Social Science Applied to Health Improvement Research (SAPPHIRE) Group, Department of Health Sciences, University of Leicester, Leicester, UK.
Sociol Health Illn. 2021 Jan;43(1):58-64. doi: 10.1111/1467-9566.13186. Epub 2020 Sep 23.
Overdiagnosis and overtreatment are increasingly discussed as a significant problem in contemporary healthcare but are yet to receive any significant sociological attention, over and above that which is arguably transferable from the medicalisation literature. Overdiagnosis and overtreatment are often constructed as problems best addressed by educating patients and clinicians, and improving the relationships between them. The emergence of tools seeking to support decision-making and to facilitate patients' asking questions about whether interventions are really necessary supports this conceptualisation. This article questions whether significant traction on overdiagnosis and overtreatment is possible through these means alone, arguing that even when professionals and patients may wish to do less rather than more, the system within which care is delivered and received can make this challenging to achieve. Drawing on Scott's (Sociology, 2018, 52, 3) 'sociology of nothing', the article demonstrates that a sociological perspective on overdiagnosis and overtreatment recasts them as issues that must be understood as a consequence of the organisational, financial and cultural attributes of the system, not just individual interactions, and advances a research agenda for the area.
过度诊断和过度治疗作为当代医疗保健中的一个重大问题，越来越受到关注，但尚未得到任何重要的社会学关注，除了可以从医学化文献中推断出来的关注之外。过度诊断和过度治疗通常被认为是通过教育患者和临床医生以及改善他们之间的关系来解决的最佳问题。寻求支持决策并促进患者询问干预措施是否真正必要的工具的出现支持了这种概念化。本文质疑仅通过这些手段是否可以对过度诊断和过度治疗产生重大影响，认为即使专业人员和患者可能希望减少而不是增加治疗，提供和接受护理的系统也可能使这一目标难以实现。本文借鉴了斯科特（Sociology，2018，52，3）的“无社会学”观点，表明对过度诊断和过度治疗的社会学观点将其重新定义为必须将其理解为该系统的组织、财务和文化属性的后果的问题，而不仅仅是个人互动，并为该领域提出了一个研究议程。
