UMMS Affiliation

Department of Family Medicine and Community Health

Publication Date


Document Type



Analytical, Diagnostic and Therapeutic Techniques and Equipment | Community Health and Preventive Medicine | Diagnosis | Family Medicine | Preventive Medicine | Primary Care


Overdiagnosis and overtreatment are often thought of as relatively recent phenomena, influenced by a contemporary combination of technology, specialization, payment models, marketing, and supply-related demand. Yet a quick glance at the historical record reveals that physicians and medical manufacturers have been accused of iatrogenic excess for centuries, if not millennia. Medicine has long had therapeutic solutions that search for ever-increasing diagnostic problems. Whether the intervention at hand has been leeches and lancets, calomel and cathartics, aspirins and amphetamines, or statins and SSRIs, medical history is replete with skeptical critiques of diagnostic and therapeutic enthusiasm. The opportunity cost of this profusion shapes the other side of the coin: chronic persistence of underdiagnosis and undertreatment. Drawing from key controversies of the 19th and 20th centuries, we chart the enduring challenges of inter-related diagnostic and therapeutic excess. As the present critique of overdiagnosis and overtreatment seeks to mobilize resources from inside and outside of medicine to rein in these impulses, we provide an instructive historical context from which to act.


history of diagnosis, overdiagnosis

Rights and Permissions

©2015, Stephen A. Martin et al., published by De Gruyter. This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License. (CC BY-NC-ND 3.0).

DOI of Published Version



Steve Martin, SH Podolsky and JA Greene. Overdiagnosis and Overtreatment Over Time. Diagnosis. Volume 2, Issue 2, Pages 105–109, DOI: 10.1515/dx-2014-0072, April 2015. Link to article on publisher's website

Journal/Book/Conference Title


Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.