doctor-whitecoat

Don’t Just Do Something — Stand There!

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.

Join the largest health conversation in 140 characters or less! Tweet what you want to talk about to @SharecareNow and let’s start chatting!

File under: In the News

Contributor

Lisa Davis

Lisa Davis is a deputy editor at Sharecare. She's spent years covering health at a variety of national magazines and in the digital universe, developing an allegiance to scientific research and a respect for what people know about their own bodies. She’s written for newspapers and magazines across the country, and helped launch Hippocrates magazine and guide it as it became Health magazine. Later, she was Deputy Executive Editor at Prevention, and then Health Editor at Reader’s Digest. She tries to spend as much time as possible with her family and friends, figuring that happiness is a key to health and a lot more fun than taking vitamins.

View my Sharecare profile

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Comments

  1. Charyl Nichols

    I do believe the doctor’s can run to many test. For example in October I was having stomach pain (which I now believe was gas) but the doctor ordered an MRI the next thing I know they find a mass on my liver. Oh my gosh was I in shock.The doctor said I can tell you if the mass looks this way we can just cut offfthe mass but if it looks this way we will have to do a transplant. The pain and anguished my family, myself my husband felt.
    They then said I needed to go to a specialistt in another town. This specialist said oh you need a liverbiospy, oh my gosh it was the most painful experience I have ever went thru. First he could not find the mass under the normal procedures of the liver biopsy because he could find no mass, so they move me to do the liver biosy under a sonigram. Where instead of taking 2 to 3 samples they ended up taken 7 samples in which he struggled the entire time. They did not give me enough pain meds. When they recieved the results my husband and I went together, good or bad we could do this. The doctor said it was nothing. I asked…why did they do this.. he said so we could COB what (so we could cover our butts. Well it sure will make you think twice before having anything done.All because on doctor thought they seen something on the MRI

    April 17th, 2012, 4:12 pm
  2. Andrea

    I think they run far too many test and once your are in the system it’s a vicious cycle. My doctors does an annual EKG on me and get the same results but this year because I turned 50 she decides to send me to an Cardiologist. He starts running all these test, when he found nothing wrong. So he ran more test and found nothing wrong. So he tells me I will see you in 2 to 3 years. I have to ask myself Why?

    April 17th, 2012, 5:40 pm
  3. Emanuel

    What adds to the problem is that doctors feel they have to cover their backsides because of the threat of being sued. If they don’t do a test and then you end up sick (or worse), they get sued for negligence. Years ago i sat on a jury for just such a case.

    Tests may not be absolutely necessary, but you have to decide whether you are willing to take that risk with your health.

    April 18th, 2012, 10:41 am
  4. Brin Cavan

    I was pregnant at 36 with my third child when my OB said I needed amniocentesis. This procedure procures amniotic fluid for testing using a needle inserted through the placenta wall. I had read that this procedure can actually cause some problems, so I probed further to find out why it was necessary. My first two pregnancies had been normal with natural births. Current blood tests showed no suggestions of possible abnormalities. Finally, I learned that the only reason for the test was because I was over 35 years of age. I said that was not a good enough reason and I declined to have the test. The OB was not very happy with my decision. However, when he delivered my healthy baby boy – he had to digress!

    April 27th, 2012, 3:01 pm
  5. Adrienne Jarnagin

    Another bit of advice is do your homework when you get older and have multiple disorders. This internet is a blessing because there are people like Dr. Oz who WANT to help people and he is not selling stuff, he is exploring the most helpful ways to see that all people get the true values of health.
    Do you know how many e-mails that have the good news if you buy their product. For a lot of money. Find more truthful people who want to share their good news and not so hungry or greedy for their own benefit.
    As for these doctors whose patients who think they are some super human being, stop that nonsence. Don’t allow them to bully or scare you into anything until you go home and discuss with family.Thank you, Dr. OZ for your unselfish service! Adrienne J. TEX.

    September 19th, 2012, 12:01 pm
  6. Vivian lovlein

    The Dr.s through the years told me I need my gall bladder out.I finally told my Dr. to give me one last exam because I believe my stones were gone. He was so nice and said OK but this is the last test. When they were checking my gall bladder the nurse that was giving me the exam went to the right to take pictures of my left kidney. To make a long story short, I had and encarcerated cancer on my left kiddney, they operated right away, and took my left kidney out. The Dr. told me it was a miracle they found it like that I had no symptom. Thank God for my Dr. that let me have this last test. The Lord sure was looking after me. A year later I had my gall blader out. It has been 13 years since my operation.

    September 19th, 2012, 10:16 pm

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