One reason most people overestimate the benefits of treatment and underestimate the harms is that the medical care industry is a rigged game. It is about doing things to people, rather than for them, because that’s how everyone (except the patient, very often) makes out financially; if the patient is diligent and lucky he or she achieves an outcome that they value, which could be quite different from the outcomes used to reward providers. The medical care marketing machine is ubiquitous and powerful. Unfortunately, the current debate about overdiagnosis and overtreatment is not cutting very deeply into healthcare excess, for the simple reason that there is too much money to be made by pharma, hospitals, doctors, and health plans.
The smarter you are about how the healthcare industry makes its money (or takes your and your employer’s money), the better off you will be. The path to successful interaction with the medical care machine lies in skeptical, minimalist interaction.
Despite the existence of metrics to help patients appreciate benefits and harms, a new systematic review suggests that our expectations are not consistent with the facts. Most patients overestimate the benefits of medical treatments, and underestimate the harms; because of that, they use more care.