There is widespread agreement that more is not always better in health care. Doing more can harm patients, generate excess costs, and defy patient preferences. All are major threats to the delivery of high-quality health care. Reflecting this notion, the Institute of Medicine (IOM) National Roundtable on Health Care Quality coined the term overuse in 1998,1 adapting the definition of an inappropriate service developed for the RAND Appropriateness Method in the 1980s.2 Overuse was defined as “a health care service [that] is provided under circumstances in which its potential for harm exceeds the possible benefit.”1(p1002)
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