Too Much Information
Too Much Information
Joy Stepinski, MSN, RN-BC
August 10, 2025
Returning to the discussion of health assumptions that drive too much medical care, let’s review the fourth assumption in Less Medicine More Health by Dr. H. Gilbert Welch. The fourth assumption is that getting more information is always the right choice.
Welch describes that more information is not necessarily better [1]. In several studies, when the intervention group had more follow-up, their outcomes did not necessarily improve. For example, an article Does Increased Access to Primary Care Reduce Hospital Readmissions? printed in the New England Journal of Medicine [2], researchers discovered that veterans who received close follow-up care after a hospitalization with diabetes, chronic obstructive pulmonary disease, or congestive heart failure increased the rate of hospital readmission.
A separate study investigated the follow-up of breast cancer [3] among 1,243 women. Both groups were assigned to undergo a physical examination and a mammogram. One group received more intensive follow-up, with the addition of a chest x-ray and bone scan. The authors concluded that the extra follow-up was not necessary because there was no impact on the patient’s prognosis after five years. Although the intensive group had earlier detection of recurrence, there was no difference in 5-year overall mortality, and likely more information caused greater fear in the treatment group.
These are two examples of several that the author discussed. Seeking more information in patients with a known medical condition may not produce better outcomes. In the same regard, looking for clinical data in patients who are well may not be beneficial. Welch writes [1], “More clinical data not only can create anxiety for patients, they can also initiate cascades that lead to unneeded medical care” (p. 95).
What does this mean to you if you’re the patient? Making decisions about seeking further information depends on several factors. For example, does the information produce useful knowledge? Will further information affect your well-being and resilience? In other words, will more data simply cause fear and terror?
To make informed decisions, questions to ask include:
“What are we looking for?” (p. 125). Is your healthcare provider looking for anything that may be wrong or a specific diagnosis? Looking for just anything may lead to more tests and medical care without much benefit.
“If we find what we are looking for, what may we do differently?” (p. 125). If the information does not change the course of treatment, what benefit will it have?
What do you feel is useful information? Is information from a machine always valuable?
What will you do if your healthcare provider discovers an incidental finding? Diagnostic tools are improving; are unexpected results always essential to pursue?
Informed decisions are invaluable. Exploring these questions may help determine one’s values in decision-making. Informed care allows you to be in the driver’s seat with your health!
References:
Welch, H. G. (2015). Less medicine, more health: 7 assumptions that drive too much medical care. Beacon Press.
Weinberger, M., Oddone, E. Z., & Henderson, W. G. (1996). Does increased access to primary care reduce hospital readmissions?. New England Journal of Medicine, 334(22), 1441-1447
Del Turco, M. R., Palli, D., Cariddi, A., Ciatto, S., Pacini, P., & Distante, V. (1994). Intensive diagnostic follow-up after treatment of primary breast cancer: a randomized trial. Journal of the American Medical Association, 271(20), 1593-1597.