferation of inaccurate health information on the Internet is partly to blame. Patients read about the latest miracle cure and demand their doctor do more. Doctors, who are busy and are paid by volume, too often give in to the demands.
"There is also a cultural fascination with technology and interventions. The default position is that more is better," Lewis said.
Lewis said doctors' attitudes are changing.
A recent Saskatchewan Medical Association survey showed most doctors agree they should be stewards of the public purse. A majority also showed willingness to work under a new model other than the traditional volume-based fee for service system.
"It may take longer to talk somebody out of a drug or a test than to just go ahead and prescribe it," Lewis said.
Lewis said education is key. The most important things are for health providers and patients to listen to each other and be guided by evidence.
Appropriate care strategy in works
The provincial government agrees in principle with the goals of Choosing Wisely and it is working to eliminate unnecessary care, an official said.
"Improving the appropriateness of care is one of the Saskatchewan healthcare system's key priorities," an emailed response said.
A working group has been formed in the province. It made progress on decreasing unnecessary MRIs for people with certain types of lower back pain.
The official added that the amalgamation of health authorities should increase co-ordination and efficiency.
In advance of the March 22 provincial budget, the CBC is examining how people in Saskatchewan are impacted, and possible solutions to the projected deficit.