Thursday, October 26, 2006

Unnecessary Medical Tests

Unnecessary Medical Tests" Americans probably spend more money on unnecessary tests and procedures than they do on quackery.
The big problem in combating this problem is
that the tests and procedures may be offered by
highly respected and well-meaning physicians. Some
doctors claim that a full battery of expensive tests is
needed to protect themselves against later charges
of malpractice if something is overlooked. While
there is some validity to this defense, there are other
reasons why testing is overdone. One is the demand
of the public—people who are bombarded with TV
and news items about the marvels of new technology.
But a doctor’s job is to resist doing a procedure if it
is not going to help the patient.

Questions You Should Ask.

Before undergoing a test or procedure, always ask
the following questions:
l What is the purpose of this test? Is it being
done to screen for a possible asymptomatic
disorder, such as high blood pressure, or is it
needed to confirm a suspected diagnosis?
l Is it definitive or will additional tests be
l What will it cost? Is there a less expensive
l How accurate is it?
l Does it cause discomfort?
l Are there possible complications or hazards?
Does it require anesthesia or hospitalization?
l How will the information be used? Will it, for
example, alter the recommended treatment?
l What is likely to happen if the test or procedure
isn’t done?
Much of the time the answer will be that the test is
being used to provide baseline data or to
confirm something picked up on a physical
examination. This may not be a sufficient
reason to justify the procedure. For example,
the presence of a few extra or skipped beats in
a patient without symptoms of coronary heart
disease is not an indication for a 24-hour Helter
monitor; even in patients with heart disease it
may not be indicated. The presence of a heart
murmur is not, by itself, an indication for an
echocardiogram. Everyone who has a heart
attack does not have to be catheterized. It is
very difficult for a layperson to make a judgment
about the necessity for a medical test, but by
being informed, one can perhaps avoid at least
some unnecessary inconvenience and expense."

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