Per the article ...
Most experts agree that American patients are frequently overtreated, especially with regard to expensive tests that aren't strictly needed. The standard explanation for this is that doctors and hospitals promote these tests to keep their income high. This notion likely contains some truth.
But another big factor is patient preference. A study out of Johns Hopkins's medical school found doctors' two most common explanations for overtreatment to be patient demand and fear of malpractice suits -- another particularly American concern.
In countless situations, such as blood tests that are mildly out of the normal range, the standard of care is "watchful waiting." But compared with patients elsewhere, American patients are more likely to push their doctors to treat rather than watch and wait.
American patients similarly don't like to be told that unexplained symptoms aren't ominous enough to merit tests.
Robert Joseph, a longtime ob‑gyn at three Boston-area hospital systems who last year became a medical director at a firm that runs clinical trials, says some of his patients used to come in demanding laparoscopic surgery to investigate abdominal pain that would almost certainly have gone away on its own. "I told them about the risks of the surgery, but I couldn't talk them out of it, and if I refused, my liability was huge," he says.
Hospitals might question non-indicated and expensive surgeries, he adds, but saying the patient insisted is sometimes enough to close the case. Joseph, like many American doctors, also worried about getting a bad review from a patient who didn't want to hear "no." Such frustrations were a big reason he stopped practicing, he says.
In most of the world, what the doctor says still goes. "Doctors are more deified in other countries; patients follow orders," says Josef Woodman, the CEO of Patients Beyond Borders, a consulting firm that researches international health care. He contrasts this with the attitude of his grown children in the U.S.: "They don't trust doctors as far as they can throw them."
American patients' flagrant disregard for routine care is another problem.
Take the failure to stick to prescribed drugs, one more bad behavior in which American patients lead the world. The estimated per capita cost of drug noncompliance is up to three times as high in the U.S. as in the European Union. And when Americans go to the doctor, they are more likely than people in other countries to head to expensive specialists.
Finally, the U.S. stands out as a place where death, even for the very aged, tends to be fought tooth and nail, and not cheaply.
Welcome to the United States of Dysfunction.