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Insights on the German College of General Practitioners and Family Physicians (DEGAM) guideline addressing medical overuse
  1. Lisette Warkentin1,
  2. Susann Hueber1,
  3. Thomas Kühlein1,
  4. Martin Scherer2
  1. 1Institute of General Practice, Uniklinikum Erlangen, Erlangen, Germany
  2. 2Institute and Polyclinic for Primary Care and Family Medicine, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
  1. Correspondence to Dr Lisette Warkentin, Institute of General Practice, Uniklinikum Erlangen, Erlangen, Germany; lisette.warkentin{at}

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Overdiagnosis is a common phenomenon. It is defined as the identification of an abnormality that would not have harmed the patient if it had not been detected. However, once detected, the knowledge of such an abnormality alone has the potential to harm the patient, both psychologically and physically.1 Next to problems for individuals, ‘too much medicine’ also contributes to problems in our healthcare systems: continuously rising healthcare costs, a shortage of healthcare workers, increasing burnout rates among them and increasing greenhouse gas emissions by the healthcare sector.2 Due to limited human, financial and environmental capacities, solutions must be found to better allocate the available resources. The international Preventing Overdiagnosis Conference (PODC) has been dedicated to this topic for 10 years now.3 In August 2023, the conference was held in Copenhagen. The aim of the PODC is the international scientific exchange on the topic of overdiagnosis. In addition to the impact of overdiagnosis on individual patients’ well-being, the focus of the conference lies on its impact on general healthcare, society and medical practice. Concepts, methods and tools are presented that aim to reduce overdiagnosis and identify opportunities to improve patient care and to use healthcare resources wisely.

This article addresses how recommendations concerning overuse were assembled into one guideline, which recommendations are most suitable for implementation and how these can be successfully transferred into clinical practice. First, the article describes the methodology and development of a guideline with the aim to counteract medical overuse and underuse by the German College of General Practitioners and Family Physicians (DEGAM). Second, we will share and discuss the results of a workshop at the PODC 2023. The workshop included defining criteria to select recommendations that are most preferable for implementation and to exchange experiences with successful and less successful implementation strategies for …

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  • TK and MS contributed equally.

  • Correction notice The authors of the paper have flagged an error in the analysis of the survey presented in the workshop for the question regarding physicians' preferences regarding "do not do" recommendations. The initial paper indicated that physicians disagreed with the need for more recommendations when, in fact, they very much did. This had implications for some of the conclusions following the conference workshop and the figure, which have been revised and corrected.

  • Contributors This paper based on a workshop organised and hosted by all authors. LW drafted the first version. It was then revised and edited by SH, TK and MS. All authors agreed and approved the final version of this paper.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.