Growing Crisis of Unnecessary Tests and Medications in Indian Healthcare

Unnecessary medical tests, treatments, and prescriptions are fueling a growing crisis of overtreatment across India, even as many citizens still lack basic primary care.

Causes of Overtreatment

Five primary factors drive this trend, starting with excessive and unneeded screening tests that trigger a cascade of further investigations, false-positive results, and patient anxiety. The second driver is the fragmentation of healthcare, marked by an over-reliance on specialists and super-specialists who treat patients in isolation rather than looking at overall health. This fragmentation heavily impacts older adults, as a 2021 study published in Frontiers in Pharmacology showed polypharmacy in about 49% of older seniors, while a 2025 study in Scientific Reports found that roughly one-third of older adults took five or more medicines, with nearly 29% containing potentially inappropriate prescriptions. The third force turns healthcare into a marketplace where devices, lab tests, and procedures are sold under a fee-for-service model that rewards activity over restraint. Health insurance also contributes by creating moral hazards that discourage prevention and push stakeholders toward costlier interventions. Fourth, patient beliefs and expectations drive overmedication, as people often equate reassurance with inaction and prefer a tangible prescription or scan over lifestyle advice. Finally, defensive medicine pushes clinicians to order extra tests out of fear of missing a rare diagnosis, ignoring the physical and financial risks those tests carry.

Proposed Solutions

Fixing this issue requires India to rebuild functional primary care by restoring the family physician as the first point of contact to coordinate care and stop unnecessary procedures. Every prescription should include a review or stop date, and older adults taking five or more drugs need structured medication reviews. Furthermore, professional medical societies and the Indian Council of Medical Research should create local lists of low-value tests and treatments similar to the global Choosing Wisely movement. Patients should ask four key questions before starting any test: why it is needed, what happens if they wait, the benefits and risks, and what the alternatives are. Lastly, payment systems and health insurance must reward clinical reasoning and health outcomes rather than sheer volume.

Context

The rising trend of overmedicalisation is a well-documented global issue that first gained attention in wealthy nations before spreading to middle-income countries. It highlights a modern medical paradox where the ability to test and treat has expanded much faster than the clinical restraint needed to apply those tools wisely.