Doctor-patient relationship is essential to curtail overdiagnosis

The BMJ’s continuing focus on the harms of too much medicine is heartening,1 but the available antidotes struggle to keep pace with commercial pressures driving overdiagnosis and overtreatment. For several reasons, doctor-patient communication will be a decisive factor in this struggle. How we regard patients is crucial; the words we use both reflect and influence clinical relationships. Recent evidence shows the extent to which medical language and unhelpful attitudes can cause patients to feel disengaged and disempowered.2 By contrast, positive, mutually respectful doctor-patient relationships foster the therapeutic alliance and sensible decision making.3Responsible medical treatment depends on reliable information about likely effects, both good and ill. Unfortunately, distortion of the evidence base by commercial bias makes it difficult for both doctors and patients to access relevant, balanced information to guide decision making. Direct-to-consumer advertising compounds the problem, causing many to see the doctor with requests for inappropriate investigation or treatment.4 Effective…
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