Working Paper: “Too Much Medicine” - Investigating how Physicians’ Professional Values Influence Overtreatment in Oncology

Overtreatment of low-risk disease is one of the most important problems in medicine, yet there has been little conceptual and empirical research on the factors influencing this phenomenon. This study examines how biased heuristics in expert decision-making influence physicians’ treatment decisions by promoting more defensive decision-making behavior. Combining theories of Naturalistic Decision Making (NDM) and the sociology of the professions, we theorize that emotional dispositions and professional values may lead to cautious decision patterns and heuristics which ultimately results in overtreatment. Our analysis of a sample of cancer specialists suggests that stress from uncertainty in patient care, a professional feeling of responsibility, and value congruence explain a substantial amount of the variance in health professionals’ decision-making and their tendency to recommend treatment for low-risk prostate cancer. Implications for future research on expert decision-making and overtreatment in medicine are discussed.