When is Less Medicine Better?

Does more health care mean better health care? That is the question associate professor of medicine Elliot Fisher wants to answer. "Few studies have explicitly examined the possibility that increasing amounts of health care might lead to harm," says Fisher. Still, Americans have been receiving increasing amounts of health care. In fact, the dosage has doubled since 1975.

"A fundamental principle of economics is the law of diminishing returns; that each additional input of any good or service yields a declining return of benefit. At some point the return becomes negative," says Fisher.

To illustrate his point, Fisher explains that powerful diagnostic tests and aggressive therapies increase the tendency toward earlier intervention for milder diseases. "Patients with milder disease are less likely to benefit, yet still will face substantial risks from therapy."

The goal of his $1.6 million study, funded by the Robert Wood Johnson Foundation, is to study where we are in the curve of diminishing returns.