Doctors love running medical tests, it seems—but sometimes, more is not better. Sometimes, more is actually worse.
Last year I read a report of a woman who went to her doctor with chest pain. The doctor thought it was probably a pulled muscle, but he ordered a CT scan of her arteries to reassure her. The results were ambiguous, so the next step was an angiogram, which involves snaking a catheter from a blood vessel in the groin or arm all the way to the heart. It tore the lining of an artery. Ultimately this woman, who probably just had a pulled muscle, ended up with a heart transplant and a lifetime of taking antirejection drugs—all because of an unnecessary test.
In our “more is better” society, it’s hard for us to believe that even common tests carry some dangers, and that every treatment involves risks along with benefits. But they do.
Last week, nine top doc groups spoke up to say not so fast. As part of a campaign called Choosing Wisely, the American College of Physicians, the American College of Radiology, the American College of Cardiology, and six other groups asked doctors and patients to think twice before prescribing or receiving 45 different tests and treatments that they say are frequently overused. Among them:
-Antibiotics for a straightforward case of sinusitis
- X-rays or other imaging tests for new low back pain when there aren’t any red flags (like signs of nerve involvement)
- Bone-density screening (the DEXA test) in women younger than 65 or men younger than 70 who have no risk factors for osteoporosis
- Annual EKGs (unless a patient has symptoms of heart disease or risk factors).
Sure, there are times when you need an X-ray for low back pain or antibiotics for a sinus problem, the groups said — but more often than not, these and the other tests and treatments they list are unnecessary and can cause more problems than they solve.
I spoke to Shannon Brownlee, author of Overtreated: Why Too Much Medicine is Making Us Sicker and Poorer, for her perspective.
“When I wrote Overtreated, very few patients thought this was a problem and a lot of doctors wanted to pretend it wasn’t happening,” said Brownlee. “The fact that nine specialty societies have now not only acknowledged the problem but are willing to list some of the unnecessary tests and procedures that are done routinely – well, that’s a giant leap forward.”
“If you get a test you don’t need, the test itself may not be harmful, but chances are good that it will turn up something else — a false positive, for example, that leads to more invasive, potentially dangerous testing, or even unnecessary treatment.”
Before you get any test or procedure, or even a new medication, it’s worth asking a few questions. Do I really need it? What are the risks? Can we try something less invasive, expensive, risky?
“A lot of truly good information can be gleaned from such an exchange,” says Sharecare expert David Katz, MD. “But actually it serves another purpose too. It slows down a doctor who may be harried and hurried, and forces her/him to deal with you as…a person, rather than a patient.”
You know the saying “Don’t just stand there, do something!”? Sometimes the opposite is true: Sometimes, the best thing to do is to stand there.
Do you think your doctor runs too many tests—or not enough? Let us know in the comments box below.
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