The Hidden Harms of ‘Doing More’: A Cardiologist’s Perspective
Dr. Rita Redberg explains that adhering to evidence and a “less is more” strategy reduces waste and harm by helping ensure “new” doesn’t overshadow what is truly “better.”
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Our Guest
Rita Redberg, MD Cardiologist,
Dr. Rita F. Redberg is a cardiologist who practices general and preventive cardiology. She is passionate about helping her patients adopt healthful lifestyle behaviors to reduce their heart disease risk and stay healthy. She also has an interest in promoting high-value health care, an approach that emphasizes delivering appropriate treatments while avoiding tests or therapies with no known benefits.
Dr. Redberg’s research looks at how the assessment of medical technology’s safety and effectiveness influences—and is influenced by—public health policy. In particular, she studies high-risk medical devices and women’s inclusion in clinical trials for such devices.
Episode Description
In this episode of Quality Talks With Peggy O’Kane, NCQA President Peggy O’Kane sits down with Dr. Rita Redberg, a cardiology pioneer and fierce advocate for evidence-based care. Dr. Redberg, who famously served as Editor-in-Chief of JAMA Internal Medicine for 14 years, shares her “Less is More” philosophy — a perspective that challenges the view that “more” care is always better.
Join Peggy and Rita as they explore:
- The Problem with “More”: Why a health care culture focused on technology and volume over patient needs leads to runaway costs and poor results.
The Stent Story: How a widely adopted procedure in cardiology gained traction without initial evidence of patient benefit, and the uphill battle to integrate rigorous clinical trials. - Mary Caldwell’s Odyssey: A cautionary tale illustrating the dangerous cascade of unnecessary testing and interventions, based on a desire for reassurance rather than clinical need.
- Re-evaluating Statins: Rita’s unconventional view on the use of statins in asymptomatic people. She advocates lifestyle changes over medication when the evidence of benefit is thin.
- Rebuilding Trust: How the fee-for-service payment model erodes the patient-doctor relationship and how regulatory reforms can shift incentives towards patient wellbeing.
Rita reminds us that health care quality isn’t about more tests or interventions. It’s about thoughtful, patient-centered decisions and a commitment to “first, do no harm.” This episode is a must-listen for anyone curious about improving health outcomes and reducing waste in health care.
But most people I see, and most people taking statins, are not in that category. They’re healthy people that want to prevent a heart attack and want to live longer. They definitely are not going to feel better.
Timestamps
(02:09) Misconceptions in Medicine
(10:01) Mary Caldwell: A Cautionary Tale
(13:35) Choosing Wisely Campaign: A Step Towards Better Care
(16:32) Debating the Use of Statins
(21:31) Trust, Incentives and the High Cost of Care
(27:05) Technology, Teams and Trust
